At a time of accelerating change, when the news cycle feels more like a cyclone, a historic meeting this weekend could be overlooked. It shouldn’t be. The health ministers of G20 countries are gathering for the first time – a clear indication of the role of health in global development agenda.
The G20 has identified three pillars of that development agenda: building resilience, improving sustainability and assuming responsibility. While these broad themes can be applied to almost any sector, they are especially relevant to public health and global health security. When universal health coverage was included in the globally agreed Sustainable Development Goals, nations of the world committed to taking responsibility for the health of their citizenry by building resilient, sustainable systems for health.
This is not driven solely by moral outrage over needless, preventable deaths – though when malaria kills one child every two minutes, we could probably do with a bit more outrage.
Nor is it driven solely by fear of emerging new threats such antimicrobial resistance, Zika and Ebola – though with new Ebola cases confirmed within the last week in Democratic Republic of Congo, a healthy dose of fear isn’t a bad thing if it motivates an appropriate response.
Rather, and rightly, the commitment to universal health coverage in the SDGs is driven by the overwhelming evidence that investment in health systems returns economic dividends. The 2013 Lancet Commission on Investing in Health found that in low- and middle-income countries, health improvements drove 24 percent of full income growth between 2000 and 2011.
This inaugural ministerial meeting signals a growing understanding that strong economies are the product of more than fiscal or trade policy. There are many avenues to achieve growth, and investing to end epidemics creates a rising tide that lift all boats. At the most basic level, health financing supports interventions that save individual lives; beyond this, it builds stronger systems that forestall myriad potential health crises. Robust systems for health are the sentinels that guard against regional or global outbreaks.
We saw this in practice during the 2014 Ebola outbreak in West Africa: countries with strong systems like Nigeria, Senegal and Mali quickly contained the outbreak, while those without – such as Sierra Leone, Liberia and Guinea – were overcome.
A well-timed study released this week from the U.S. National Academies of Sciences, Engineering, and Medicine is unequivocal in its findings and recommendations, stating that while “foreign assistance is often considered a type of charity … when directed toward health [it] is an investment in the health of the recipient country, as well as that of the United States and the world at large.” Emphasis on investment is the authors’. The study makes an explicit link between protecting against global health threats and promoting productivity and economic growth.
South Africa, a G20 member, is Africa’s second-largest economy and is a leader in domestic financing for health. This investment in health supports the world’s largest antiretroviral program, allowing more than 3 million people with HIV to live full, productive lives. The country and the continent still face numerous challenges when it comes to responding to diseases, but today Africa is mobilizing more domestic resources for health than foreign investment in the sector. This is what “building resilience, improving sustainability and assuming responsibility” looks like in action.
When they work, the everyday, lifesaving benefits of resilient and sustainable systems for health can be taken for granted – outbreaks make headlines. The Global Fund works in partnership to reduce the likelihood of those preventable tragedies by building stronger supply chains, improving surveillance for rapid responses and sharing data across borders.
This historic meeting of G20 health ministers is an important affirmation that diseases and the people they threaten are part of a bigger picture. They exist within a health system that either provides a springboard to well-being and economic prosperity or fuels the cycle of poverty and insecurity by limiting opportunities for education and employment. The Global Fund is working to build the former, using innovative public-private partnerships that are defining social and economic development in the 21st century.
Human history tells us that we are vulnerable to disease. There is nothing in our biology we can change to alter that fact. But the degree to which that vulnerability can cause catastrophic loss of life and social upheaval is in our power to influence. We can immunize children, prevent malaria, and cure tuberculosis. We can help empower people to stay free of HIV. We can build systems that provide prevention and care, and – when necessary – respond swiftly to crises that threaten our global health security. We can invest in research and technology that allows us to stay ahead of drug resistance. These are the hallmarks of universal health care, and this is the foundation for sustainable development.
Marijke Wijnroks will become Interim Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria on 1 June.