BACKGROUND:
Health systems in resource-limited settings (RLS) continue to face chronic financing challenges driven by high disease burdens, limited fiscal space, and sustained dependence on external assistance. Although development aid has expanded access to essential health services, its volatility and fragmentation increasingly threaten long-term system sustainability. Health diplomacy has emerged as a potentially transformative, yet underutilized, mechanism for strengthening health financing and reducing aid dependence in RLS.

METHODS:
This study adopts a narrative review approach, synthesizing evidence from recent global health policy literature and documented experiences from low- and middle-income countries. Peer-reviewed articles, policy reports, and multilateral agency publications were examined to assess how health diplomacy operates across domestic, regional, and international domains to mobilize resources, align financing priorities, and support governance reforms in health systems.

RESULTS:
The review finds that strategic health diplomacy contributes to improved health financing outcomes by facilitating domestic resource mobilization, fostering multisectoral budget commitments, enhancing donor coordination, and strengthening regional cooperation. Diplomatic engagement supports the alignment of external funding with national priorities and promotes governance mechanisms that improve efficiency and accountability in health spending. However, the effectiveness of health diplomacy is constrained by power asymmetries between donors and recipient countries, limited institutional capacity, and the absence of specialized diplomatic expertise within health ministries.

CONCLUSIONS:
Health diplomacy should be repositioned as a core component of health governance rather than a peripheral funding tool. Strengthening diplomatic capacity within health systems is essential for building political consensus, institutional credibility, and cross-sector coordination necessary for sustainable health financing. As development assistance plateaus and global health challenges grow increasingly transnational, health diplomacy will be critical to advancing universal health coverage and long-term system resilience in resource-limited settings.