Health financing revisited
2006
Pablo Gottret, George Schieber
The World Bank
Health is now widely recognized as a basic human right, and the urgency of some global health issues has pushed global health policy to the top of the international agenda. With globalization comes the flow of ideas, capital, and people across borders, which has profound implications for the spread and treatment of disease. The epidemics of HIV/AIDS and SARS, the potential impact of avian flu, and the international public goods dimensions of public health make global health policy both a national security issue and a foreign policy issue.
Furthermore, it has become clear that the Millennium Development Goals cannot be achieved without massive infusions of new overseas development assistance, much of it targeted to health.
These issues have produced new global health policy dynamics among multilateral and bilateral donors, the new financiers (such as the Bill and Melinda Gates Foundation), the new global programs (such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria), and recipient countries. Multilateral and bilateral institutions and foundations, nongovernmental organizations (NGOs), and joint donor initiatives are helping countries to finance, rationalize, and operationalize health reforms.
The international community must live up to its promise to scale up development assistance and make it predictable and sustainable. Nevertheless, it is
ultimately the developing countries that must face the challenges of organizing their institutions and health financing systems to provide sufficient
financial resources, ensure equitable access to effective health interventions, and protect their people against health and income shocks. These reforms
must be based on social and macroeconomic realities and especially on good governance.
Keywords: health financing
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