2023 will be a critical year to learn the lessons from the COVID pandemic and determine if there is the political will to build resilient health systems.
With more than 15 million deaths from COVID to date and the growing impact of cardiovascular disease and cancer in low- and middle-income countries (LMICs), to adequately deliver a fit-for-purpose healthcare system It is clear that we need new funding mechanisms for — It cannot be made through Official Development Assistance (ODA) or charity.
The Financial Intermediary Fund for Pandemic Prevention, Preparedness and Response (PPR) was created earlier this year after major efforts by the Italian and Indonesian presidencies of the G20. At $1.5 billion, the fund is just a fraction of the estimated $10.5 billion needed each year to protect the world from the next pandemic.
Replenishment models have been disappointing for the major funds created in the last two decades to tackle specific diseases.
Moreover, as a result of the nationalism of vaccines, treatments and diagnostics (VTD) that became apparent during the COVID pandemic, many countries are making new decisions that challenge traditional donor-recipient international health structures. doing.
Some G20 and G7 countries are approaching PPR from an outdated ‘donor-beneficiary’ approach. urgent health crisis.
Japan’s G7 Presidency, India’s G20 Presidency and the United Nations all have Universal Health Coverage (UHC) firmly on their 2023 agenda.
Government leaders have politically recognized the importance of UHC, better PPR and measures to reverse climate change, but the level of national debt caused by the COVID crisis has left many It means that you have to make a choice. Trying to find a budget to address health and climate change threats.
In October, the International Monetary Fund (IMF) launched a new Resilience and Sustainability Trust aimed at helping low- and middle-income countries meet pressing health and climate challenges. This is a welcome initiative, but as it currently operates, this funding requires countries to meet standard IMF rules and conditions, and typically requires fiscal consolidation. This must be rectified urgently by IMF shareholders. Otherwise, many countries will not be able to exploit their potential.
As the donor model fails to meet the underlying challenges posed in building stronger health systems and resilient nationwide It should be a year that gives us the tools and financial space to grow year after year.
Some countries already have the financial resources to increase their healthcare costs. In such cases, the international community, including the multilateral development banks, can work with those governments to invest an additional 1-2% of GDP in health care systems that will bring significant economic and social benefits to their countries. You have to produce proof that you get it.
In India, an increase of 1% of GDP is invested in strengthening the health system, equivalent to about $30 billion annually.
It takes political courage to do this, but when leaders commit to increasing domestic investment in public health, it is a proven electoral winner. Based on the model already deployed in G20 countries, we want to develop indicators and toolkits that demonstrate the value of increasing investment in public health.
Of course, not all countries currently have the financial resources to increase investment in public health. Many of these countries are dedicated to managing the burden of servicing government debt. The coronavirus pandemic has exacerbated this debt crisis in many countries around the world.
On the one hand, the G20 and World Bank are pushing a new FIF for PPR, and on the other hand, the IMF is seeking its legitimacy, resulting in 85% of the world’s population stopping investment in critical public services. or reduced.
At the height of the 2020 pandemic, LMICs delivered approximately $110 billion in debt service, compared with only $23 billion in 2021-22 support from the ACT Accelerator.
If countries develop resilient plans for investment in PPR, international organizations can help them move away from their long-term dependence on traditional donor-recipient models. We must help develop a working domestic financial framework.
These countries need proactive support to modify their fiscal regimes to increase investment in health. If governments are committed to this roadmap, the IMF urgently needs to develop new models that will benefit this domestic investment strategy, not penalize it.
Some political leaders are already considering new ways to build the economy’s vital fiscal space. Barbados Prime Minister Mia Motley has created a “pandemic clause” in the country’s sovereign bonds. This would lead to the postponement of debt repayment, when the WHO officially declares a pandemic in the region.
The G20 and G7 must press the IMF to encourage and work with leaders developing responsible financial and public investment initiatives that should not adversely affect a country’s credit rating. The Global Fund or the more recent Belize Natural Debt Swap.
With 60% of low- and middle-income countries at risk of default and many emerging markets facing recession, IMF shareholders have asked the Managing Director to invest in health systems and climate change. We need to give clear mandate to create new models that reward governments that invest in efforts to
The COVID pandemic and the growing threat of antimicrobial resistance, cardiovascular disease and cancer demand more from the G7 and G20. Let us provide fragile countries and their leaders with the encouragement and tools to develop sustainable domestic solutions that represent a major step forward in providing universal health coverage and adequate pandemic preparedness.