Dr. Gyan Pathak
The 75th World Health Assembly, currently in progress in Geneva, Switzerland, that began on May 22 and will conclude on May 28, 2022, has already made a history by adopting a new financial model for global health, but the key to success lies in good governance across the countries of the world even if we presume the member states would honour their commitments in respect to their contributions, especially when the world knows that annual global corruption loss in health sector is $455 billion a year.
The present decision in the first in-person Health Assembly since the start of the COVID-19 pandemic has special significance, though many may find it ambitious, since the decision to adopt, in full, the recommendations of the Sustainable Financing Working Group made up of WHO's member states will translate into over three times increase in their assessed contribution in WHO's budget from 16 per cent in 2020-21 to 50 per cent by 2028-29 if possible, and by 2030-31 at the latest. In absolute terms, WHO would see an increase of roughly US$600 million a year by 2028-29 in the part of its income that comes from the most sustainable and predictable sources. The gradual increase to assessed contributions is to start from the next WHO's budget for 2024-25 by 20 per cent from the current 16 per cent of the approved 2022-23 base budget.
The total estimated budget increase for the biennium 2022–2023 is US$ 604.4 million, a 13% increase over the earlier budget presented, bringing the total budget for WHO's work for 2022-2023 to US$ 4.968 billion. The previously approved 2020-2021 Programme Budget amounted to US$ 3.769 billion. There is convergence of opinions that increasing the proportion of assessed contributions to cover a greater part of the base budget of WHO's programme budget would create a secure, sustainable financing stream, enabling a greater focus on fulfilling the core aims of the Organization.
To encourage contribution the WHO has already come out with a study that shows economic sense in investing in the organization. The new analysis titled “A healthy return: Investment case for a sustainably financed WHO” has shown that the return for every dollar invested in WHO has a resulting return of at least 35 dollars. The cost of WHO in net present value terms over the coming 10-year period, 2022–2031, is US$ 33 billion and the public value created as a result of this investment, in the most conservative estimation possible, is likely to be between US$ 1.155 trillion and US$ 1.46 trillion, it says.
The new financial model is also significant in the backdrop that the current financing model has been identified by a number of experts as posing a risk to the integrity and independence of its work. Another shortcoming of the present model that has been pointed out time and again was over-reliance on voluntary contributions with a large proportion earmarked for specific areas of work which resulted into ongoing misalignment between organizational priorities and the ability to finance them.
The report of the Working Group, set up in January 2021, chaired by Björn Kümmel, from Germany, has also included other recommendations, such as exploring the feasibility of a replenishment mechanism to broaden the financing base, which clearly indicates that the decision of adoption need follow up action in right earnest, if at all we want to achieve the target.
It is also subject to fulfilment of other conditions by the member states and also by the WHO in terms of governance. The report has asked the WHO Secretariat to work with a Member States task group to strengthen WHO's governance, which is supposed to make further recommendation on transparency, efficiency, accountability and compliance.
The success of the new financial model for the WHO will also be sustainable only if the task group will be able to help, that is supposed to be the case, ensure that increases to Member States' assessed contributions will be accompanied by further reforms to the way the WHO operates.
The disruptive shock of the COVID-19 pandemic has sharpened global awareness of the value of health and the need for investment in it. Investment in the WHO is catalytic by nature, meaning that funds invested in WHO are used to support Member States in taking action on health issues which is done through the three key functions of WHO – leadership, development of technical products and country support. There has never been a more critical moment to invest in WHO, and strengthen the unique role it plays in global health.
The chair of the WHO's Working Group of Sustainable Funding sees this decision even going beyond the future role of the WHO in global health. It is about what we envisage for the global health architecture he says: a less fragmented, better coordinated, more efficient and truly inclusive global health governance with a fundamentally strengthened WHO at its centre as the enabled leading and coordinating authority.
“The decision addresses head-on the decades-long challenge WHO has faced on predictable, flexible and sustainable funding,” says the WHO DG Dr Tedros Adhanom Ghebreyesus. Even though the road ahead may present great challenges, the present decision is certainly a great leap forward. The pandemic has laid bare inequalities and undermined the health related SDG targets which will require further shifting of priorities, apart from the present decision of adopting new financial model. (IPA Service)
