Article

An Investment the World Can’t Afford Not to Make

President Kaboré, Burkina Faso, and Prime Minister Solberg, Norway

Every year, more than 5 million women, children and adolescents die from preventable causes – that’s equivalent to the entire population of Norway, or more than a quarter of the population of Burkina Faso. Too many women, children and adolescents are still being left behind, their health and nutrition persistently underfunded and not sufficiently prioritized. For too long theirs have been the forgotten voices in international development.

Areas like primary care, maternal services, neo-natal health and family planning suffer from chronic under-funding – despite the huge returns on investment these create over the long-term. At the same time, the structural changes required to make health systems work for women and children are often slow and difficult for governments to implement, and suffer from uncoordinated donor funding efforts.

If we are going to do something about this daily, global outrage affecting women and children, especially girls, then the world must put the health, education, and equality of women at the centre of development. And the local communities who will implement these programmes, and the developing countries that ultimately need to sustainably fund them, need to be in the driving seat.  

A decisive moment

We are at decisive moment in global health and development. On the one hand, this is a time of significant risk. As the populations of many of the world’s low and middle-income countries continue to grow, the number of people who rely on the health systems will increase. A failure to invest enough in health today could magnify these problems for decades to come and undermine the potential for economic growth.

But we also have an historic opportunity. By transforming health in the next 12 years and reaching the Sustainable Development Goals – particularly by focusing on investments in the health and nutrition of women, children and adolescents – we can ensure that the benefits are locked in for future generations. We can create a virtuous, sustainable circle: healthy populations leads to higher economic growth and prosperity, which in turn means that more can be invested in improving health.     

This opportunity to transform lives is not a foregone conclusion. Capitalizing on it means closing a significant gap in health funding.

Established in 2015 by the World Bank, United Nations, and the governments of Canada and Norway, the Global Financing Facility (GFF) in support of Every Woman, Every Child is working with governments, development partners and the private sector to do just that.

The starting point is a plan written by the people on the ground. Under government leadership, civil servants, health professionals, private sector, NGOs and development partners work with the GFF to prioritise the greatest needs of women, children and adolescents, needs like sexual and reproductive health, maternal and newborn care and nutrition. They then identify solutions that will work best for them and develop a costed implementation plan. These investment cases are highly specific and responsive to local needs. They provide a framework around which external donors can rally and feed into, creating a fundamental change in development funding – a bottom up, need and demand driven model in a field which has all too often been top down and supply side led.

The GFF then helps develop a financing plan, focusing on increased use of domestic resources and leveraging external funding. This national investment case and financing plan empowers ministers of health to make the case for funding to Ministers of Finance. With the ability they have to bring in the GFF’s trust fund resources, linked to IDA allocations, on the condition of more domestic resourcing for these health priorities, it lowers the total cost of interventions that save the lives of women, children, and adolescents, making investing in them even more powerful.

That means that, from the start, the solutions implemented are more financially sustainable. It means that as countries transition away from aid investing in women, children, and adolescents continues to be incentivised.

Early results

The GFF is already working with 27 countries, and progress these countries are making is encouraging. In Tanzania where initial work has focused on those living below the poverty line, access to outpatient care has risen from 2.5% to 14% in 18 months, and the number of high-performing health facilities has risen from 1% to 22%. And in Cameroon, the government has committed to increasing its budget allocation for primary and secondary healthcare from 8% in 2017 to 20% by 2020. In facilities using performance-based financing, the number of antenatal care visits doubled to 100,000.

However, the GFF needs to raise US$2 billion if it is to extend its reach to all 50 countries with the greatest need. On November 6th, Norway and Burkina Faso will co-host the GFF’s replenishment event in Oslo, Norway, alongside the World Bank, and the Bill & Melinda Gates Foundation.

For Burkina Faso, the GFF brings both a new way of thinking about health and more empowerment, helping to make greater strides on the path towards universal healthcare coverage and economic prosperity. For Norway, the GFF is a ground-breaking approach to improving global health that maximises the effect of investment in health, helping to ensure that every woman, every child and every adolescent has the chance to survive and thrive.

We are proud to co-host the GFF replenishment event. The opportunity to expand and accelerate the impact of the GFF is an opportunity we cannot afford to ignore.