Financing common goods for health
External funders and governments alike have failed to prioritize investments in core health system functions that are fundamental to protecting and promoting health and well-being. In order to address these under-investments WHO, in close collaboration with external partners, has developed a knowledge programme on financing common goods for health (CGH).
This knowledge programme articulates, provides the technical and economic rationale for, and identifies sources and modalities of financing for core CGH. Due to the broad-based benefits of these common goods, related externalities, and often multi-sectoral nature, there is a need for targeted action and investments by both governments, as well as the global community.
Key points about financing common goods for health
Current threats to the natural systems upon which all health and life depend threaten to undermine the health gains of the past decades, particularly vulnerable populations and communities most at risk from the harms of environmental degradation and the effects of climate change. These transitions require health systems to adapt in terms of prioritizing services, how they are delivered, and how health systems overall are financed. Even the most basic functions of a health system, such as surveillance, have to adapt to recognize that NCDs and environmental risks are becoming more important for human health.
CGH are a new construct born out of the observed failures exposed by Ebola, SARS, Zika and other communicable diseases as well as by additional health and environmental elements. These CGH are defined as a cluster of feasible population-based interventions and functions exhibiting two fundamental characteristics: (i) market failures due to their public good nature or the large health externalities they generate; and (ii) strong potential impact on human life.
This programme of work makes the case for the centrality of collective financing of these goods and discusses why markets and governments tend to fail in the provision of CGH as well as specific issues related to national financing mechanisms (e.g. budgeting processes, intergovernmental fiscal transfers, incentives, and organizational arrangements) that influence the level and efficiency of financing CGH. It addresses how these financing mechanisms interact with and complement other aspects of health system financing, and how to improve alignment across the system.
Additionally, it looks beyond national-level financing to supranational entities as disease outbreaks do not follow administrative boundaries. It examines current financing flows to global functions as well as how global aid assistance can assist in the domestic capacity of sustainably financing these core health functions within countries.
An initial output of this work will be a series of related papers published in a special issue of Health Systems & Reform to coincide with the September 2019 United Nations General Assembly (UNGA). The focus this year for the UNGA is on Universal Health Coverage (UHC), and this programme of work is clearly situated within overall country and global efforts to move towards UHC.