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CATALYST DIALOGUE ON HEALTH FINANCING
Insights from a debate on how to increase funding for health and spend existing funds more effectively.
Catalyst Dialogue participants:
Christoph Benn, Director for Global Health Diplomacy, Joep Lange Institute • Jayati Ghosh, Professor of Economics, Univer
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sity of Massachusetts at Amherst • Tom Hart, Research Fellow, ODI • Lesley-Anne Long, President & CEO, Global Business Coalition for Health • Riaz Tanoli, CEO, Social Health Protection Initiative, Health Department Khyber Pakhtunkhwa, Pakistan
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The 2020 Financing for Sustainable Development Report, the fifth report of the Inter-agency Task Force on Financing for Development, provides a comprehensive assessment of the state of sustainable finance. Prepared by more than 60 agencies of the United Nations system and partner international organ
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izations, the report brings together a wide range of expertise and perspectives. It puts forward a set of policy recommendations to mobilize financing flows, and align them with economic, social and environmental priorities. These recommendations should assist Member States and all other stakeholders as they work toward fully implementing the Addis Agenda and achieve the SDGs.
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The 2022 Financing for Sustainable Development Report identifies a “great finance divide” as a main driver of the divergent recovery. Developed countries were able to borrow record sums at ultra-low interest rates to support their people and economies, but the pandemic response and investment in
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recovery of poor countries was limited by fiscal constraints. This joint report, by over 60 agencies of the United Nations system and partner international organizations, provides analysis and puts forward policy recommendations to overcome this “finance divide” and enhance developing countries’ access to financing for recovery and productive and sustainable investment.
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Guidelines for the Implementation of the SHA 2011 Framework for Accounting Health Care Financing
Organisation for Economic Co-operation and Development (OECD) and World Health Organization (WHO)
Organisation for Economic Co-operation and Development (OECD) and World Health Organization (WHO)
(2014)
CC
The accounting framework for health care financing is a key component of A System of Health Accounts 2011, published by OECD, Eurostat and WHO in October 2011.1 The framework makes health accounts more adaptable to rapidly evolving health financing systems, further enhances crosscountry comparabilit
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y of health expenditures and financing data, and ultimately improves the information base for the analytical use of national health accounts (NHAs). It is hoped that SHA 2011 – including its financing framework – will make health accounts a more useful assessment and monitoring tool for health systems and health expenditure in the economy as a whole.
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Securing a minimum of financial resources permitting to bring the full range of critical health services to all people constitutes a fundamental human right and an indispensable condition for human dignity. The model outlined here demonstrates that it is within our reach to close the financing gap e
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ven for the poorest countries by 2020 if all governments, from the privileged and underprivileged parts of the world alike, just fulfil the commitments and recommendations for financing human development and health that already were agreed many years ago.
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The majority of developing countries will fail to achieve their targets for Universal Health Coverage (UHC)1 and the health- and poverty-related Sustainable Development Goals (SDGs) unless they take urgent steps to strengthen their health financing. Just over a decade out from the SDG deadline of 20
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30, 3.6 billion people do not receive the most essential health services they need, and 100 million are pushed into poverty from paying out-of-pocket for health services. The evidence is strong that progress towards UHC, core to SDG 3, will spur inclusive and sustainable economic growth, yet this will not happen unless countries achieve high-performance health financing, defined here as funding levels that are adequate and sustainable; pooling that is sufficient to spread the financial risks of ill-health; and spending that is efficient and equitable to assure desired levels of health service coverage, quality, and financial protection for all people— with resilience and sustainability.
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According to most recent data, the world economy grew by 3.1 per cent in 2022. To many, the rebound
suggested that a soft landing was possible in 2023, and that the key problems of the year 2022 – rising
prices, supply-chain disruptions and recession risks – have been addressed. As a result, t
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he very first
months of 2023 were viewed with optimism by decision-makers, as it appeared that the anti-inflationary
stance of the central banks had set a path to price stabilization without causing a major disruption to
growth.
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The importance of robust mortality surveillance systems cannot be overstated in an era marked by increasing global health challenges where health threats loom large and population dynamics continue to evolve. Accurate and timely mortality data is essential for identifying trends and detecting emergi
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ng health threats, evaluating the impact of interventions, and guiding evidence-based policy decisions.
This framework outlines a holistic approach to strengthening routine mortality surveillance systems, considering the unique contextual factors and challenges faced by African countries. It emphasizes the importance of establishing efficient data collection mechanisms, enhancing data quality and completeness, and promoting data sharing and collaboration among stakeholders.
Moreover, the framework recognizes the pivotal role of technology in the integration of data from fragmented mortality data sources. It highlights the potential of innovative data capture methods, advanced analytics, and real-time reporting systems to enhance mortality data’s accuracy, efficiency, and timeliness.
The continental framework for mortality surveillance aligns with Africa CDC’s mission and strategic goal by serving as a fundamental component in strengthening public health systems, enhancing disease surveillance capacities and capabilities, informing evidence-based policies and interventions, and promoting collaboration and coordination among African countries to address health challenges and improve health outcomes on the continent.
The successful implementation of this framework requires collective commitment and concerted efforts from governments, health institutions, and the international community. We hope this document will serve as a catalyst for transformative change, enabling countries to build resilient mortality surveillance systems that protect public health, save lives, and contribute to evidence-based decision-making.
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L'importance de systèmes de surveillance de la mortalité robustes ne peut être surestimée à une époque marquée par des défis sanitaires mondiaux croissants, où les menaces sanitaires pèsent lourd et la dynamique des populations continue d'évoluer. Des données précises et opportunes sur
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la mortalité sont essentielles pour identifier les tendances et détecter les menaces émergentes pour la santé, évaluer l'impact des interventions et orienter les décisions politiques fondées sur des données probantes.
Ce cadre décrit une approche holistique pour renforcer les systèmes de surveillance de routine de la mortalité, en tenant compte des facteurs contextuels uniques et des défis auxquels sont confrontés les pays africains. Il souligne l'importance d'établir des mécanismes de collecte de données efficaces, d'améliorer la qualité et l'exhaustivité des données et de promouvoir le partage des données et la collaboration entre les parties prenantes.
De plus, le cadre reconnaît le rôle central de la technologie dans l'intégration des données provenant de sources de données fragmentées sur la mortalité. Il met en évidence le potentiel des méthodes innovantes de capture de données, des analyses avancées et des systèmes de notification en temps réel pour améliorer la précision, l'efficacité et l'actualité des données sur la mortalité.
Le cadre continental de surveillance de la mortalité s'aligne sur la mission et l'objectif stratégique d'Africa CDC en servant d'élément fondamental dans le renforcement des systèmes de santé publique, l'amélioration des capacités et des capacités de surveillance des maladies, l'élaboration de politiques et d'interventions fondées sur des données probantes et la promotion de la collaboration et de la coordination entre les pays africains pour relever les défis sanitaires et améliorer les résultats sanitaires sur le continent.
La mise en œuvre réussie de ce cadre nécessite un engagement collectif et des efforts concertés de la part des gouvernements, des établissements de santé et de la communauté internationale. Nous espérons que ce document servira de catalyseur pour un changement transformateur, permettant aux pays de mettre en place des systèmes de surveillance de la mortalité résilients qui protègent la santé publique, sauvent des vies et contribuent à la prise de décision fondée sur des données probantes.
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The 2018 global health financing report presents health spending data for all WHO Member States between 2000 and 2016 based on the SHA 2011 methodology. It shows a transformation trajectory for the global spending on health, with increasing domestic public funding and declining external financing. T
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his report also presents, for the first time, spending on primary health care and specific diseases and looks closely at the relationship between spending and service coverage
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Past quantitative research on health financing has focused mostly on the level and distribution of total expenditure, with little emphasis on the specific role of public funds, despite their known importance for universal health coverage (UHC). Health Accounts data do not disaggregate public expendi
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ture on health by source of funding. Achieving a better understanding of public financing for health in the context of the macro-fiscal and health financing environment is of fundamental importance to the development of future health financing policy, particularly in low- and middle-income countries (LMICs).
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The Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) project has conducted a multi-year, multi-country study that provides stark insights on the under-reported depth of the antimicrobial resistance (AMR) crisis across Africa and lays out urgent policy recommendations to addr
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ess the emergency.
MAAP reviewed 819,584 AMR records from 2016-2019, from 205 laboratories across Burkina Faso, Cameroon, Eswatini, Gabon, Ghana, Kenya, Malawi, Nigeria, Senegal, Sierra Leone, Tanzania, Uganda, Zambia, and Zimbabwe. MAAP also reviewed data from 327 hospital and community pharmacies and 16 national-level AMC datasets.
more
The Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) project has conducted a multi-year, multi-country study that provides stark insights on the under-reported depth of the antimicrobial resistance (AMR) crisis across Africa and lays out urgent policy recommendations to addr
...
ess the emergency.
MAAP reviewed 819,584 AMR records from 2016-2019, from 205 laboratories across Burkina Faso, Cameroon, Eswatini, Gabon, Ghana, Kenya, Malawi, Nigeria, Senegal, Sierra Leone, Tanzania, Uganda, Zambia, and Zimbabwe. MAAP also reviewed data from 327 hospital and community pharmacies and 16 national-level AMC datasets.
more
The increasing amounts of official development assistance (ODA) for health have been aimed primarily at fighting HIV/AIDS, malaria and tuberculosis. Neglected tropical diseases (NTD), one of the most serious public health burdens among the most deprived communities, have only recently drawn the atte
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ntion of major donors. While frequently stated, the low share
of funding for NTD control projects has not been calculated empirically. Our analysis of ODA commitments for infectious disease control for the years 2003 to 2007 confirms that Development Assistance Committee (DAC)-countries and multilateral donors have largely ignored funding NTD control projects. On average, only 0.6% of total annual health ODA was dedicated
to the fight against NTDs while the average share of control projects for HIV/AIDS was 36.3%, for malaria 3.6%, and for tuberculosis 2.2%. This allocation of health ODA does not reflect the diseases’ respective health burdens.
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The urgency of now - Turning the tide against epidemic and pandemic infectious diseases
Coalition for Epidemic Preparedness Innovations (CEPI)
Coalition for Epidemic Preparedness Innovations (CEPI)
(2021)
CC
CEPI is seeking to raise $3.5 billion to implement CEPI’s next 5-year plan. To mitigate the immediate threat of COVID-19 variants, it is activating key elements of this plan now—and seeking to mobilise a portion of this $3.5 billion in 2021. We have already launched R&D programmes to initiate de
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velopment of next-generation vaccines against COVID-19 variants and we are planning studies to answer critical scientific questions related to the durability of immunity, effectiveness of mixed-vaccine regimens, and vaccine effectiveness in vulnerable populations such as pregnant women. We are also bringing forward our plans to develop vaccines that could protect against multiple COVID-19 variants and other coronavirus specie
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This results report for the biennium 2020–2021 presents the progress towards the triple billion targets, outcomes and outputs, based on the GPW 13 results framework and indicators. It uses structured methodologies, both quantitative and qualitative, for measuring and analysing the achievements and
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challenges to achieving them, and includes country and impact case studies to exemplify how the Organization’s work is driving health impacts at the country level, where it matters most. For the first time, the WHO Secretariat is reporting on its investments, results and performance through a scorecard methodology for every country or territory it serves.
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There has been no systematic comparison of how the policy response to past infectious disease outbreaks and epidemics was funded. This study aims to collate and analyse funding for the Ebola epidemic and Zika outbreak between 2014 and 2019 in order to understand the shortcomings in funding reporting
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and suggest improvements. Methods: Data were collected via a literature review and analysis of financial reporting databases, including both amounts donated and received. Funding information from three financial databases was analysed: Institute of Health Metrics and Evaluation’s Development Assistance for Health database, the Georgetown Infectious Disease Atlas and the United Nations Financial Tracking Service. A systematic literature search strategy was devised and applied to seven databases: MEDLINE, EMBASE, HMIC, Global Health, Scopus, Web of Science and EconLit. Funding information was extracted from articles meeting the eligibility criteria and measures were taken to avoid double counting. Funding was collated, then amounts and purposes were compared within, and between, data sources.
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ACT-A - Urgent Priorities & Financing Requirements at 10 November 2020
World Health Organization (WHO), The Global Fund, Gavi et al.
World Health Organization (WHO)
(2020)
CC
Six months after its launch on 24 April, the Access to COVID-19 Tools (ACT) Accelerator has already delivered concrete results in speeding up the development of new therapeutics, diagnostics, and vaccines. Now mid-way through the scale-up phase, the tools we need to fundamentally change the course o
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f this pandemic are within reach. But to deliver the full impact of the ACT-Accelerator – and ultimately an exit to this global crisis – these tools need to be available everywhere. On behalf of the ACT-Accelerator Pillar lead agencies – CEPI, Gavi, the Global Fund, FIND, Unitaid, Wellcome Trust, the World Bank, and the World Health Organization, as well as the Bill & Melinda Gates Foundation – I am pleased to share this document setting out the near-term priorities, deliverables and financing requirements of the ACT-Accelerator Pillars and Health Systems Connector. Urgent action to address these financing requirements will boost the impact of the ACTAccelerator achievements to date, fast-track the development and deployment of additional game-changing tools, and mitigate the risk of a widening gap in access to COVID-19 tools between low- and high-income countries. Delivering on this promise requires strong political leadership, financial investment, and incountry capacity building. COVID-19 cannot be beaten by any one country acting alone. We must ACT now, and ACT together to end the COVID-19 crisis.
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The development of this draft Proposed programme budget 2022–2023 comes at a unique moment for WHO. The world is in the grip of the coronavirus disease (COVID-19) pandemic and faces health, social and economic consequences on an unprecedented scale. Although it is not known when the COVID-19 pande
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mic will end, recent encouraging vaccine results, in addition to the examples of countries that have achieved good results through public health measures, hold out the prospect of better days ahead. The full impact of the pandemic cannot yet be determined. But whatever its implications, the Secretariat will rise to the challenge and is ready to adapt so that it is fully equipped to support Member States for any eventuality in the future – to make sure that the world will never again have to face this kind of crisis.
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The biennium 2020–2021 has revealed more clearly than ever the need for a strong, credible and independent WHO on the world stage. The coronavirus disease (COVID-19) crisis has demonstrated the fundamental importance of the global detection, response and coordination roles that only WHO can play a
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cross all Member States. At the same time, the challenges to global health systems and the pressure to ensure equal access to quality health care and the best health possible for all have mounted. The triple billion targets of the Thirteenth General Programme of Work, 2019–2023 remain relevant. The work of WHO in all contexts has never been more critical. However, as several Member States have pointed out, the COVID-19 pandemic has highlighted the discrepancy between what the world expects of WHO and what it is able to deliver with the resources/capacity it has at its disposal. Sustainable financing is thus a key challenge for the Organization that must be addressed as part of the lessons learned from the current COVID-19 pandemic. Member States discussed this issue in detail during the Seventy-third World Health Assembly and their conclusions were reflected in resolution WHA73.1 (2020). The topic of adequate funding is not new. However, discussions on the matter have, to date, remained rather abstract. Building on previous discussions and taking account of lessons learned, the WHO Secretariat would like to initiate a process aimed at finding a concrete solution to the sustainable financing of WHO. This document proposes a process through which to arrive at such a decision, including the key stages and timeline.
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