Paying for Health in poor countries

In too many countries access to basic health services is severely limited. Commitments for assistance from the international community are variable and provided for finite periods. Financial support of this kind doesn’t allow for the long-term investments needed to build a comprehensive health care system, such as infrastructure and training the necessary personnel.

In the latest IBP brief, Gorik Ooms of the Institute of Tropical Medicine proposes the creation of a Global Health Fund that could provide constant long-term support to poor countries. He argues that-as the creation of the Global Fund did in the fight against AIDS-a Global Health Fund could provide an international foundation on which national social health protection could be built.

He argues further that such a fund is affordable and sustainable if one looks at total global health expenditure rather than at the revenue of individual poor countries. If we assume that the global economy can afford to spend the equivalent of 4 % of their GDP on health – which is far less than what most countries are currently spending on health – then a health expenditure level of US$ 300 per person per year would become affordable and sustainable.

Ooms also argues that in the last analysis, the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights also puts a legal obligation on rich countries to support poor countries in this way.
What do you think? Will sustainable long term funding help poor countries create the health systems they need? And do you think that they creation of such a fund is sustainable?

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Global Health: What would Barack do?

As the American Presidential campaign heats up, it is good to see that candidates’ views on the US’s global health agenda is also getting some column space.

Unsurprisingly global health is nowhere near as prominent in the McCain campaign as it is for Obama. Apart from supporting PEPFAR, McCain has been vague on other global health issues.

In a recent CGD Policy Brief, health economist Ruth Levine sets out a systematic to-do list for Obama. Some of her key points are:

• Work more closely with UN and other multilateral partners
• Live up to your funding commitments, also smaller ones like those for malaria and child health
• Make decisions based on scientific evidence, not political or narrow moral preferences
• Find  a balance between AIDS and non-AIDS health spending (click here for more on this debate)
• Establish exchange programs for training and research.

Obama’s campaign documents have made extensive commitments around expanding PEPFAR; taking on drug and insurance companies and supporting the Global fund and the MDGs. He has also made promises about adressing health infrastructure and the migration of health workers.

True to form, though, these campaign promises don’t explain how all these promises will be paid for or how  the strong interests that litter the health sector in the US and the rest of the world will be navigated. While Obama may attach more importance to questions of global  health, it only merits one paragraph in his 64 page ‘Blueprint for Change‘. It seems fairly clear therefore that he would only be able to move as far and as quickly on global health as his domestic constituency will let him.

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