Returns on health investments

Returns on health investments

Amid global political and economic turmoil, failure to invest in bolstering and bettering our health systems will be costly – both financially and in terms of health and well-being – in the long run

The past three years have been a watershed moment in our collective European and global community. The seismic shocks brought about by the Covid-19 pandemic have shaken the foundations of our health systems, leaving us with one clear lesson: if we fail to invest in preparing our health systems, we will pay in the long run.

The pandemic has taught us that countries that had invested in preparedness and showed strong leadership and flexibility in reacting to the first Covid-19 waves were also able to come up with a comprehensive response to address the spread of infection, and could count on the trust of their populations. Those that did not were more likely to go into crisis mode, fearful that their health systems would be overrun and their societies would collapse.

Investing in health systems is like an insurance policy: countries can take a risk by not paying the premiums, but in these uncertain times they are taking a gamble with the lives and well-being of their populations.

The risks are even higher if we consider that the current spotlight
on health is not necessarily a constant. With new security, political and energy challenges emerging, political leaders in countries may be tempted to shift both capital and commitment away from health and towards other sectors.

But this is not the time to disinvest in health – especially since health and the economy are inextricably linked.

Investing in health means investing in the economy

Last year, the Pan-European Commission on Health and Sustainable Development called for necessary investments to allow countries to build more resilient health systems, while preparing for future crises that pose a severe threat to health and the economy.

The World Health Organization estimates that the initial Covid-19 shock was worse than that of the 2008 global financial crisis. All country income groups in Europe experienced a deeper fall in gross domestic product in 2020 compared to 2009, although the difference between the two periods is particularly marked in middle-income countries.

There is evidence that investing in health and health systems is clearly beneficial for achieving economic objectives. A healthy population is a precondition for sustainable development and a strong macroeconomy. At the same time, a strong economy is necessary to generate sufficient resources for health systems.

In the current global situation, marked by security and economic challenges, high energy costs and labour shortages, many finance ministers face difficult choices as they seek to balance their books while meeting other calls on their budgets, including defence. This makes it all the more important to protect and, where possible, to increase health budgets to safeguard populations and ensure that health systems are resilient to inevitable future challenges.

A driver of economic growth

We know that healthier populations are happier and more productive ones. This is especially important in advanced economies, where ageing populations and falling birth rates mean that more and more working-age people are supporting pensions through taxes on their wages.

We also know that health care has expanded to include prevention measures and the management of long-term chronic conditions, also thanks to people’s longer life expectancy.

But this is not all. Health is now a key component of the economy, in several ways. One is through the rewards of scientific innovation, recognised by those countries that have adopted ambitious life science strategies. Another is through the benefits that health facilities bring to their local economies, by creating employment opportunities – especially for women – and as local suppliers of goods and services.

The road ahead

We must invest now if we are to prepare our health systems for future crises. This is especially the case if we look at some of the areas that have usually attracted fewer resources, such as primary health care and mental health. Investing in health also means investing in health workers – in their training, education, career paths and leadership.

Today – and in hindsight – we know that if countries had invested more in preparedness, the pandemic would have left less pain and suffering in its wake. But this requires a new way of thinking, based on One Health.

One Health means looking at the relationships between the health of humans, animals and the environment as one interconnected system. Wealthy and poorer countries will need to work together to pool resources and development assistance towards research, procuring vaccines and medicines and to tackle rising antimicrobial resistance.

Most importantly, both high- and low-income countries need to pool resources to make good on their promises to invest in health systems – with investment in their health workers as key. Only with motivated, cared for and well-resourced health workers can we create truly resilient health systems.

Governments have the power to make choices today that will decide the future of generations to come. We know what it takes. The time to act is now.