Global Responsibilities for Global Health Rights Towards a Global Health Fund

From idea to reality

To this day 2,5 billion people in the world do not have access to basic health care. The Millennium Objectives in relation to health care will not be achieved by 2015. Hélène De Beir Foundation staff  has recently conducted scientific research which indicates that, according to the most current development models,  people living in the poorest countries of the world will not even have access to basic health care 30 to 40 years from now. This is unacceptable.

On the basis of an extensive working paper, which included the main findings of the research, the Foundation organized the International Global Responsibilities for Global Health Rights Conference in Brussels from 19 to 21 October  2009. More than 80 international experts and fieldworkers in world health care worked towards new solutions to this unacceptable reality. The Conference has encouraged the Foundation in its endeavor to stimulate the elaboration of feasible solutions that can give the poorest people in the world quicker access to basic health care.

The present developing-aid objectives which aim at national financial independence for health care are doomed to fail.

According to the WHO 40 USD per person per year is needed for basic health care. This is an unrealistic amount for low income countries. Dr. Gorik Ooms, former director of Médecins Sans Frontières and administrator of the Hélène De Beir Foundation – also associated with London School of Hygiene & Tropical Medicine, has published accurate figures on the subject for dozens of developing countries.

Even if the developing countries keep up their promise (Abuja Declaration) to spend 15% of their GDP to health care, they will still fall short of the funds needed. Furthermore the IMF has warned developing countries that they should not count too much on international aid because it is uncertain. Therefore many developing countries keep investing in infrastructure instead of in personnel and training  which constitute recurrent costs. The result of all this is that the existing and especially the new infrastructure cannot function due to the lack of personnel.

A shift in thinking about world health care is unavoidable: new funds in adjusted structures: the objective of a Global Health Fund.

The OECD countries have promised to spend 0.7% of their GDP on international solidarity. In order to provide everyone with health care only 0.1% of this promise is needed. By 2015 this would be 50 billion USD (33.5 billion euro). Combined with a realistic 50 billion USD on behalf of the developing countries, this results in 100 billion USD (67 billion euro) or 40 USD per person per year. This is feasible and realistic.

It is not recommended to establish new management structures within the global community. Recently established world health care structures such as the Global Fund for the prevention of aids, malaria and tuberculosis, prove that it is possible to collect substantial funds, while at the same time keeping an eye on reducing the risk of corruption and bad management. On the basis of scientific research, the Hélène De Beir Foundation proposes to extent the Global Fund mandate to a Global Health Fund.

At the moment volunteer based aid is the strongest motivation in the approach of developing aid but this proves to be really problematic in the field of health care. All experts agree on abandoning the idea that aid between countries should only be temporary and based on charity, and they argue that the idea of making health care the responsibility of the whole world should be accepted. A Global Health Fund is also compatible with different health systems, if at all they exist in certain developing countries. In countries which support a NHS system, a Global Health Fund could for example carry 90% of the costs if families are unable to contribute more than 4 USD of the 40 USD needed for basic health care. This approach would also prevent that people who can only afford a small contribution, should only receive limited benefits, which in turn makes the NHS system unattractive, or that they are completely cut off from health care in case they cannot afford to make a contribution.

Many developing countries use the so-called ”Beveridge” model: access to health care in exchange for tax payments. A basic condition for this system is that the government can generate sufficient funds of its own, which according to the findings of the Foundation will not be the case for many developing countries, not even 30 years from now. A Global Health Fund can support both systems, dependent on the choice of each developing country, in order to guarantee that each individual gains minimum access to basic health care and this within a reasonable period of time. The impact on, among other things, migration flows, overpopulation and related issues such as food safety and famine, and terrorism can hardly be underestimated.

The Hélène De Beir Foundation is supporting the resolution for the creation of a global health fund, accepted by the Belgian Senate on the basis of a proposal of Dr. Marleen Temmerman, member of the Belgian Senate. The resolution is currently under discussion in the First Chamber of Belgian Parliament.