Increasing Investments in Health Outcomes for the Poor
Second Consultation on Global and National Responses on Macroeconomics and Health
Geneva, 28 – 30 October 2003
There is growing international acceptance that effective investments in health are vital to poverty reduction and to human and economic development. Health is receiving increased attention within poverty reduction strategies. Sector-wide approaches for health focus increasingly on health outcomes. New outcome-oriented and results-based funding mechanisms (such as the Global Alliance for Vaccines and Immunization and the Global Fund to fight AIDS, Tuberculosis and Malaria) have been set up, drawing on alliances for health such as Stop TB and Roll Back Malaria. This outcome orientation is being taken forward under the overall umbrella of the Millennium Development Goals, with their central focus on poverty reduction. The Millennium Campaign, which applies macroeconomic analysis to the achievement of all the MDGs and is well embarked on local and international advocacy for a scaled-up response, will ensure continued visibility of these issues.
The World Health Assembly 2002 Resolution on Health and Sustainable Development (WHA55.11) "noted with concern that, despite much social and economic progress, health continues to be severely compromised in many countries by inadequacies in the implementation of required measures in all areas of sustainable development". In order to follow up on the Report of the Commission on Macroeconomics and Health and to identify future directions and define WHO's role in the process, a first Consultation was convened in Geneva in June 2002. Ministers and senior representatives from the ministries of health, finance and planning from 20 countries came together with representatives from the World Bank, a dozen bilateral agencies, the Bill and Melinda Gates Foundation and senior WHO staff. They discussed how to translate these principles into concrete actions at country level.
Status of activities
Some 40 countries are currently working to substantially scale up investments in health. Several of them are already at an advanced stage of planning and analysis. WHO is helping catalysing the national level processes, offers knowledge and expertise through experienced staff, and contributes financially to promote the involvement of national and international expertise. WHO country teams work in alliance with interested development and civil society groups.
Building a consensus around increased health investments also involves the establishment of tracking systems. The national process for scaling up investments provides an opportunity for countries to establish their own options and identify the research, technical guidance, alliances, management processes and tracking mechanisms that are needed. A number of global initiatives can be involved in supporting these needs, such as the multi-partner health metrics programme and the post-Ottawa High-level Forum, both focusing on accelerating the achievement of health-related MDGs.
The Consultation aims to keep the political momentum and strengthen commitment of interested countries and current and potential aid agencies to investing in health services and health systems for poverty reduction and economic development. It is envisaged that the Consultation will bring together the ministers of health, finance and planning from around 30 developing countries and senior representatives of a number of development agencies. The Consultation will encourage participants to strengthen common action for appropriate integration of health investments in poverty reduction and development cooperation mechanisms, in line with, and contributing to, the achievement of the Millennium Development Goals. The progress made at country level will be the focus of the event, and the meeting will be organized around a series of presentations of country experiences and plans.
In summary, the Consultation will offer an important opportunity to:
- share and disseminate experiences, based on presentations and discussion on the key policy issues and progress countries are making;
- strengthen inter-linkages and favour joint planning among initiatives which have similar partners and goals;
- network with decision makers and analysts most committed to and experienced in health investments for poverty reduction and economic development.
Focus and structure
The Consultation will pay special attention to the following themes, which have proven to be of primary interest to countries involved in macroeconomics and health activities:
- How to improve effectiveness of health delivery systems and monitor outcomes for management;
- How to integrate health more strongly into the country macroeconomic framework and increase internal allocation of resources to health;
- How to strengthen predictability of external funding and coordination between donors.
Country experiences will be the focus of the event, which is structured around:
- Opening and official reception (28th October, evening);
- Panel discussions of key themes and country and regional experiences (29th and 30th October);
- Adoption of recommendations for follow-up (30th October).
It is expected that at the end of the Consultation:
- Finance and planning ministers of CMH hosting countries will have an increased commitment to the macroeconomics and health principles, and that they will be equipped to make with the health ministers the strategic choices, inter alia in terms of targets, financing options and human resources, which are necessary to better direct, and increase, investments in health for poverty reduction and economic development.
- A set of recommendations and proposed follow-up actions addressed to developing governments, developed countries, international organizations and multilateral institutions will be agreed upon and guide future WHO's and other partners' activities on macroeconomics and health.
Some 150 participants are expected to attend. These will include Ministers of Health, Finance and Planning from around 30 MHS interested governments; several donor agencies and foundations; WHO offices in headquarters, regions and countries; regional UN commissions, IMF, WB and regional development banks, other international organizations, representatives of civil society and private sector, media, universities and research institutions. (27/08/03)