Kenza Zerrou
Innovative Finance Lead, World Health Organization
SUMMIT SPOTLIGHT
An
interview with Ms. Kenza Zerrou from the World Health Organization (WHO)
on Health Financing
In this fourth and last interview around the UNITE Global Summit 2024, Kenza Zerrou, Innovative Finance Lead at the World Health Organization (WHO), discusses the global shortfalls in funding for health systems, especially in lowand middle-income countries (LMICs), and highlights how Primary Health Care (PHC) serves as the foundation for resilient health systems.
Global efforts to secure sustainable health financing continue to struggle given the many competing economic needs and challenges globally. Could you provide a brief picture of the current state of global health financing and where are the most severe shortfalls?
KZ: Health systems around the world are facing increasingly complex challenges due to demographic trends, epidemiological burden, technological shifts, ongoing conflict and climate change.
In particular, the COVID-19 pandemic has highlighted the consequences of neglecting health systems, setting us even further back in meeting the health-related SDGs targets by 2030.
For example, the estimated additional investment needs across 67 Low- and Middle-income Countries (LMICs) ranges from USD200 - USD328 billion per year from 2020 to 2030 for the different Primary Health Care (PHC) measures to expand service delivery to meet the Sustainable Development Goals (SDGs) targets.
This significant financing gap is also set against a backdrop of the recent global economic downturn, fiscal constraints, reducing the prioritization of health in domestic budget allocations, declining levels of official development assistance and tightening financial conditions such as higher interest rates.
PHC is widely regarded as the most inclusive,
equitable and cost-effective way to achieve universal health coverage (UHC).
It is also key to strengthening the resilience of health systems to prepare for, respond to, and recover from shocks and crises.
PHC is the foundation to broader health systems, providing the most efficient and equitable way to simultaneously accelerate progress towards universal health care and strengthen health security.
Through focusing on prevention, early detection, and management of common health conditions, PHC can meet 90% of a person’s health needs throughout their lifetime. Moreover, it can help to ensure better preparation, response, and recovery from crises by helping to detect earlier signs of outbreaks and address surges in demand for services.
Developing a strong PHC foundation has been proven to improve overall health outcomes, reduce all-cause mortality, and promote better quality of care.
It is estimated that scaling up PHC interventions across LMICs could save 60 million lives and increase average life expectancy by 3.7 years by 2030, offering the potential to achieve 75% of projected health gains from the SDGs. Investing in PHC, therefore, offers the potential to not only improve the health of individuals, but also strengthen our collective health security.
Despite these potential benefits, PHC systems in many low and lower-middle income countries remain weak.
50% of the world’s population still lack access to some or all essential health services, and the world is estimated to be only going at a quarter of the pace needed to achieve the health-related SDG targets by 2030.
50% of the world’s population still lack access to some or all essential health services, and the world is estimated to be only going at a quarter of the pace needed to achieve the health-related SDG targets by 2030.
In many places, traditional methods of health financing have proven largely unsustainable and require new approaches and collaborations that account for existing challenges. What are some new, workable ideas under implementation around the world?
KZ: The Platform is a joint initiative of the Founding Partners, to be hosted by the WHO, aimed at creating a coordination mechanism whereby non-reimbursable and reimbursable forms of financing, as well as expertise from its participating entities are brought together with a view to preparing Projects and/or Programmes in the public sector which address critical primary healthcare challenges in Beneficiary Countries
The Platform aims to help develop and/or deliver on the objectives of the relevant national strategies and policies of Beneficiary Countries for primary healthcare.
This Governance Framework sets forth the objectives and governing principles for the set up and operation of the Platform; the structure and governance arrangements for the Platform and the related working methods of the Platform governing and administrative bodies; and general conditions for the operation of the Platform Fund(s).
In what ways can national assemblies intervene in driving state policy on innovative health financing?
KZ: National Assemblies can play a crucial role in shaping health policy and ensuring that the health needs of the population are prioritized:
1. National Assemblies can identify pressing health issues within the population.
2. Once the national health priorities are established, Assemblies can analyze current funding streams.
3. By aligning funding with the most pressing health needs, National Assemblies can improve the overall health impact of financial investments.
4. As Official Development Assistance (ODA) faces constraints and shortages, National Assemblies have a pivotal role in advocating for innovative financing strategies. This can include public-private partnerships, social impact bonds, and other financial instruments that leverage private investment for public health initiatives. By championing these solutions, Assemblies can help diversify funding sources and reduce reliance on traditional aid.
National Assemblies have a vital role in enhancing the health of their populations by clearly identifying health priorities, mapping these against available funding, and advocating for innovative financing solutions.
National Assemblies have a vital role in enhancing the health of their populations by clearly identifying health priorities, mapping these against available funding, and advocating for innovative financing solutions.
By taking these steps, they can ensure that health interventions are both effective and sustainable.
What opportunities exist for collaboration between states and development partners, or perhaps the market especially, particularly in Lower Income States? How can these collaborations be optimized?
KZ: The Health Impact Investment Platform that the WHO and four Multilateral development banks (MDB) partners have developed and started to implement is aiming to do exactly this, to coordinate development partners financing around government health plans and priorities, with a focus on primary health as that is typically underfinanced.
Our ambition with the platform is that these plans can inform wider funding decisions from other actors as well to enable holistic health finance and funding.
Why do you believe the UNITE Global Summit 2024 is a pivotal platform to address these critical issues? What are your hopes for the outcomes of the summit?
KZ: The critical element for the UNITE Global Summit is for parliamentarians to support the case for prioritizing health and particularly primary health care investment.
The greater clarity from Parliaments into government and from governments into the health financing community the greater the ownership that governments will have of health funding and priorities. ■
Ensuring the protection of communities and the resilience of healthcare systems hinges on sustainable financing for health. Countries across the world differ significantly on how they organise and finance national health systems, with extremes going fully State-funded models to fully private-funded or even supported almost exclusively by international development aid.
Therefore, prioritizing sustainable, long-term funding mechanisms that can support equitable and affordable healthcare services for all, while mitigating financial strain is key.
How can innovative financing models support countries in expanding support for global health and help LMICs transition away from overdependence on Official Development Assistance?
How can parliamentarians prioritize the financing of primary health care?