Somehow, everyone in the universal health coverage (UHC) universe seems to assume that the future of health financing will be built on centralized financing institutions fed by a mix of general tax revenue, payroll taxes and other contributions. This large pot of money, so the assumption goes, is administered by bureaucrats sitting in big buildings in national or provincial capitals. They contract with providers and pay them through capitation, diagnosis-related groups, fee for service, and reimburse retailers (pharmacists) for medicines that the patient takes home.
This week at the Third International Financing for Development Conference in Addis Ababa, we’ve seen the birth of a new era in global health financing.
The World Bank Group, together with our partners in the United Nations, Canada, Norway, and the United States, just launched the Global Financing Facility in support of Every Woman Every Child. It’s hard to believe it’s been less than 10 months since the GFF was first announced at the 2014 UN General Assembly by World Bank Group President Jim Yong Kim, UN Secretary-General Ban Ki-moon, Prime Minister Stephen Harper of Canada and Prime Minister Erna Solberg of Norway. We’re grateful to the hundreds of representatives from developing countries, UN agencies, bilateral and multilateral development partners, civil society and the private sector who have contributed their time, ideas, and expertise to inform and shape the design of the GFF to get it ready to become operational.
This week in Addis Ababa, Ethiopia, during the Third International Financing for Development Conference, the United Nations, along with the World Bank Group, and the governments of Canada, Norway and the United States, joined country and global health leaders to launch the Global Financing Facility (GFF) in support of Every Woman Every Child. Partners announced that $12 billion in domestic and international, private and public funding had already been aligned to country-led five-year investment plans for women’s, children’s and adolescents’ health in the four GFF front-runner countries: Democratic Republic of the Congo, Ethiopia, Kenya and Tanzania.
Forty-five years ago, the World Bank began a major shift in its approach to development. Prior to the 1970s, the Bank’s overwhelming focus was on infrastructure projects, consistent with our origins as an agency focused on post World War II reconstruction. The later shift came with recognition that sustained economic development had a lot to do with human development, not just physical development, which led to our first projects on population. In the early years, these focused on the Caribbean, North Africa and South and East Asia, and were underpinned by recognition that population dynamics have direct impact on poverty, health, human capital and economic growth.
Let’s be clear. Tobacco use, and its negative health, social and economic impact, is not a global problem that is simply going away.
As documented in a recent study, despite significant reductions in the estimated prevalence of daily smoking observed at the global level for both men and women since 1980, the actual number of smokers has increased significantly over the last three decades as the result of population growth. In 2012, it is estimated that close to one billion people were smokers, up from 721 million in 1980.
Clearly, tobacco use is a global epidemic. If we do not want to be passive spectators to the unhindered growth of this threat to global health, then political will at the highest levels of government needs to be galvanized, coupled with sustained support from civil society and international organizations. This is required not only to shine light upon this deadly but entirely preventable threat, but more importantly, to promote effective and sustained action to deal with it.
A new World Health Organization (WHO) report on tobacco taxation, launched today in Manila, raises a troubling question for policymakers across the world: If, as shown by scientific evidence, tobacco is a leading global disease risk factor, why then are so few governments levying appropriate levels of tax on cigarettes and other tobacco products?
Maya is waiting for the physician to call her name. Her three children play in the waiting room, making happy noises, but she is worried about her health. The physician confirms her worst fears: it turns out that she has cervical cancer. Now what? A social worker tries to comfort her, saying that the medical staff will do their best to get her treated soon so that she can keep on working to sustain her family.
Anybody who has been through the California school system, like me, will immediately recognize the phrase, “Stop, Duck, and Cover” to mean one thing – EARTHQUAKE! On a lucky day, it would be a drill, but we’d often get the real deal. Not that we didn’t learn other things in school, but preparing for natural disasters, in our case earthquakes, was an integral part of our education in California. As soon as I would hear this phrase, I knew to stop what I was doing, duck down under my school desk, and clasp my hands together and cover the back of my neck to protect it from falling debris.
Let me begin with a disclaimer. I attended Jesuit schools as a boy and adolescent. Belief in the sanctity of human life and the principles of social justice, which were at the core of the teaching imparted there, shaped me. The vision and language spoken by Pope Francis, himself a Jesuit, with an emphasis on the “preferential option for the poor and vulnerable”, profoundly resonate with me.
Last Friday, I had the privilege of attending the launch of a new global report that provides the clearest picture to date of countries’ progress moving toward universal health coverage (UHC). UHC is critical for building resilient health systems, which protect communities and strengthen societies in times of crisis and calm alike.
As we know from many health financing studies, drug expenditure typically ranks first or second among out-of-pocket expenses. In fact, it is often the cause of catastrophic expenditure, driving people from lower middle class into poverty once a severe or chronic disease affects a family member.