Mobilizing Domestic Resources for Health Security in the COVID-19 Era

7th GHSA Ministerial Meeting | Sustainable Financing for Preparedness Action Package

November 28, 2022

At the 7th GHSA Ministerial Meeting in Seoul, the Sustainable Financing for Preparedness Action Package organized an expert forum to engage GHSA members on their experiences mobilizing domestic resources for health security and other health sector priorities considering the fiscal constraints caused by multiple crises. The global spread of COVID-19 which affected all aspects of global society with significant impact on economies and health made evident the need to invest in preparedness. Unfortunately, numerous crises before now from SARS to Ebola have demonstrated the challenges of maintaining political will for preparedness. For lower-and-middle-income countries (LMICs), the pandemic has increased the need for more revenue and made domestic resource mobilization (DRM) more challenging although not impossible. This situation starkly highlights the need for more DRM for health security as well as efficient use of current resources.

Deputy Secretary Andrea Palm of the U.S. Department of Health and Human Services opened the session stressing the need to break the cycle of panic and neglect that often characterizes the international community’s response to epidemics and pandemics. Deputy Secretary Palm highlighted some of the Action Package’s accomplishments since launching in 2019, such as a landscape scan of existing efforts and resources for preparedness financing, and noted its valuable role in the wake of COVID-19 and in support of some of the emerging initiatives in the evolving global health architecture such as the newly established Pandemic Fund.

In his keynote address, Juan Pablo Uribe, World Bank’s Global Director for Health, Nutrition & Population, noted that an estimated $31.1 billion USD needs to be invested annually in pandemic preparedness and response systems. However, in the wake of COVID-19, multiple overlapping crises, and unequal economic recovery, many countries will be unable to make the necessary investments for which approximately $10.5 billion USD will need to come from international financing.

First Assistant Secretary Robin Davies of the Australian Department of Foreign Affairs and Trade facilitated a panel discussion with representatives from the governments of Indonesia, Nigeria and the Philippines who shared their country experiences mobilizing domestic resources for health security.

  • Pak Bonanza Taihitu, Head of Centre for Global Health Policy and Health Technology in Indonesia, opened the panel discussion by highlighting Indonesia’s health sector strategy and associated financing which has outpaced GDP growth over the last decade.
  • Dr. Priscilla Ibekwe, Director of Special Duties & Partnerships in the Nigeria Centre for Disease Control, highlighted how Nigeria used their Joint External Evaluation at the national and subnational levels to identify gaps, justify the need for investments, and demonstrate results from those investments. Dr. Ibekwe also emphasized the importance of accountability and regular and ongoing engagement with the Finance Ministry
  • Dr. Alethea De Guzman, Director of the Epidemiology Bureau, Department of Health of the Philippines, highlighted the role of their National Health Insurance program as part of Philippines’ journey towards Universal Health Coverage.

During the panel discussion, Pak Bonanza stressed that the health sector must do a better job of demonstrating to finance partners what it can do with its limited allocation to health. Under the Indonesian Presidency in 2022, the G20 established the Joint Health and Finance Taskforce which will provide a platform to encourage more strategic interaction between health and finance ministries. Dr. Ibekwe further added that the health sector must engage with finance partners using their language, understanding the fiscal space available, prioritizing what needs to be financed and demonstrating value for money. Dr. De Guzman highlighted the importance of donor coordination and alignment to country needs and how digital transformation supported by development partners has benefited their health financing and improved efficiency of the system. Dr. De Guzman and Dr. Ibekwe both commented of the various roles private sector partners play in terms of mobilizing resources, procurement, and outsourcing services where there is a comparative advantage and improved efficiency such as for technology transfers.

In closing, Mr. Davies noted that the value of the Sustainable Financing Action Package in bringing countries together to share experiences and best practice in health financing, to consider implications for global health policy and practice, and discuss opportunities to plug into new global initiatives such as the Pandemic Fund and the G20 Health and Finance Taskforce.

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