Financing Common Goods for Health: A Country Agenda

West Africa's Ebola epidemic of 2014-2016 exposed, among other problems, the under-funding of transnational global health activities known as global common goods for health (CGH), global functions such as pandemic preparedness and research and development (R&D) for neglected diseases. To mobilize sustainable funding for global CGH, it is critical first to understand existing financing flowing to different types of global CGH. In this study, we estimate trends in international spending for global CGH in 2013, 2015, and 2017, encompassing the era before and after the Ebola epidemic. We use a measure of international funding that combines official development assistance (ODA) for health with additional international spending on R&D for diseases of poverty, a measure called ODA+. We classify ODA+ into funding for three global functions-provision of global public goods, management of cross-border externalities, and fostering of global health leadership and stewardship-and country-specific aid. International funding for global functions increased between 2013 and 2015 by $1.4 billion to a total of $7.3 billion in 2015. It then declined to $7.0 billion in 2017, accounting for 24% of all ODA+ in 2017. These findings provide empirical evidence of the reactive nature of international funders for global CGH. While international funders increased funding for global functions in response to the Ebola outbreak, they failed to sustain that funding. To meet future global health challenges proactively, international funders should allocate more funding for global functions.

Section: Discussionmentioning

confidence: 99%

International Funding for Global Common Goods for Health: An Analysis Using the Creditor Reporting System and G-FINDER Databases

Schäferhoff¹,

Chodavadia

Martínez³

et al. 2019

“…The following article, "Financing Common Goods for Health: A Country Agenda" by Sparkes, Kutzin, and Earle, provides an evidence-based argument about how government and donor financing can be reorganized to enable the more efficient delivery of CGH. 42 Specific countries' experiences are cited, and issues related to fragmentation of financingwithin the health sector, across sectors, and across levels of government-clearly emerge as key constraints. In order to effectively address fragmentation issues, the article considers policy responses, including realigning budgets and adapting organizational structures.…”

Section: Finding Our Way Back To Basicsmentioning

confidence: 99%

When Both Markets and Governments Fail Health

Yazbeck

Soucat

2019

This paper presents the rationale and motivation for countries and the global development community to tackle a critical set of functions in the health sector that appear to be under-prioritized and underfunded. The recent eruptions of Ebola outbreaks in Africa and other communicable diseases like Zika and SARS elsewhere led scientific and medical commissions to call for global action. The calls for action motivated the World Health Organization (WHO) to respond by defining a new construct within the health sector: Common Good for Health (CGH). While the starting point for developing the CGH construct was the re-emergence of communicable diseases, it extends to additional outcomes resulting from failures to act and finance within and outside the health sector. This paper summarizes global evidence on failures to address CGHs effectively, identifies potential reasons for the public and private sectors' failures to respond, and lays out the first phase of the WHO program as represented by the papers in this special issue of Health Systems & Reform. OBJECTIVE AND MOTIVATION FOR THIS SPECIAL ISSUEThe last 20 years have seen amazing improvements in health indicators globally. Global attention directed to health has been impressive and resources have been expanding at unprecedented rates. External spending on health grew fivefold since 2000, reaching about $20 billion USD in 2015 1 and health sector resources go beyond external funds. We have known for years that OECD countries, especially the wealthiest, have spending rates that grow faster than economic growth. 2 A recent publication from the World Health Organization (WHO) using global data on health expenditures shows that this expansion is not unique to high-income countries. Between 2000 and 2016, global spending on health has increased at 4% per annum, while the global economy grew at 2.8%. Health spending growth has in fact been even more rapid in low-and middle-income countries -at 6% per year, it amounted to $1.6 trillion USD in 2016. 1

“…The first articles in this series discuss the "what," defining CGH and providing the conceptual foundation for the definition. 4,6 Subsequent papers focus on how to finance and provide CGH, 5,7,8 with focused discussions on health emergency and disaster risk management 9 and on environmental issues. 10 Commentaries and case examples highlight some challenges to financing CGH, but also present effective approaches that have been taken to prioritizing financing for CGH.…”

Section: Developing the Case For Cghmentioning

confidence: 99%

“…Another notable example is Sri Lanka's experience investing in population-level prevention and disaster preparedness 15 ; these investments are proving to also be effective platforms for addressing increased demands on the health system due to the growing burden of NCDs. Sparkes et al 7 highlight constraints to financing CGH posed by structural fragmentation at various levels, including across the health sector, among government sectors, and across levels of government. Their analysis shows that aligning budgets and governance coordination can effectively overcome those constraints.…”

Section: Developing the Case For Cghmentioning

confidence: 99%

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

Soucat

2019

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