How much do we value our health? If the covid-19 has taught us something is that we clearly don’t value it enough. This harsh reality has been ignored for far too long at a price the entire world can now see. Repeated warnings to bolster the world’s defenses once morest pandemics triggered by new pathogens were largely underheeded, leaving the world severely ill-prepared almost two years ago to deal with the tsunami of suffering. what was coming
The subsequent toll has been enormous and continues to grow: more than five million lives have been lost, a figure that continues to rise, and many millions more people have been infected, many of whom have fallen seriously ill around the world without being able to receive the care they need in hospitals that are overwhelmed.
Add to this long-standing covid-19 and unfathomable mental anguish: many more people have been scarred in painful, varied and, above all, avoidable ways.
The lack of investment in pandemic preparedness and response, and in general in the health of all people, has been the most glaring symptom of the wrong approach taken around the world for decades regarding investment in public health. world and universal health coverage.
The leaders of G20 meeting in Rome last fall upped the ante, but they did not do enough to address the insufficiencies in funding the work needed to protect the world from pandemics and, in particular, in the funding that World Health Organization (WHO) needs to fulfill its broad and growing mandate to act as the world’s foremost authority on global health.
We appreciate the recognition by world leaders that global health and the health of WHO are intertwined, and that ensuring funding for WHO on a sustainable basis is not only an urgent need, but also a realistic and achievable goal by 2022. .
WHO’s funding problems are not new, but have been going on for decades and, in turn, have manifested themselves in a number of revealing ways. They are symptomatic of a general inability to invest sufficiently in global public health. This must end now.
In recent years, WHO’s financial and operational independence has steadily declined. Forty years ago, the WHO received 80% of its resources in the form of “assessed contributions”, that is, the staggered membership fees paid by countries. These revenues were predictable and not tied to specific issues, but might be used to address a wide range of critical health issues, from WHO’s basic scientific work to its role in fighting health emergencies. The rest was obtained from voluntary contributions from various donors, from governments to foundations, earmarked for specific areas of health.
However, currently only 16% of WHO’s finances are provided by governments through ‘no strings attached’ membership fees. The vast majority of the remainder is provided in the form of voluntary contributions, often with strict and sometimes restrictive conditions, and usually in two-year cycles.
In addition to making long-term planning impossible, this has progressively weakened WHO’s ability to carry out the wide and growing range of tasks that all governments, and thus their populations, demand and need. This has led, in particular, to underfunding of both emergency preparedness and the prevention and control of non-communicable diseases.
And it’s not just regarding the amount of funding the organization receives, but also the quality of the resources provided, specifically how flexible 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 response to the pandemic, and are now in the crosshairs of governments, who are debating how to make it better able to deliver on the mandate it has been given. entrusted.
All independent experts in the COVID-19 lessons learned review process have called on WHO Member States to invest in the organization’s independence and integrity by substantially increasing their assessed contributions.
We continue to believe that funding WHO at a substantially higher level of assessed contributions, closer to the 80% of the early 1980s, is the best way forward. But we accept that the main proposal now being considered through a Member State-led working group process is to increase assessed contributions from current levels of less than 20% of the core budget to 50% and, to give all countries time to budget and prepare, do it gradually, introducing the change in stages starting in 2028.
Taking this action would ensure more predictable funding for WHO’s work in emergency preparedness, from laying the groundwork for protecting communities from Ebola to the strengthening of health care systems in vulnerable settings. It would also allow the WHO to invest in supporting countries to recover from covid-19 and tackle epidemics of chronic non-communicable diseases such as diabetes, heart disease and cancers, as well as to establish plans, for example, to address the growing health threats posed by climate change.
The G20 leaders also underlined the need for the WHO to be financially prepared to fulfill its purpose, acknowledging that “an adequately and sustainably funded WHO” is needed to carry out its work of leading and coordinating global health.
If covid-19 has taught us anything, it is that we must radically re-evaluate the value we place on health. The billions needed to prevent and respond to health crises are dwarfed by the trillions lost in bankruptcies, job losses and stimulus packages that various emergencies like Covid-19 have cost the global economy.
When countries invest in health, the dividends are large. Nations that dedicate resources to universal health coverage and primary health care are investing in the well-being of children, adults, and older people, enabling them to attend schools, enter the workforce, and stay as long as possible. healthier as possible. This investment is the basis for greater health security.
The mission of providing health for all is at the heart of everything WHO does. However, the fulfillment of this mission depends on WHO itself being in good financial health. Committing to more sustainable financing of WHO is an investment in a healthier and safer world for all of us.
For 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 Pandemic Preparedness and Response Group 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.