The COVID-19 pandemic demonstrated that
the world was not well prepared to respond
to an infectious disease threat of this magnitude. Countries across all socioeconomic and development categories have struggled
to implement effective national responses. Substantial amounts of additional investmen...t are required to support the development of country capacities to prevent, detect and respond to both existing and emerging
infectious disease threats. Prior research efforts have estimated that between US$96 and $204billion is required, globally, to
advance country-level health security capacities, with US$63–131billion needed over a 3-year period. Given the substantial costs
of ongoing COVID-19 response, estimated to
be over US$12.5trillion through 2024, and an estimated 12.1–22.7million excess deaths, globally, due to COVID-19 as of January 2022,
the importance and potential return on investment of such upfront investments in capacity building are more evident than ever before.
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Over the past decade, countries in the African region experienced slow progress in mobilizing resources for health while facing continued challenges. In their revised estimates published in 2017, Stenberg et al., developed two costs scenarios, termed progress and ambitious, aimed at strengthening co...mprehensive health service delivery to achieve SDG 3 and universal health coverage in low-income and middle-income countries (Stenberg et al., 2017). Out of the 47 countries in the WHO African region only eight, on average, met the recommended threshold of spending a minimum of US$ 249 per capita on health during the period from 2012 to 2020. In 2020, this achievement was observed in only five countries while the remaining countries spent less than US$ 249 per capita, with health expenditures ranging from US$ 16.4 to US$ 236.6, highlighting significant disparities across the region.
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One approach to development assistance for health, or health aid, emphasizes the ex ante selection of cost-effective health interventions, an approach that began with the World Development Report (1993) on Investing in Health and has since been adopted by the Effective Altruism community. But just h...ow much of health aid is cost-effective? In this paper, we examine projects in the Organisation for Economic Co-operation and Development (OECD) Creditor Reporting System, the standard dataset that measures and characterizes development assistance for health, for the
years 2019 to 2021, and count the number of projects that refer to interventions from a list of highly cost-effective interventions as defined by the Disease Control Priorities Project, third edition. This exploratory quantitative analysis indicates that 61% of projects used a key word/phrase of a costeffective intervention. There were 11.9 interventions mapped per project on average. There is little evidence that donors tailor the set of interventions to country income levels by cost-effectiveness.
Policymakers may benefit from reviewing the full portfolio of interventions covered by domestic and external resources.
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The relative priority received by issues
in global health agendas is subjected to impressionistic
claims in the absence of objective methods of assessment
of priority. To build an approach for conducting structured
assessments of comparative priority health issues receive,
we expand the public ...arenas model (2021) and offer a
framework for future assessments of health issue priority
in global and national health agendas.
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IHME’s Financing Global Health report provides an overview of health spending around the world, with a special focus on investments in health in low- and middle-income countries. The report examines how this funding for health is changing each year and forecasts how it may change in the future. Fi...nancing Global Health examines where money for health originates and what health issues it funds.
This year, Financing Global Health 2023 looks at how interest payments on loans that many countries took out during the COVID-19 pandemic to keep their economies afloat and their people protected are now straining health budgets. It also details how development partners’ investments in health in low- and middle-income countries – development assistance for health – have changed since reaching historic levels during the COVID-19 pandemic, dropping by $19.4 billion between 2021 and 2023, from $84.0 billion to $64.6 billion.
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In the last three decades, health financialization has surged in
several creative ways, yet this growing phenomenon remains surprisingly
unknown, and neglected, in the global health arena. Financialization in the
health domain could be described as the uncontrolled expansion of finance along vari...ous lines of healthcare provision. Health has been intentionally transformed into a commodity as private for-profit actors have been allowed freedom to operate - and ultimately play with people’s fundamental right to health - for their vested financial interests, nationally and internationally. Health financialization is thrivingly pursued today for example through the institutionalization of medical knowledge monopolies, the expansion of markets and of financial techniques applied to healthcare insurance schemes, the soaring digitalization of global health interventions and the booming data industry.
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The key tools and governance approaches for
international cooperation for sustainable development
(hereafter, international cooperation) were set up in a
markedly different time and age. International
cooperation – with official development assistance
(ODA) as the dominant means of implementa...tion –
remains key, despite being generally considered as no
longer adequate for addressing today’s common and
collective challenges.
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Development finance is at a turning point, as the macroeconomic environment has changed profoundly and the financing gap for low- and middle-income countries has widened. The events that led to this new situation are the multiple crises that the global economy is facing, such as the climate crisis, ...the COVID-19 crisis and the war in Ukraine. As a
result, interest rates have risen sharply over the past year and are not expected to decline anytime soon. High interest rates further restrict low- and middle-income countries’ access to international financial markets by making borrowing more expensive. At the same time, debt
levels in several countries are rising to levels that are almost impossible to repay. Poorer countries find themselves in a trap where financing the Sustainable Development Goals (SDGs) becomes a distant goal for them.
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En su condición de departamento técnico de la OMS para el paludismo, al Programa Mundial sobre Malaria le corresponde una importante función de liderazgo de la respuesta mundial. Por medio de sus acciones directas y su red, tiene la capacidad de conformar el ecosistema de la respuesta al paludism...o y lograr un impacto a nivel de los países. Teniendo esto en cuenta, el Programa Mundial sobre Malaria ha elaborado una estrategia operativa en la que se exponen sus prioridades para el periodo 2024-2030 y las cuatro palancas estratégicas para controlar y eliminar el paludismo que son parte esencial del mandato del Programa: normas y criterios, nuevos instrumentos e innovación, información estratégica para generar impacto, y liderazgo. La estrategia describe el modo en que el Programa Mundial sobre Malaria se transformará también por medio de una colaboración más eficaz con otros programas, con las oficinas regionales y en los países, y con los asociados, tomando como guía las enseñanzas extraídas del Decimotercer Programa General de Trabajo (13.º PGT) de la OMS y las prioridades del 14.º PGT.
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The Council was established in late 2020 by Dr Tedros Adhanom
Ghebreyesus (Director-General, WHO) to provide new economic thinking – reassessing how health and wellbeing are valued, produced and distributed across the economy. An all-female group of 10 distinguished economists and area experts, t...he Council has focused on reimagining how to put Health for All at the heart of government decision-making and private sector collaboration at regional, national and international levels.
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This comprehensive HPFM report thoroughly explores Kenya’s health financing landscape. It provides an in-depth analysis of the current state of affairs and sheds light on required strategic changes in health financing. The report points out the need to improve public financial management within th...e health sector, for more efficient financial systems. It focuses on better resourceraising and utilization mechanisms. The matrix highlights the need for consolidation of fragmented health financing arrangements, for a more efficient health system. It also emphasizes the need for enhancing strategic purchasing of health services, to improve the overall efficiency and quality of care. Additionally, the report stresses the critical
role of leveraging data and information systems for more evidence-based informed decision-making. These recommendations are crucial for advancing Kenya’s health financing system and moving closer to the UHC goal.
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There is growing pressure on PEPFAR, the U.S. global HIV program, to increase its planning for sustainability, including through domestic resource mobilization and, ultimately, transitioning financing at
least in part to recipient countries. While this is connected to a broader push in global healt...h and development, driven by a constrained financing environment and desire to promote more countryownership of programs and services, there are specific questions facing PEPFAR’s future. A National Academy report from 2017, for example, recommended that PEPFAR look toward phasing down its spending and supporting countries in their transition from bilateral aid to domestic financing for HIV. At a
Senate hearing last year, PEPFAR was asked how it was working to increase domestic resources and under what conditions would it need less resources to accomplish its goals. Recent challenges in securing a five-year reauthorization of the program have only served to heighten the focus on
sustainability and domestic resource mobilization. How PEPFAR does this, however, remains an ongoing question.
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This paper examines the implications of the IMF’s April 2024 macro-fiscal forecast updates on government health expenditure (GHE) across 170 economies through 2029, covering nearly all years remaining to achieve the Sustainable Development Goals (SDGs). The findings reveal wide disparities in gove...rnments' capacities to increase health spending, with differences not only observed across income groups but also within them. Primary concerns focus to two groups of low- and lower middleincome
countries: the first group is projected to experience a contraction in real per capita GHE from 2019 and 2029, threatening to reverse progress toward the health SDG targets, while the other group faces stagnation in real per capita GHE, greatly limiting advancement. The insights presented are crucial for health policymakers and their external partners to respond to evolving macro-fiscal circumstances and stabilize investment growth in health. While increasing the priority of health in spending is a key policy option, it will not be sufficient on its own. Effective responses also
require improving spending efficiency and addressing broader fiscal challenges. Without decisive action, many countries have little chance of achieving the health SDGs.
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There has never been a more critical moment to invest in WHO, and strengthen the unique role it plays in global health. Now is the time to sustainably finance WHO and invest in a healthy return for all.
This Guide is part of WHO’s overall programme of work on Political Economy of Health Financing Reform: Analysis and Strategy to Support UHC. The impetus for this work came from demands for more concrete evidence, recognition and integration of political economy issues within
health financing, and... overall system, reform design and implementation processes. This Guide is complementary to WHO’s Health Financing Progress Matrix assessment, as well as Health Financing Strategy development guidance. In this way, it promotes an embedded political
economy analysis approach that can be used in conjunction with other health financing assessments and guidance. The political economy framework can also be extended and easily adapted to broader health policy reforms.
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Frequent efforts to revise the official development assistance (ODA) accounting rules have raised important questions about the integrity and relevance of what currently “counts” as ODA spending. In this note, we outline a brief history of the evolution of the ODA accounting rules to date, highl...ighting how—and why—the ODA concept has changed since it emerged in 1969. Doing so provides a starting point for considering whether the current concept of ODA remains “fit for purpose” and whether, or how, the concept could reform to better meet current needs.
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All malaria-endemic countries in the Region of the Americas have taken on the challenge to eliminate the disease and to put in place measures to orient their health programs and strategies in that direction. This manual explains how to implement measures to achieve malaria elimination and prevent it...s reestablishment by increasing the intensity and quality of interventions, reorienting initiatives, reducing delays that favor transmission, and ensuring adequate monitoring to adjust interventions. In this regard, the first suggested step is to stratify the territory - so that interventions and population groups can be planned and prioritized - and then implement diagnosis, treatment, investigation and response (DTI-R) actions as a key strategy aimed at effectively eliminating the disease and preventing its reestablishment in all strata. In addition, the document seeks to operationalize the concept of "surveillance as an intervention" promoted by the World Health Organization through the Global Technical Strategy for Malaria 2016-2030 and highlights the importance of communities having access to early diagnosis and treatment. Finally, the manual also includes management and monitoring aspects that must be taken into account to eliminate the foci with transmission.
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Le Plan d’action pour l’élimination du paludisme 2021-2025 a été élaboré en consultation avec les pays et les partenaires régionaux comme cadre de référence pour orienter les efforts nationaux et les contributions des donateurs et partenaires dans le but d’éliminer la maladie dans la ...Région des Amériques. Le plan souscrit aux objectifs et aux piliers de la Stratégie technique mondiale de lutte contre le paludisme 2016-2030 adoptée par l’OMS, et présente également des éléments clés pour relever les défis spécifiques à la Région.
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All malaria-endemic countries in the Region of the Americas have taken on the challenge of eliminating malaria and have focused their health programs and strategies on that goal. The risk of emergence of artemisinin resistance in the Americas, the characteristics of P. falciparum parasite, and the e...pidemiological evidence of subnational territories experiencing reintroduction of P. falciparum urge for a call to push for P. falciparum elimination as an intermediate goal of the elimination of all malaria human species. Derived from the elimination of P. falciparum, other important results are expected, such as the empowerment of different actors and entities for the elimination of malaria inspired by the achievements of the elimination of P. falciparum, using early victories as a catalyst. This technical note provides guidance on actions to accelerate P. falciparum elimination in areas close to achieving this goal without compromising unified malaria elimination efforts (P. vivax - P. falciparum), while contributing to the country's ultimate goal of eliminating malaria overall. The acceleration of P. falciparum elimination has several goals: mitigating the risk that resistance to artemisinin and associated drugs will emerge and spread; accelerating the reduction in the total number of malaria cases in areas with a significant proportion of P. falciparum; accelerating malaria elimination (both P. vivax and P. falciparum), considering that P. falciparum is one of the triggers of P. vivax relapses; developing capacities in interventions to accelerate malaria elimination by building on the experience of P. falciparum elimination; and empowering different actors, including high-level authorities, donors, municipalities, and other entities involved in malaria elimination, by inspiring them with the achievements of P. falciparum elimination.
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Le plan stratégique de la RBM Partnership to End Malaria pour 2021-2025 présente les priorités stratégiques du partenariat mondial visant à éliminer le paludisme. Le document se concentre sur trois objectifs stratégiques principaux : optimiser les programmes régionaux et nationaux, maximiser... le financement et faciliter le déploiement de nouveaux produits et stratégies. Le plan met l'accent sur la collaboration multisectorielle, en exploitant les partenariats au niveau mondial, régional et national pour lutter efficacement contre le paludisme. Il souligne également l'importance du partage de données, du plaidoyer et de la communication pour garantir que le paludisme reste une priorité en matière de santé. Le document met aussi en lumière les défis posés par la pandémie de COVID-19 et la nécessité de maintenir l'élan dans la lutte contre le paludisme.
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