OBJECTIVES: This multi-country study in the South-East Asia Region reviewed trends of expenditure on health promotion, innovative financing experiences, and views of policy stakeholders on innovative financing for health promotion. METHODS: Literature review on burden of disease (BOD), health care financing in general, and financing health promotion in particular, in five selected countries (India, Indonesia, Nepal, Sri Lanka, and Thailand).  Self-administered questionnaire surveys on policy maker's and key stakeholders’ views on health care financing, and innovative financing for health promotion were carried out. RESULTS: The profile of BOD indicates advanced stage of epidemiological transition in Sri Lanka, Thailand, and Indonesia towards non-communicable disease (NCD) burden, whereas Nepal and India are facing dual burdens from infectious disease and NCD.  Limited data of the National Health Accounts (NHS) indicate a very small amount of health resources was spent on health promotion, mostly on conventional clinical-based preventive health services, rather than social mobilization and reduction of primary risk factors, notably tobacco and alcohol consumption, and fatty diets. Only Nepal and Thailand have innovative financing from an earmarked sin tax. Results from the questionnaire surveys indicate serious under-funding for health and especially health promotion.  In view of the current burden from chronic NCD, governments should spend more than double or triple of the current spending level on health promotion. A consensus view emerged in favour of the potential role of earmarked tax from alcohol and tobacco, as the most desirable and most feasible sources of finance. CONCLUSIONS: Current levels and effectiveness of spending on health promotion in these countries are far from amounts realistically needed to halt the trend of chronic NCD. It is recommended to increase value for money of the current health promotion program by addressing primary reduction of risk factors, and to mobilize more resources from tobacco and alcohol earmarked tax.