Financing Common Goods for Health: Fundamental for Health, the Foundation for UHC

Abstract

World Health Organization (WHO), presents a comprehensive argument that "common goods for health" are a priority for action on the road to Universal Health Coverage (UHC). Its publication is juxtaposed with the September 2019 United Nations General Assembly High Level Meeting on UHC, an event that represents the global community's commitment to UHC. This special issue proposes a key approach to moving the UHC agenda forward: financing the common goods that form the foundation of health globally. The world faces formidable, often paradoxical, challengespopulation growth and aging, increasing wealth and widening inequities, undernutrition among some and obesity among others, and environmental and pandemic threats that seem to emerge in the wake of fast-paced development. 1 In this, the Anthropocene era, the global human community is reaching the limits of our planet's capacities, creating a need for all people to become aware, actively engage, and come together to collectively demand action and change from our leaders. 2 Hundreds of millions, maybe even billions, of our lives are at stake. In recent decades, overall health outcomes have been improving and spending on health has increased substantially. However, blind spots persist, and these pose substantial risks to human health and economic well-being; indeed, they have the potential to undo recent progress. 3 These blind spots include: systems unable to effectively respond to pandemics such as influenza and outbreaks of communicable diseases like Ebola and Zika; health system structures unfit to cope with the rapidly increasing prevalence of non-communicable diseases (NCDs) like type 2 diabetes; threats posed by the emergence of drugresistant tuberculosis and other evolving diseases; and the complex health impacts of large population movements, environmental degradation and climate change. Two features are common to all these challenges-they have an enormous impact on human health and welfare, and combating them effectively requires governments to

Global Common Goods for Health: Towards a New Framework for Global Financing

“…Facing the global threat of COVID-19, the global community does not have the well-tested health system structures and fiscal instruments of a modern nation state and so finds it difficult to respond as one. Despite the evident need, it remains unclear how people around the world, with all their diversity of experience and perspectives, can come together to support a global mechanism to address the global common goods for health (Soucat, 2019), those essential public health functions that underpin effective prevention and constitute a comprehensive response to health threats, whether environmental, epidemic, or behavioral (Swinburn et al, 2019).…”

A Framework for Improving Policy Priorities in Managing COVID-19 Challenges in Developing Countries

“…Another way to improve policy coherence is to manage externalities. A positive (beneficial) or negative (harmful) externality is the consequence of an industrial or commercial activity which affects other parties without this being reflected in market prices ( 10 , 37 ). For example, when bees kept for honey pollinate surrounding crops there is a positive externality for the owner of the crops.…”

“…Another result of private decision makers not being required to consider the broader social consequences of their decisions is that social goods tend to be under produced and private goods over produced ( 19 , 37 ). The divergence of private and social interests often leads to sub-optimal production of social goods such as public health, public transport, clean air, clean water, education, research, and innovation, which generate positive externalities for society.…”

“…However, it is difficult for governments to deliver the required social goods alone, and private sector participation is important for filling the gap between public need and financial capacity. Appropriate incentive mechanisms can be developed to encourage private investment in social goods, including improvements in the healthcare system ( 37 , 40 ). Choices that internalize such external costs should be considered carefully and prioritized.…”

Health system governance: welcoming the reboot

“…Conceptual and empirical efforts dedicated to identifying dimensions of interest (transparency, accountability, etc) and supportive institutional mechanisms remain very valuable. 26 27 In the end, governments formally take on much of the responsibility for governance; reminding them their duties towards their citizens, especially for 'common goods for health', 28 should remain a central task of multilateral agencies. Our point is that this must be embedded in a broader perspective.…”