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The COVID-19 pandemic has resulted in a double shock - health and economic. As of March 1, 2021, COVID-19 has cost more than 2.5 million lives and triggered an economic recession surpassing any economic downturn since World War II.
Part I of this paper explores the impact of this current macro-fisc
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al outlook on the three primary sources of health spending. Drawing on experiences from previous economic crises, scenario analyses suggest a fall in government per capita spending on health in 2021 and 2022 unless governments make bold choices to increase the share of health in general government spending.
Part II of the paper discusses policy options to meet the spending needs in health. These options encompass strategies to make fiscal adjustments work and channel funds where they are most needed, as well as policies to stabilize the balance sheets of social health insurance (SHI) schemes. The paper explains how the health sector can play an active role in expanding fiscal space, contributing to tax reforms, most importantly pro-health taxes, and mobilizing and absorbing external financing, including debt relief.
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The 2022 Financing for Sustainable Development Report identifies a “great finance divide” as a main driver of the divergent recovery. Developed countries were able to borrow record sums at ultra-low interest rates to support their people and economies, but the pandemic response and investment in
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recovery of poor countries was limited by fiscal constraints. This joint report, by over 60 agencies of the United Nations system and partner international organizations, provides analysis and puts forward policy recommendations to overcome this “finance divide” and enhance developing countries’ access to financing for recovery and productive and sustainable investment.
more
Guidelines for the Implementation of the SHA 2011 Framework for Accounting Health Care Financing
Organisation for Economic Co-operation and Development (OECD) and World Health Organization (WHO)
Organisation for Economic Co-operation and Development (OECD) and World Health Organization (WHO)
(2014)
CC
The accounting framework for health care financing is a key component of A System of Health Accounts 2011, published by OECD, Eurostat and WHO in October 2011.1 The framework makes health accounts more adaptable to rapidly evolving health financing systems, further enhances crosscountry comparabilit
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y of health expenditures and financing data, and ultimately improves the information base for the analytical use of national health accounts (NHAs). It is hoped that SHA 2011 – including its financing framework – will make health accounts a more useful assessment and monitoring tool for health systems and health expenditure in the economy as a whole.
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Globale Gesundheit benötigt eine angemessene und verlässliche Finanzierung
Aktionsbündnis gegen AIDS
Verband Entwicklungspolitik und Humanitäre Hilfe deutsche Nichtregierungsorgansationen e.V. (VENRO)
(2020)
CC
Die Corona-Pandemie zeigt die Bedeutung, die einem umfassenden Engagement der Bundesregierung im Bereich Globale Gesundheit zukommt. Im Standpunkt legen VENRO und das Aktionsbündnis gegen AIDS dar, wie eine adäquate und qualitativ hochwertige globale Gesundheitsfinanzierung aussehen sollte.
The ongoing COVID-19 pandemic has shown that public financial management (PFM) should be an integral part of the response. Effectiveness in financing the health response depends not only on the level of funding but also on the way public funds are allocated and spent, this is determined by the PFM r
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ules, and how money flows to health service providers. So far, early assessments have shown that PFM systems ranged from being a fundamental enabler to acting as a roadblock in the COVID-19 health response. While service delivery mechanisms have been extensively documented throughout the pandemic, the underlying PFM mechanisms of the response also merit attention. To highlight the importance of PFM in health emergency contexts, this rapid review analyses various country PFM experiences and identifies early lessons emerging from the financing of the health response to COVID-19. The assessment is done by stages of the budget cycle: budget allocation, budget execution, and budget oversight. Identifying lessons from the varying PFM modalities used to finance the response to COVID-19 is fundamental both for health policy-makers and for finance authorities to prepare for future health emergencies.
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The importance of robust mortality surveillance systems cannot be overstated in an era marked by increasing global health challenges where health threats loom large and population dynamics continue to evolve. Accurate and timely mortality data is essential for identifying trends and detecting emergi
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ng health threats, evaluating the impact of interventions, and guiding evidence-based policy decisions.
This framework outlines a holistic approach to strengthening routine mortality surveillance systems, considering the unique contextual factors and challenges faced by African countries. It emphasizes the importance of establishing efficient data collection mechanisms, enhancing data quality and completeness, and promoting data sharing and collaboration among stakeholders.
Moreover, the framework recognizes the pivotal role of technology in the integration of data from fragmented mortality data sources. It highlights the potential of innovative data capture methods, advanced analytics, and real-time reporting systems to enhance mortality data’s accuracy, efficiency, and timeliness.
The continental framework for mortality surveillance aligns with Africa CDC’s mission and strategic goal by serving as a fundamental component in strengthening public health systems, enhancing disease surveillance capacities and capabilities, informing evidence-based policies and interventions, and promoting collaboration and coordination among African countries to address health challenges and improve health outcomes on the continent.
The successful implementation of this framework requires collective commitment and concerted efforts from governments, health institutions, and the international community. We hope this document will serve as a catalyst for transformative change, enabling countries to build resilient mortality surveillance systems that protect public health, save lives, and contribute to evidence-based decision-making.
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L'importance de systèmes de surveillance de la mortalité robustes ne peut être surestimée à une époque marquée par des défis sanitaires mondiaux croissants, où les menaces sanitaires pèsent lourd et la dynamique des populations continue d'évoluer. Des données précises et opportunes sur
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la mortalité sont essentielles pour identifier les tendances et détecter les menaces émergentes pour la santé, évaluer l'impact des interventions et orienter les décisions politiques fondées sur des données probantes.
Ce cadre décrit une approche holistique pour renforcer les systèmes de surveillance de routine de la mortalité, en tenant compte des facteurs contextuels uniques et des défis auxquels sont confrontés les pays africains. Il souligne l'importance d'établir des mécanismes de collecte de données efficaces, d'améliorer la qualité et l'exhaustivité des données et de promouvoir le partage des données et la collaboration entre les parties prenantes.
De plus, le cadre reconnaît le rôle central de la technologie dans l'intégration des données provenant de sources de données fragmentées sur la mortalité. Il met en évidence le potentiel des méthodes innovantes de capture de données, des analyses avancées et des systèmes de notification en temps réel pour améliorer la précision, l'efficacité et l'actualité des données sur la mortalité.
Le cadre continental de surveillance de la mortalité s'aligne sur la mission et l'objectif stratégique d'Africa CDC en servant d'élément fondamental dans le renforcement des systèmes de santé publique, l'amélioration des capacités et des capacités de surveillance des maladies, l'élaboration de politiques et d'interventions fondées sur des données probantes et la promotion de la collaboration et de la coordination entre les pays africains pour relever les défis sanitaires et améliorer les résultats sanitaires sur le continent.
La mise en œuvre réussie de ce cadre nécessite un engagement collectif et des efforts concertés de la part des gouvernements, des établissements de santé et de la communauté internationale. Nous espérons que ce document servira de catalyseur pour un changement transformateur, permettant aux pays de mettre en place des systèmes de surveillance de la mortalité résilients qui protègent la santé publique, sauvent des vies et contribuent à la prise de décision fondée sur des données probantes.
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The 2021 Global monitoring report on financial protection in health shows that before the COVID-19 pandemic, the world was off-track to reduce financial hardship due to health expenditures because trends in catastrophic health spending were going in the wrong direction and the number of people incur
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ring impoverishing health spending remained unacceptably high (Chapter 1). Chapter 2 summarizes emerging evidence on the consequence of the pandemic and the related macroeconomic and fiscal crisis that points to the likely worsening of financial protection for households, particularly as a result of declining income and consumption, along with rising poverty and inequality
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The 2018 global health financing report presents health spending data for all WHO Member States between 2000 and 2016 based on the SHA 2011 methodology. It shows a transformation trajectory for the global spending on health, with increasing domestic public funding and declining external financing. T
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his report also presents, for the first time, spending on primary health care and specific diseases and looks closely at the relationship between spending and service coverage
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The increasing amounts of official development assistance (ODA) for health have been aimed primarily at fighting HIV/AIDS, malaria and tuberculosis. Neglected tropical diseases (NTD), one of the most serious public health burdens among the most deprived communities, have only recently drawn the atte
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ntion of major donors. While frequently stated, the low share
of funding for NTD control projects has not been calculated empirically. Our analysis of ODA commitments for infectious disease control for the years 2003 to 2007 confirms that Development Assistance Committee (DAC)-countries and multilateral donors have largely ignored funding NTD control projects. On average, only 0.6% of total annual health ODA was dedicated
to the fight against NTDs while the average share of control projects for HIV/AIDS was 36.3%, for malaria 3.6%, and for tuberculosis 2.2%. This allocation of health ODA does not reflect the diseases’ respective health burdens.
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The Creditor Reporting System was analysed for official development assistance funding disbursements towards TB control in 11 conflict-affectedstates, 17 non-conflict-affected fragile states and 38 comparable non-fragile states. The amounts of funding, funding relative to burden, funding relative to
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malaria and human immunodeficiency virus (HIV) control, disbursements relative to commitments, sources of funding as well as funding activities were extracted and analysed.
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UNAIDS leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. It unites the efforts of 11 UN Cosponsor organizations- UNHCR, UNICEF, WFP, UNDP,UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank- and a Secretari
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at.
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This results report for the biennium 2020–2021 presents the progress towards the triple billion targets, outcomes and outputs, based on the GPW 13 results framework and indicators. It uses structured methodologies, both quantitative and qualitative, for measuring and analysing the achievements and
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challenges to achieving them, and includes country and impact case studies to exemplify how the Organization’s work is driving health impacts at the country level, where it matters most. For the first time, the WHO Secretariat is reporting on its investments, results and performance through a scorecard methodology for every country or territory it serves.
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The present information document supplements the WHO audited financial statements for 2018. It contains information on WHO's voluntary contributions by fund and by contributor in the year 2018.
ACT-A - Urgent Priorities & Financing Requirements at 10 November 2020
World Health Organization (WHO), The Global Fund, Gavi et al.
World Health Organization (WHO)
(2020)
CC
Six months after its launch on 24 April, the Access to COVID-19 Tools (ACT) Accelerator has already delivered concrete results in speeding up the development of new therapeutics, diagnostics, and vaccines. Now mid-way through the scale-up phase, the tools we need to fundamentally change the course o
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f this pandemic are within reach. But to deliver the full impact of the ACT-Accelerator – and ultimately an exit to this global crisis – these tools need to be available everywhere. On behalf of the ACT-Accelerator Pillar lead agencies – CEPI, Gavi, the Global Fund, FIND, Unitaid, Wellcome Trust, the World Bank, and the World Health Organization, as well as the Bill & Melinda Gates Foundation – I am pleased to share this document setting out the near-term priorities, deliverables and financing requirements of the ACT-Accelerator Pillars and Health Systems Connector. Urgent action to address these financing requirements will boost the impact of the ACTAccelerator achievements to date, fast-track the development and deployment of additional game-changing tools, and mitigate the risk of a widening gap in access to COVID-19 tools between low- and high-income countries. Delivering on this promise requires strong political leadership, financial investment, and incountry capacity building. COVID-19 cannot be beaten by any one country acting alone. We must ACT now, and ACT together to end the COVID-19 crisis.
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I examine the effectiveness of donors in targeting the highest burden of malaria in the Democratic Republic of Congo when health information structure is fragmented. I exploit local variations in the burden of malaria induced by mining activities as well as financial and epidemiological data from he
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alth facilities to estimate how local aid is matching local health needs. Using a regression discontinuity design, I find significant but quantitatively small variations in aid to health facilities located within mining areas. Comparing local aid with the additional cost of treatment and prevention associated with the increased risk of malaria transmission, I find suggestive evidence that local populations with the highest burden of the disease receive a proportionately lower share of aid compared to neighbouring areas with reduced exposure to malaria infection. The evidence of disparities in the allocation of aid for malaria supports the view that donors may have inaccurate information about local population needs.
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Achieving the Sustainable Development Goals (SDGs) will require the international community to mobilize significant additional financing over the next decade. Tracking and analyzing this funding is central to measuring progress and making more informed choices to direct financial flows where they wi
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ll have the greatest impact. This brief highlights AidData’s updated methodology to track financing to the SDGs, providing a baseline of funding for the years immediately before and after their launch. To track SDG-related financing, we build on our 2017 pilot methodology. Using data from the OECD CRS database on all official development assistance between 2010 and 2016, we identify individual projects that are linked to specific SDG goals or targets and then quantify total financing by SDG. This brief highlights four countries that represent different development contexts and trajectories, exploring how a country’s individual context impacts its SDG-related donor funding by examining the composition of funding and financing trends. We also look at SDG financing from the perspective of donors to see how their own interests are reflected in development portfolios across different countries.
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Mental disorders are a leading cause of the global burden of disease, and the provision of mental health services in developing countries remains very limited and far from equitable. Using the Creditor Reporting System, we estimate the amounts and patterns of development assistance for global mental
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health (DAMH) between 2007 and 2013. This allows us to examine how well international donors have responded to calls by global mental health advocates to scale up evidence-based services. Although DAMH did increase between 2007 and 2013, it remains low both in absolute terms and as a proportion of total development assistance for health (DAH). The average annual DAMH between 2007 and 2013 was US$133.57 million, and the proportion of DAH attributed to mental health is less than 1%. Approximately 48% of total DAMH was for humanitarian assistance, education, and civil services. More annual DAMH was channelled into the nonpublic sector than the public sector. Despite an expanding body of evidence suggesting that sustainable mental health care can be effectively integrated into existing health systems at relatively low cost, mental health has not received significant development assistance.
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Development finance institutions owned by European governments and the World Bank Group are spending hundreds of millions of dollars on expensive for-profit hospitals in the Global South that block patients from getting care, or bankrupt them, with some even imprisoning patients who cannot afford th
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eir bills. At the height of the COVID-19 pandemic, some of these same hospitals denied entry to patients suffering from the virus or sold intensive care beds at eyewatering prices to the highest bidder. These development institutions have woefully inadequate safeguards, invest via a complex web of tax-avoiding financial intermediaries, and offer little to zero evidence on the impacts their investments are having. Oxfam is calling on rich-country governments and the World Bank Group to immediately halt their spending on for-profit private healthcare, and for an urgent independent investigation to be conducted into all active and historic investments.
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We combine data on Chinese development projects with data from Demographic and Health Surveys to study the impact of Chinese aid on household welfare in sub-Saharan Africa. We use a novel methodology to test the effect of Chinese aid on three important development outcomes: education, health, and nu
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trition. For each outcome, we use difference-in-difference estimations to compare household areas near Chinese project sites to control areas located farther away, before and after receiving Chinese aid. This empirical strategy rules out many confounding factors that can bias measuring the impact of Chinese aid on our outcome variables. First, we find that Chinese projects significantly improve education and child mortality in treatment areas, but do not significantly affect nutrition. Second, social sector projects have a larger effect on outcomes than economic projects. Third, we do not find significant effects for projects that ended more than five years before the post-treatment survey wave. Our results are robust to a host of robustness checks.
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