When G20 finance and health ministers meet this week for the Rome summit, health financing must be high on their agendas. Additional funds are urgently needed to tackle the current pandemic and prepare for future threats.
The leaders of the IMF, the World Health Organization, the World Bank and the WTO have already joined in saying that “investing $ 50 billion to end the pandemic would pay a huge development dividend and would stimulate growth and well-being on a global scale. But the longer we wait to act, the more costly the action becomes – in human suffering and economic loss. “
However, throwing money at the problem will not be enough.
As two WHO organizations recently pointed out, Covid-19 has exposed our current business model as insufficient, outdated and neglectful. We mistakenly treat health as a short-term cost on tight public budgets rather than a long-term investment in expanding public value. We facilitate private investments in health that prioritize short-term profits over human needs; and health financing generally serves immediate demand rather than seeking to improve long-term supply and build public capacity to deal with future crises, including another global pandemic.
The model is broken – it’s high time we fixed it.
Finance is not neutral – quantity and quality matter. We must radically increase, reorient and regulate health spending to prioritize the equitable and sustainable provision of human health and well-being – in short, health for all. This means asking how the economy can serve health, and not the other way around.
As ministers meet in Rome, three considerations should be in mind as they address the pressing need for increased funding focused on ending the pandemic and building resilience.
The first is the need to create the fiscal space necessary to significantly increase public investment. It is about setting aside common perceptions that impose artificial constraints on public spending. Public debt is not the same as household debt, and deficit spending in pursuit of human economic well-being is more than justified. International lending organizations such as the IMF and the World Bank need to rethink the fiscal restraint requirements they have traditionally imposed on borrowing states and instead allow them to treat health spending as an investment in individual and collective goals.
Second, governments must reorient their investments so that health for all becomes a central objective of economic policy, and not the sole competence of ministries of health. And third, we must change the governance of public and private financing for health to prioritize universal well-being.
Concretely, this means rethinking and restructuring grants, transfers and loans with good, mutually agreed-upon measures at the center of public and private partnerships. Stricter conditions must be attached to bailout and stimulus packages to ensure that government subsidies are tied to investments that steer the economy in a more sustainable and equitable manner. And patents in particular must be designed differently to make them less extractive so that they promote the increase of collective knowledge rather than just private profits.
These changes are urgently needed to avoid the mistakes of the past. Public and private investments in vaccine production, for example, are woefully short of what is needed to end the pandemic because jabs are not universally accessible, leading to what the WHO director calls “Vaccine apartheid”.
An overhaul of health financing is only one component, though vital, of a much needed radical paradigm shift. G20 states should learn from the lessons of the pandemic and heed this call for more targeted investments and for governments and businesses to work in partnership to ‘build economic resilience as a global public good’, such as the G7 Economic Resilience Expert Panel recently said.
We must reorient economic policy around ambitious missions with clear public goals. Health for all is one of them. The COP26 goal of achieving zero net carbon emissions by 2050 and limiting global warming to 1.5 ° C is another.
The only way to build resilience in the face of escalating global crises and future health shocks is to establish a new relationship between states and between business and the state. For too long, economic growth has been an end in itself. Covid makes it clear that the global economy must be remade to serve the common good.