Macroeconomics and Health (CMH)

The Ten Recommendations

The recommendations of the Report are summarised into an agenda for action, providing the conceptual framework for review and open debate. Each country is invited to assess and analyse the CMH recommendations and to adapt them to their own socio-economic situation.

The main recommendations of the CMH Report are:

  • Developing countries should begin to map out a path to universal access for essential health services based on epidemiological evidence and the health priorities of the poor. They should also aim to raise domestic budgetary spending on health by an additional 1% of their GNP by 2007, rising to 2% in 2015, and use resources more efficiently.
  • Developing countries could establish a National Commission on Macroeconomics and Health or similar mechanism to help identify health priorities and the financing mechanisms, consistent with the national macroeconomic framework, to reach the poor with cost-effective health interventions.
  • Donor countries would begin to mobilize annual financial commitments to reach the international recommended standard of 0.7% of OECD countries' GNP, in order to help finance the scaling up of essential interventions and increased investment in health research and development and other "global public goods".
  • The WHO and the World Bank would be charged with coordinating the massive, multi-year scaling up of donor assistance for health and with monitoring donor commitments and funding.
  • The WTO member governments should ensure adequate safeguards for developing countries, in particular the right of countries that do not produce the relevant pharmaceutical products to invoke compulsory licensing for imports from third-country generic suppliers.
  • The International Community and agencies such as WHO and the World Bank, should strengthen their operations. The Global Fund to Fight AIDS, TB, and malaria (GFATM) should have adequate funding to support the process of scaling up actions against HIV/AIDS, TB and malaria. A Global Health Research Fund (GHRF) is proposed.
  • The supply of global public goods should be bolstered through additional financing of agencies such as WHO and the World Bank.
  • Private-sector incentives for drug development to combat diseases of the poor must be supported. The GFATM and purchasing entities should establish pre-commitments to purchase new targeted products (such as vaccines for HIV/AIDS, malaria, and TB) as a market-based incentive.
  • The international pharmaceutical industry, in cooperation with WHO and low-income countries, should ensure that people in low-income countries have access to essential medicines. This should be achieved through commitments to provide essential medicines at the lowest viable commercial price in poor countries and to license the production of essential medicines to generic producers.
  • The IMF and the World Bank should work with recipient countries to incorporate the scaling up of health and other poverty reduction programmes into a viable macroeconomics framework.