The recent, devastating Ebola crisis reminded the world of a hard truth: Pandemics are not just a threat to human health, they are a threat to societies and economies. That there will be another pandemic is not a question of “if,” but a question of “when.” A catastrophe on the scale of the 1918 flu epidemic could conceivably wipe out all development gains of the last century. We recognize this, but, still we are unprepared.
Nigeria has reason to celebrate. The country recently marked one year with no polio cases, bringing the world one step closer to eradicating a terrible disease that now circulates in only two remaining countries. To commemorate the global health milestone, Nigeria’s President Buhari gave his own three-month-old granddaughter a few drops of oral polio vaccine – a moment captured by a photographer and sent round the world via social media. It also sent a clear public health message: vaccination works.
I consider myself a pretty lucky person. I often work across the beautiful islands of the Caribbean, with their glistening turquoise seas, the lush greenery, fresh tropical fruit… I could go on, but I think you get the idea. Paradise is not always perfect, however: Beneath the postcard views is an often not-so-perfect public health system.
A recent “close encounter” in the Caribbean served as a stark reminder of this truth. Different from the movie “Close Encounters of the Third Kind”, it didn’t involve little green men nor giant floating spaceships, but something just as unknown, at least to me: chikungunya, a viral disease transmitted by the bite of infected mosquitoes.
Unfortunately, I was infected with chikungunya a little over a year ago during a work trip to the Eastern Caribbean in support a results-based financing project for the health sector. Our team was de-briefing near the ocean when it happened: I felt a quick sting from a mosquito bite, but didn’t think much of it. I felt unusually tired that evening, and by the next morning a number of other symptoms appeared – it was indeed chikungunya.
Exactly one year ago, I received an unexpected call from my manager just as I was finishing a week of paternity leave following the birth of my daughter. She asked me to lead an “absolutely urgent” project and said she was cutting her summer break short to return to the office. That project was on Ebola response. We had monitored Ebola cases in Guinea, Liberia and Sierra Leone over the previous months with growing concern, but now the World Bank was mobilizing its first emergency funding commitment to help the three affected countries contain the disease’s spread and help communities cope with the economic fallout.
On July 24th Nigeria celebrated a huge milestone in the global effort to eradicate polio. It has been one year since the country has had a case of wild polio. This means that it has interrupted transmission of the crippling disease.
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?