Pacific countries have emerged as among the most at-risk globally from the economic damage resulting from the COVID-19 pandemic, despite being largely spared its direct health effects so far. Projections indicate that all Pacific countries will experience an economic contraction, worse than most countries on average. Given that more than 80% of financing for health in the Pacific comes from domestic and external public sources, the net impact of the economic contraction on health will depend on whether overall public spending can offset the decline in economic activity and how health will be prioritised in government budgets.