Africa: Covid shows World Health Organization funding must increase and be predictable

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Geneva – Ahead of a crucial meeting of the Executive Board of the World Health Organization (WHO) this week, an influential group of health leaders and former heads of government are urging WHO member states – made up of members of the United Nations – to tackle the long-term funding challenge.

How much is our health worth? If Covid-19 is any guide, it is clearly not enough.

This harsh reality has been ignored for too long – at a price the whole world is now paying.

Despite warning after warning to strengthen global defenses against pandemics caused by new pathogens, the world has been woefully ill-prepared for the tsunami of suffering to come.

The resulting toll has been enormous and continues to grow: more than five million lives lost, the death toll continues to rise and countless millions more infected, and many seriously ill around the world cannot get the care they need for any longer. stretched hospitals.

Many more people have been scarred in painful, varied and, above all, preventable ways, including persistent Long Covid symptoms and unfathomable mental anguish.

The world is paying a high price for not investing in global health.

The failure to invest in pandemic preparedness and response has been the most glaring symptom of the failing global approach to global public health and universal health coverage. WHO funding has been inadequate for decades. This must stop now.

The Group of 20 – the “G20”, made up of the European Union and 19 other countries – addressed the issue at a summit in Rome last October. But they have not done enough to address the lack of funding to protect the world from pandemics, and, in particular, to fund the WHO to fulfill its broad – and ever-growing – mandate to act as the world’s leading health authority.

We appreciate the recognition by world leaders that global health is closely linked to the institutional health of WHO and that adequate and sustainable funding for WHO is not only urgently needed, but a realistic and achievable goal. in 2022.

Sufficient and sustainable funding for WHO is achievable this year.

In recent years, WHO’s financial and operational independence has steadily declined. Forty years ago, the WHO received 80% of its resources through “assessed contributions” – the evolving membership fees that member countries pay. In the past, WHO’s revenues were predictable and untied and could be deployed to address a wide range of critical issues – from the WHO’s basic scientific work to its role in addressing health emergencies. Other funds came from voluntary contributions from various donors, such as governments and philanthropic organizations, earmarked for specific health areas.

But today, only 16% of WHO’s finances are provided by government membership dues, with no strings attached. 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 to underfunding of emergency preparedness and non-communicable disease prevention and control.

The quantity, predictability and flexibility of funding must be improved.

WHO’s funding needs have recently been highlighted by multiple independent reviews of the pandemic response. Its needs are now in the spotlight as governments consider how to make the organization better able to fulfill the mandate they have given it.

All independent experts in the Covid-19 “lessons learned” process have called on WHO member states to invest in the independence and integrity of the health body through a substantial increase in their assessed contributions.

We continue to believe that funding WHO’s work 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 under consideration in a working group process led by Member States is to increase assessed contributions from current levels to 50%, and to give all countries time to budget and to prepare and do so gradually, introducing the change in stages from 2028.

The billions needed to meet global health needs are far less than the trillions lost to health emergencies.

Taking this step would ensure more predictable funding for WHO’s emergency preparedness work, such as laying the foundations to protect communities from Ebola and strengthening health care systems in vulnerable settings. It would also allow the WHO to invest in helping countries recover from Covid-19 and tackle epidemics of chronic non-communicable diseases, such as diabetes, heart disease and cancers. Importantly, this plan would allow the WHO to plan ahead – for example, to deal with the growing health threats associated with climate change.

The need to make the WHO financially fit for purpose was underscored by G20 leaders, who recognized that “an adequately and sustainably funded WHO” is needed to lead and coordinate global health. If Covid 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 of bankruptcies, job losses and stimulus packages that emergencies like Covid have cost the global economy.

The economic and social benefits of investing in health far outweigh the cost of that investment.

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 sustainable funding for WHO is investing in a healthier and safer world for all of us.

Gordon BrownWHO Ambassador for Global Health Financing and former Prime Minister of the United Kingdom; Helen Clarkco-chair of the Independent Panel for Pandemic Preparedness and Response and former Prime Minister of New Zealand; Dr Felicity Harveyco-chair of the Independent Advisory and Oversight Committee of the WHO Health Emergencies Programme; Graca Machelco-founder of The Elders and former First Lady of Mozambique and South Africa; Paul Martinformer Prime Minister of Canada; Ellen Johnson SirleafCo-Chair of the Independent Panel for Pandemic Preparedness and Response and former President of Liberia; Elhadj As Syco-chair of the Global Preparedness Monitoring Board and former Secretary General of the International Federation of Red Cross and Red Crescent Societies.

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