The Health Impact Investment Platform is designed to accelerate progress towards the Sustainable Development Goals and achieve universal health coverage this decade – but to be successful it requires input from all corners
There is no doubt that the Covid-19 pandemic was a cruel wake-up call for all of us about the importance of investing in strong health systems that can deliver integrated health services through a primary healthcare model of care rooted in equity and solidarity.
Although overall health spending skyrocketed during that public health emergency, there are still challenges for many countries to ensure that the appropriate financing is channelled through their primary healthcare systems, which can help build their resilience.
Increased government spending driven by the pandemic response took global health spending in 2020 to a record $9 trillion, nearly 11% of the global gross domestic product, with 63% coming from the public sector.
The World Health Organization estimates that improving pandemic preparedness and working towards a safer future for all will require an additional investment of approximately $31.1 billion every year across the world, with approximately one-third required from international financing.
The cost of development
However, development often comes at the price of public debt. And for some, more than others. A World of Debt, the recent report from the United Nations Conference on Trade and Development, found that African countries pay eight times the borrowing costs of the wealthiest European economies. Their interest payments alone eat up any investment they could make on education or health. This is where multilateral development banks can make a difference. They can provide concessional financing (below market rate) that is accessible to low- and middle-income countries. But they need to do more, and they need to do better. To be more efficient in addressing global challenges such as health and climate change, multilateral development banks should build on complementarity, join forces and work towards common goals. This would increase the impact of their contribution to the Sustainable Development Goals. The alignment of strategies and coordination among the various MDBs are key success factors to achieve these ambitious goals.
In June 2023, during the New Global Financing Pact Summit in Paris, four MDBs and the WHO did exactly that: they launched the new Health Impact Investment Platform. It aims to pool public and international debt and grant funding from MDBs that will de-risk and encourage further investments at country levels. Relying on WHO expertise to shape and guide these investments, the European Investment Bank, African Development Bank, Islamic Development Bank and the Inter-American Development Bank joined forces to invest in and strengthen essential, climate-resilient and crisis-resilient primary healthcare services in low- and middle-income countries.
The WHO will serve as a system catalyst to drive new investments in primary health care. In line with national priorities, health policies and plans, it will identify health needs and gaps in partner countries. Based on this, the WHO will help governments design sound investment plans, bring in capital providers, support accountability and monitor delivery. The EIB and other MDBs will provide long-term and concessional financing, thereby catalysing local, international, public and private investments to get projects off the ground.
The aim of the platform is to mobilise at least €1.5 billion in concessional loans, investments, grants and technical assistance in support of reaching universal health coverage, included in SDG 3, during this decade.
The funding provided by the platform comes on top of existing financing. It follows a holistic approach to primary health care, ensuring that investments contribute to universal health coverage, health security, and better health and well-being. The focus will be on delivering integrated health services, enabled by strong community engagement and multisectoral action in partner countries.
The platform is inspired by an earlier partnership between the WHO and the EIB, during which the institutions worked jointly with the European Commission to support primary healthcare investments in Africa, the Middle East and South Asia. In Rwanda and Angola, the partnership backed the implementation of EIB-financed Covid-19 projects. In Ethiopia and Palestine, the WHO is guiding and shaping the needed investments for primary health care in line with national strategies.
In addition to providing financing for countries, the platform will do much more than this: it breaks the silos, it puts countries in the leading role, and it mobilises key partners to act on the most urgent and critical needs, aiming for the greatest impact and synergies.
We are grateful that other partners decided to join to the benefit of an increasing number of countries, making a strategic political choice, because only together can we make a difference.
The ambition is big, and we want to do more.
We need all hands on deck – all stakeholders committed to a safer, healthier and sustainable future for all.
If there is one thing the Covid-19 pandemic taught us, it is that health systems are strongest when they are able to deliver integrated services. And we learned that global health spending might have skyrocketed, but it did little to build pandemic preparedness and resilience in the countries of the Global South. It is not just a moral imperative for us to address this situation. It is also the only way forward in an interconnected world.
With the additional catalytic and coordinated investments through the new platform, we are confident that we can help advance the sustainable development goal of health for all and access to universal health coverage.
This is a small but important step towards a fair and equitable distribution of funds. We can take a bigger step by mobilising more grants and developing highly concessional financing, as this will put countries in a better condition to invest in their health systems. But we cannot do this alone. We are therefore calling on multilateral, bilateral and philanthropic partners for this mission. We need all of us to build a safer, healthier and sustainable future for everyone, no matter where they are in the world.