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Partners Launch Equitable Access Initiative Report

12 December 2016

GENEVA - A group of leading organizations today launched the Equitable Access Initiative report , a new policy framework designed to better inform decision making on health and development. The new guidance takes into account countries' needs and capacities in a changing landscape affected by economic growth, rising inequality and shifts in burdens of disease.

The partners of the Equitable Access Initiative include the World Health Organization, the World Bank, Gavi, The Vaccine Alliance, UNAIDS, UNICEF, UNDP, UNFPA, UNITAID and the Global Fund, with support from the Bill & Melinda Gates Foundation and the Wellcome Trust.

The report, announced today to mark Universal Health Coverage Day, is the result of an extensive consultation process by governments, technical partners, civil society and the private sector, and is based on models proposed by four leading academic groups: the University of Oxford, the Norwegian Institute of Public Health, the University of Sheffield-Imperial College and the Institute of Health Metrics.

"The health and development nexus has greatly changed and increased in complexity in the last decades," said Pascal Lamy, the former Director General of the World Trade Organization who co-chaired the initial meeting on the Equitable Access Initiative in February 2015.

"The Sustainable Development Goals call on all partners to adapt their thinking and their investments to the new landscape, and to come up with frameworks that better reflect countries' needs. Successfully addressing these changes will be critical to better succeed in fighting against infectious diseases," Lamy said.

For decades, international development and financing institutions have used Gross National Income (GNI) as the economic yardstick to assess eligibility, allocation and co-financing policies of countries for development assistance.

However, there is common agreement among partners that policies based on income overlook vital dimensions of health and social development, such as poverty, inequality and the needs of key and vulnerable populations, particularly as the largest share of disease burden is today concentrated in middle-income countries that are also home to most of the world's poor.

The report provides a big picture view of the changing health and development landscape, and offers a more comprehensive and nuanced framework than the traditional country classification by income. It identifies areas that will be critical to achieving better health outcomes, such as domestic financing and health needs of key and vulnerable populations.

The report concludes that policymaking should not rely on a single variable to inform complex health financing policies on the eligibility for and the prioritization of investments. GNI per capita as an indicator is not designed to measure or capture health needs or government's capacity to invest in health, it said. Health financing policies should be informed by a more comprehensive framework, based on the analysis of countries' needs, domestic capacity and policies.

The report also highlights that external financers need to develop policies that favor improved health outcomes and focus on increased domestic financing for health, which are essential for achieving all of the Sustainable Development Goals.

The Equitable Access Initiative Report also recognizes the responsibility of external financers, countries, and partners to work together to plan smooth, gradual transitions from external financing that enable not only the preservation of the health gains of the past, but the acceleration of progress.