Financing Common Goods For Health

Common Goods for Health (CGH) are the core population-based functions or interventions that are essential to the health and well-being of entire societies. They necessitate public financing and public action as they are public goods or have large social externalities, and thus will not arise through market forces alone. The objectives of this guidance document are to clearly define CGH, to discuss CGH’s connections with other critical health agendas to build more responsive and resilient health systems, and to address financing issues associated with CGH at national, sub-national, and community levels. This document establishes a nomenclature that delineates relevant CGH categories, sub-categories, and functions, which can aid in policy discussions, budget dialogues (including prioritization processes in countries), and health expenditure tracking processes as means of monitoring and accountability. The document is intended to be used primarily by national and sub-national finance and health authorities, as well as by other government entities, global and regional organizations, civil society, and academic institution.

For humanitarian reasons and the concern for households' economic and health security, the health sector is at the center of global development policy. Developing countries and the international community are scaling up health systems to meet the Millennium Development Goals (MDGs) and are improving financial protection by securing long-term support for these gains. Yet money alone cannot buy health gains or prevent impoverishment due to catastrophic medical bills; well structured, results-based financing reforms are needed. Unfortunately, global evidence of successful health financing policies that can guide the reform effort is very limited and therefore the policy debate is often driven by ideological, one-size-fits-all solutions. Good Practices in Health Financing: Lessons from Reforms in Low- and Middle-Income Countries' attempts to begin to fill the void by systematically assessing health financing reforms in nine low- and middle-income countries that have managed to expand their health financing systems to both improve health status and protect against catastrophic medical expenses. The participating countries are: Chile, Colombia, Costa Rica, Estonia, the Kyrgyz Republic, Sri Lanka, Thailand, Tunisia, and Vietnam. The study seeks to identify common enabling factors of their good performance. While the findings for each country are important, collectively they send a clear message to the global community that more attention is needed to define good practice and then to evaluate and disseminate the global evidence base.

The global movement toward universal health coverage (UHC) is accompanied by requests for large increases in government health spending in some countries. This combined with the global economic situation and stagnant economic growth across many low- and middle-income countries make it more critical than ever to place health financing discussions firmly in the context of macroeconomic and fiscal realities. Unfortunately, there is often a disconnect in decision making, with key fiscal decisions made in the absence of a clear understanding on the one hand of the potential consequences for the health sector, and on the other, the consequences for the country’s macroeconomic and fiscal position of increasing or reallocating government spending. Constructive health financing policy dialogue aims to reach a common understanding between health sector leaders and central budget authorities about policy objectives for the health sector and the resources needed to achieve those objectives, how much priority will be given to health in the government budget, and how the health sector will be held accountable for using funds effectively. This common understanding should be built on a realistic picture of the country’s macroeconomic and fiscal context, the constraints and competing priorities in the budget-setting process. When ministries of health and ministries of finance have a common understanding of macroeconomic and fiscal constraints, discussions can focus productively on using funds within the potential health resource envelope in the most effective way to achieve health system objectives. This guidance note outlines the key components of the macroeconomic, fiscal, and public financial management context that need to be considered for an informed health financing discussion at the country level. The guidance note is organized around four sets of questions that are key to placing the health financing dialogue in the context of a country’s macroeconomic and fiscal context. Each section points to measures, resources, and analytical tools that are available to assist in answering these questions for a specific country. The guidance note draws on case studies from 11 countries moving toward or sustaining universal health coverage conducted as part of the Japan†“World Bank Partnership Program on UHC as well as from other country examples.

There is a growing awareness of cross-border issues in health that require new policy responses and financing mechanisms. This expanding importance of health as an international issue, and the growth in attention given to health by non-health sector bodies, has brought to prominence the concept of Global Public Goods (GPGs) as applied to health: 'goods' that are in the interest of the world as a whole, but where 'public good' attributes (non excludability and non rivalry in consumption) mean that there is a lack of incentive to produce these goods. The book addresses the growing globalism of health from the unique perspective of the economic concept of public goods. This concept identifies where a 'good' or service, such as knowledge of an infectious disease outbreak which would be of benefit globally, will not be produced if left to 'the market' because of a lack of incentive due principally to not being able to exlude people from using the good. in this case the producer, of the information on disease outbreak for example, cannot charge a price and therefore cannot recoup production expenses. Nationally, the production of these goods is usually assured by government intervention, but at the global level there is no 'global government' to undertake this role. The Global Public Good concept therefore extends the economic analysis of public goods to this international level. In this book we consider specifically the aspects of health that may be classed as Global Public Goods and considers how the concept helps to ensure their provision.

Srinath Reddy, Yasmine Rouai, Jeffrey L. Sturchio, Cicely Thomas, Tana Wuliji, Snow Yang, Pascal Zurn

While much progress has been made on achieving the Millenium Development Goals over the last decade, the number and complexity of global health challenges has persisted. Growing forces for globalization have increased the interconnectedness of the world and our interdependency on other countries, economies, and cultures. Monumental growth in international travel and trade have brought improved access to goods and services for many, but also carry ongoing and ever-present threats of zoonotic spillover and infectious disease outbreaks that threaten all. Global Health and the Future Role of the United States identifies global health priorities in light of current and emerging world threats. This report assesses the current global health landscape and how challenges, actions, and players have evolved over the last decade across a wide range of issues, and provides recommendations on how to increase responsiveness, coordination, and efficiency â€" both within the U.S. government and across the global health field.

Increasingly, the consequences of globalization call for the involvement not only of national governments but of the international development community as a whole. Such involvement needs to occur within a comprehensive framework that encompasses stakeholders from government, non-governmental organizations, and businesses acting together in partnership. This requires the leveraging of general aid and country-focused development resources along with encouraging private financing participation. 'International Public Goods' explains different ways that this type of framework might be structured and focuses on different financing strategies that can be developed. It acknowledges the value of country specific efforts while recommending a multi-national approach to addressing problems resulting from globalization. This book evaluates the concepts fundamental to the term ?public goods? and details alternative governance structures including the role of incentives.

What are public health services? Countries across Europe understand what they are or what they should include differently. This study describes the experiences of nine countries detailing the ways they have opted to organize and finance public health services and train and employ their public health workforce. It covers England France Germany Italy the Netherlands Slovenia Sweden Poland and the Republic of Moldova and aims to give insights into current practice that will support decision-makers in their efforts to strengthen public health capacities and services. Each country chapter captures the historical background of public health services and the context in which they operate; sets out the main organizational structures; assesses the sources of public health financing and how it is allocated; explains the training and employment of the public health workforce; and analyses existing frameworks for quality and performance assessment. The study reveals a wide range of experience and variation across Europe and clearly illustrates two fundamentally different approaches to public health services: integration with curative health services (as in Slovenia or Sweden) or organization and provision through a separate parallel structure (Republic of Moldova). The case studies explore the context that explain this divergence and its implications. This study is the result of close collaboration between the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe Division of Health Systems and Public Health. It accompanies two other Observatory publications Organization and financing of public health services in Europe and The role of public health organizations in addressing public health problems in Europe: the case of obesity alcohol and antimicrobial resistance (both forthcoming).