Funding the Millennium Development Goals: Exploring Innovative Finance Amidst the Recession

| April 14, 2012 | 0 Comments

UN Photo Courtesy of Mark Garten

The bursting of the U.S. housing bubble in 2007 sent the global economy into a decline, eliciting budget cuts in public spending and significant decreases in voluntary contributions, particularly in the field of health.

Although spending to improve health in the developing world has increased throughout the recession, the growth rate for this spending has leveled off. As countries like the United States reduce their health aid overseas, other organizations and must work harder to fight the economic effects of the financial crisis [1].

While it is favorable that worldwide health spending has not declined during these difficult years, the recession has hindered the progress of optimistic visions for a universal standard of health care. In 2000, all 193 member states of the UN signed on to the Millennium Development Goals  (MDGs) –  a set of eight bold objectives to improve social and economic conditions around the globe by 2015 [2]. Yet, as that date draws nearer, the likelihood of completing these goals seems slimmer than ever.

In terms of major health outcomes, the MDGs aspire to reduce child mortality, stem malnutrition, improve maternal health, reverse the spread of HIV/AIDS, and provide universal access to essential drugs [2] To achieve these goals by 2015, analysts estimate that health spending in poor countries must increase from approximately $31 billion to $67-76 billion [3]. But considering the current economic climate, where will all this money come from? In 2008, the International Health Partnership, an alliance of various health stakeholders, created the Taskforce on Innovative International Financing for Health Systems to ponder this very question [4].

Chaired by UK Prime Minister Gordon Brown and World Bank President Robert Zoellick, the taskforce issues financial recommendations that reflect a dual commitment to raise money for health systems and use this money effectively for measurable results [3]. Following its report in May 2009, the taskforce pledged to raise $5.3 billion through innovative measures such as mandatory taxes on consumer goods, frontloaded investments in healthcare, and results-based funding.  Examples include UNITAID’s $1 to $40 tax on airline tickets for passengers departing from participating countries, and the Global Fund’s Debt2Health initiative, in which countries are relieved of their debts in return for investing a specific amount of money to strengthen their health systems [6],[7],[8].

Yet, while the recommendations of the Taskforce seem relatively uncontroversial, critics highlight issues of accountability since the Taskforce takes no explicit action itself. Major critiques emphasize that the cost estimates are too optimistic, the tax schemes are burdensome and ineffective, and more importantly that there is no framework for how countries can increase their individual public budgets for health [9].  Beyond disparaging the taskforce’s recommendations, some question the need for a committee that essentially provides a stamp of approval on existing initiatives [10].

However, the Taskforce’s recommendations should be seen merely for what they are: suggestions for tackling ambitious health issues during the worst economic downturn in years. These nine recommendations do not offer every possible innovative finance measure, nor do they detail every cost-effective strategy.  Considering the financial complexities of global health, this would be nearly impossible. Instead the taskforce offers a streamlined set of guidelines to the private and public sectors alike. With 2015 only three years away and a looming financial need of at least $30-40 billion for health spending, creative collaboration among the world’s leading experts in the field of health, finance, and development can only help.

[1] Brown, David. “Global Health Aid Continues to Grow — but More Slowly — during Recession.” Washington Post. The Washington Post, 14 Dec. 2011. Web. 21 Feb. 2012. <–but-more-slowly–during-recession/2011/12/14/gIQALdjquO_story.html>.

[2] “End Poverty 2015 | We Are the Generation That Can End Poverty.” End Poverty 2015. Web. 18 Feb. 2012. <>.

[3] Taskforce on Innovative International Financing For Health Systems. “More Money for Health and More Health for the Money.” Taskforce on Innovative International Financing For Health Systems, 2009.. Web. 17 Feb. 2012. <>.

[4] “International Health Partnership (IHP ).” WHO. World Health Organization, 2012. Web. 21 Feb. 2012. <>

[5] “Leaders Commit New Finance to Tackle Women’s and Children’s Health in the Developing World.” THE TASKFORCE : IHP The International Health Partnership. 23 Sept. 2009. Web. 21 Feb. 2012. <>.

[6] Douste-Blazy, Philippe. “WHO Expert Working Group on R&D* Financing.” Lecture. Switzerland, Geneva. 13 Jan. 2009. Web. 18 Feb. 2012. <>.

[7] “How Innovative Financing Works.” UNITAID. World Health Organization. Web. 18 Feb. 2012. <>.

[8]“Debt2Health – The Global Fund to Fight AIDS, Tuberculosis and Malaria.” The Global Fund to Fight AIDS, Tuberculosis and Malaria. Web. 20 Feb. 2012. <>.

[9] McCoy, David. “The High Level Taskforce on Innovative International Financing for Health Systems.” Health and Policy Planning. Oxford Journals, 24 July 2009. Web. 13 Apr. 2012. <>.

[10] Fryatt, Robert, and Anne Mills. “Taskforce on Innovative International Financing for Health Systems: Showing the Way Forward.” NCBI. Bull World Health Organ, 1 June 2010. Web. 21 Feb. 2012. <>.

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