Can Natural Resource Wealth Finance Health for All? Governance Conditioned Effects of Resource Rents on Government Health Spending in Africa Toward SDG 3, 12, and 16

ABSTRACT Contemporary studies have underscored the relevance of governance and institutional quality (GIQ) as pathways to achieving several of the SDGs, yet its role in the nexus between natural resource rents (NRR) and government healthcare expenditure (GHCE) especially in Africa appears sparse. The study thus examines the conditioning role of GIQ in the relationship between NRR and GHCE across 47 African countries (2000–2021). Employing the Method of Moments Quantile Regression and other econometric models, the direct effect results show that NRR exhibited both positive and negative effects, consistent with both the resource “blessing” and “curse” narrative, albeit at varying quantiles, a nuanced finding which could have been masked if a sole mean‐based approach is used. Furthermore, the moderation analysis extends the conditional resource “blessing” hypothesis by offering quantile‐level and governance‐specific moderation evidence. Rule of law and voice and accountability systematically mitigate and often reverse the negative effects of the rents across the entire quantiles of GHCE, with the strongest effects at the lower quantiles. On the other hand, the mitigating prowess of control of corruption and political stability appears only at the low‐to‐middle quantiles. Overall, the finding underscored the pivotal role of strong GIQ. The study proffers the prioritization of sequenced institutional reforms that focus on improving rule of law, accountability and anti‐corruption measures, and ensuring transparency in resource revenue management mechanisms such as complying with the Extractive Industries Transparency Initiative. These reforms can translate NRR into sustainable fiscal space for healthcare spending and simultaneously advancing SDGs 3, 12, and 16.