Gordon Brown, Helen Clark, Graça Machel, Paul Martin, Ellen Johnson Sirleaf, Elhadj As Sy
How much is our health worth? If COVID-19 gave any guidance, clearly not enough.
This harsh reality has been ignored for far too long – at a cost the world can now see. Hot air, in large part, has been given in warning after warning to bolster global defenses against pandemics of novel pathogens, leaving the world woefully unprepared nearly two years ago for the tsunami of suffering to come.
The resulting toll has been heavy and continues to grow: more than 5.6 million lives lost, the death toll continues to rise, and countless millions more infected, and many seriously ill people around the world cannot get the care they need in overcrowded hospitals.
Add to that long-term COVID-19 and unfathomable mental anguish – so many more people have been scarred in painful, varied and, above all, preventable ways.
The failure to invest in pandemic preparedness, response and, more generally, in everyone’s health, has for decades been the most glaring symptom of the world’s sick approach to investing in public health. world and universal health coverage.
The WHO’s money problems are not new
Leaders of the Group of 20 industrialized and emerging countries meeting in Rome last fall stepped up their efforts but did not do enough to address funding shortfalls for the work needed to protect the world from pandemics, and in particular funding from the World Health Organization to fulfill its broad – and ever-growing – mandate to serve as the world’s leading authority on global health.
We appreciate the recognition by world leaders that global health and WHO health are intertwined, and that there is not only an urgent need to ensure that WHO funding is sustainable, but that it is This is also a realistic and achievable goal in 2022.
WHO’s funding problems are not new, but rather have been playing out for decades and, in turn, manifest themselves in several telling ways. They are symptomatic of a general failure to invest sufficiently in global public health. This must stop now.
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In recent years, WHO’s financial and operational independence has steadily declined.
These revenues were predictable and untied, and could be deployed to address a wide range of critical health issues, from the WHO’s basic scientific work to its role in addressing health emergencies. The rest came in the form of voluntary contributions from various donors, ranging from governments to foundations, earmarked for specific areas of health.
But today, only 16% of WHO’s finances are provided by governments through their dues. The overwhelming remainder is provided in the form of voluntary contributions, often with strict and sometimes restrictive conditions, and usually on two-year cycles.
In addition to making long-term planning impossible, this has led to the progressive weakening of WHO’s ability to perform the wide and ever-expanding range of tasks that all governments, and therefore their peoples, demand and need. . This has led, in particular, to underfunding of emergency preparedness and the prevention and control of non-communicable diseases.
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And it is not only a question of the amount of funds that the organization receives, but also of the quality of the resources provided, in particular the flexibility with which they can be used and whether the organization can count on receiving these resources. The more flexible and predictable they are, the better.
WHO’s funding needs have recently been highlighted by multiple independent reviews of the pandemic response and are now in the spotlight as governments discuss how to make WHO better able to fulfill the mandate they gave him.
All independent experts in the COVID-19 lessons learned process have called on WHO Member States to invest in the independence and integrity of WHO through a substantial increase in their assessed contributions.
We continue to believe that funding WHO through a significantly higher level of assessed contributions, closer to the 80% share of the early 1980s, is the best way forward. But we accept that the main proposal currently being considered through a working group process led by Member States is to increase assessed contributions from current levels of less than 20% of the core budget to 50%, and to allow all countries time to budget and prepare, to do so gradually, introducing the change in stages from 2028.
COVID has taught us to invest in health
Taking this step would ensure more predictable funding for WHO’s emergency preparedness work, from preparing the ground to protect communities against Ebola to strengthening health care systems in vulnerable settings. It would also allow the WHO to invest in helping countries recover from COVID-19 and fight epidemics of chronic non-communicable diseases, such as diabetes, heart disease and cancers, while allowing it to plan ahead – for example, to combat the growing health threats associated with climate change.
The need to make the WHO financially fit for purpose was also underscored by G20 leaders who recognized that “an adequately and sustainably funded WHO” was necessary to carry out and coordinate global health.
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If COVID-19 has taught us anything, it’s that the value we place on health needs to be radically reassessed. The billions needed to prevent and respond to health crises are dwarfed by the trillions in bankruptcies, job losses and stimulus packages that emergencies like COVID have cost the global economy.
When countries invest in health, the dividends are significant. Nations that devote resources to universal health coverage and primary health care invest in the well-being of children, adults and the elderly, enabling them to go to school, to enter the work and stay as healthy as possible. This investment is the basis for greater health security.
The mission of ensuring health for all is at the heart of everything WHO does. But the achievement of this mission depends on the financial health of the WHO itself. Committing to more sustainable funding for WHO is investing in a healthier and safer world for all of us.
By Gordon Brown, WHO Ambassador for Global Health Financing and former Prime Minister of the United Kingdom; Helen Clark, Co-Chair of the Independent Pandemic Preparedness and Response Group and former Prime Minister of New Zealand; Graça Machel, co-founder of The Elders and former First Lady of Mozambique and South Africa; Paul Martin, former Prime Minister of Canada; Ellen Johnson Sirleaf, co-chair of the Independent Panel for Pandemic Preparedness and Response and former President of Liberia; Elhadj As Sy, co-chair of the Global Preparedness Monitoring Board and former Secretary General of the International Federation of Red Cross and Red Crescent Societies.