Countries must invest at least 1% more of GDP on primary healthcare
Countries must increase spending on primary healthcare by at least 1% of their gross domestic product (GDP) if the world is to close glaring coverage gaps and meet health targets agreed in 2015, says a new report from the World Health Organization and partners on the eve of a UN General Assembly high-level meeting on Universal Health Coverage.
They must also intensify efforts to expand services countrywide.
The world will need to double health coverage between now and 2030, according to the Universal Health Coverage Monitoring Report. It warns that if current trends continue, up to 5 billion people will still be unable to access healthcare in 2030 – the deadline world leaders have set for achieving universal health coverage. Most of those people are poor and already disadvantaged.
Primary healthcare key to health for all
“If we are really serious about achieving universal health coverage and improving people’s lives, we must get serious about primary healthcare,” says Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “That means providing essential health services like immunization, antenatal care, healthy lifestyle advice as close to home as possible – and making sure people do not have to pay for this care out of their own pockets.”
Investing an additional USD200 billion a year on scaling up primary healthcare across low and middle-income countries would potentially save 60 million lives, increase average life expectancy by 3.7 years by 2030, and contribute significantly to socio-economic development. It would represent about 3% increase on the USD7.5 trillion already spent on health globally each year.
Most of that funding would come from countries themselves. The report says that most countries can scale up primary healthcare using domestic resources – either by increasing public spending on health in general, or by reallocating spending towards primary healthcare – or by doing both. At present, most countries are underinvesting in primary healthcare.
But for the poorest countries, including many affected by conflict, this may not be feasible. These countries will continue to require assistance from outside. This funding must be carefully targeted to result in a lasting improvement to health systems and services – via a systematic strengthening of primary healthcare countrywide.
Accelerate scale-up of services
Countries must also renew efforts to scale up service coverage countrywide. Although coverage has increased steadily since 2000, progress has slowed down in recent years. Most increases have occurred in lower income countries, but these countries are still lagging behind. The biggest health service gaps are in the poorest countries and those affected by conflict.
“Too many women and children continue to die from easily preventable and treatable causes simply because they can’t get the care they need to survive,” said Henrietta Fore, UNICEF Executive Director. “By working with communities to provide primary healthcare to the poorest and the most vulnerable, we can reach the last mile and save millions of lives.”
Coverage is generally lower in rural areas than in towns. The report cites lack of health infrastructure, shortages of health workers, weak supply systems, and poor-quality care leading to low trust among communities as major obstacles to achieving UHC.
“Improving and expanding primary healthcare in all regions is key,” says Natalia Kanem, Executive Director of UNFPA. “It’s the best way to ensure people can obtain services to cover the majority of their health needs from pre-birth throughout their lives.”
Protecting against financial hardship
The report also highlights the need to protect people from financial hardship.
“The goal of universal health coverage will remain elusive unless countries take urgent steps to protect people from falling into poverty to pay for essential healthcare,” says Dr. Muhammad Pate, Global Director, Health, Nutrition, and Population at the World Bank. “Expanding access to quality primary healthcare services will save more lives and keep healthcare costs affordable.”
More people are suffering the consequences of paying for services out of their own pockets than 15 years ago. About 925 million people spend more than 10% of their household income on healthcare; 200 million people spend more than 25% of their income on health. And impoverishment due to paying for healthcare increased except among the extremely poor.
“It’s shocking to see a growing proportion of the population struggling to make ends meet because they are paying too much for their own health, even in advanced economies” adds OECD Secretary-General Angel Gurría. “The only places where this is not happening is in countries that invest more and more effectively in health.”
On 23 September, world leaders will discuss a far-reaching Declaration on Universal Health Coverage. The Declaration lists a number of steps to advance progress towards UHC. These include WHO’s recommendations relating to primary healthcare, including the allocation of an additional 1% GDP to primary healthcare through additional investments or reallocation.
Global Economy’s “Speed Limit” Set to Fall to Three-Decade Low
The global economy’s “speed limit”—the maximum long-term rate at which it can grow without sparking inflation—is set to slump to a three-decade low by 2030. An ambitious policy push is needed to boost productivity and the labor supply, ramp up investment and trade, and harness the potential of the services sector, a new World Bank report shows.
The report, Falling Long-Term Growth Prospects: Trends, Expectations, and Policies, offers the first comprehensive assessment of long-term potential output growth rates in the aftermath of the COVID-19 pandemic and the Russian invasion of Ukraine. These rates can be thought of as the global economy’s “speed limit.”
The report documents a worrisome trend: nearly all the economic forces that powered progress and prosperity over the last three decades are fading. As a result, between 2022 and 2030 average global potential GDP growth is expected to decline by roughly a third from the rate that prevailed in the first decade of this century—to 2.2% a year. For developing economies, the decline will be equally steep: from 6% a year between 2000 and 2010 to 4% a year over the remainder of this decade. These declines would be much steeper in the event of a global financial crisis or a recession.
“A lost decade could be in the making for the global economy,” said Indermit Gill, the World Bank’s Chief Economist and Senior Vice President for Development Economics. “The ongoing decline in potential growth has serious implications for the world’s ability to tackle the expanding array of challenges unique to our times—stubborn poverty, diverging incomes, and climate change. But this decline is reversible. The global economy’s speed limit can be raised—through policies that incentivize work, increase productivity, and accelerate investment.”
The analysis shows that potential GDP growth can be boosted by as much as 0.7 percentage points—to an annual average rate of 2.9%—if countries adopt sustainable, growth-oriented policies. That would convert an expected slowdown into an acceleration of global potential GDP growth.
“We owe it to future generations to formulate policies that can deliver robust, sustainable, and inclusive growth,” said Ayhan Kose, a lead author of the report and Director of the World Bank’s Prospects Group.“A bold and collective policy push must be made now to rejuvenate growth. At the national level, each developing economy will need to repeat its best 10-year record across a range of policies. At the international level, the policy response requires stronger global cooperation and a reenergized push to mobilize private capital.”
The report lays out an extensive menu of achievable policy options, breaking new ground in several areas. It introduces the world’s first comprehensive public database of multiple measures of potential GDP growth—covering 173 economies from 1981 through 2021. It is also the first to assess how a range of short-term economic disruptions—such as recessions and systemic banking crises—reduce potential growth over the medium term.
“Recessions tend to lower potential growth,” said Franziska Ohnsorge, a lead author of the report and Manager of the World Bank’s Prospects Group. “Systemic banking crises do greater immediate harm than recessions, but their impact tends to ease over time.”
The report highlights specific policy actions at the national level that can make an important difference in promoting long-term growth prospects:
Align monetary, fiscal, and financial frameworks: Robust macroeconomic and financial policy frameworks can moderate the ups and downs of business cycles. Policymakers should prioritize taming inflation, ensuring financial-sector stability, reducing debt, and restoring fiscal prudence. These policies can help countries attract investment by instilling investor confidence in national institutions and policymaking.
Ramp up investment: In areas such as transportation and energy, climate-smart agriculture and manufacturing, and land and water systems, sound investments aligned with key climate goals could enhance potential growth by up to 0.3 percentage point per year as well as strengthen resilience to natural disasters in the future.
Cut trade costs: Trade costs—mostly associated with shipping, logistics, and regulations—effectively double the cost of internationally traded goods today. Countries with the highest shipping and logistics costs could cut their trade costs in half by adopting the trade-facilitation and other practices of countries with the lowest shipping and logistics costs. Trade costs, moreover, can be reduced in climate-friendly ways—by removing the current bias toward carbon-intensive goods inherent in many countries’ tariff schedules and by eliminating restrictions on access to environmentally friendly goods and services.
Capitalize on services: The services sector could become the new engine of economic growth. Exports of digitally delivered professional services related to information and communications technology climbed to more than 50% of total services exports in 2021, up from 40%in 2019. The shift could generate important productivity gains if it results in better delivery of services.
Increase labor force participation: About half of the expected slowdown in potential GDP growth through 2030 will be attributable to changing demographics—including a shrinking working-age population and declining labor force participation as societies age. Boosting overall labor force participation rates by the best ten-year increase on record could increase global potential growth rates by as much as 0.2 percentage point a year by 2030. In some regions—such as South Asia and the Middle East and North Africa—increasing female labor force participation rates to the average for all emerging market and developing economies could accelerate potential GDP growth by as much as 1.2 percentage points a year between 2022 and 2030.
The report also underscores the need to strengthen global cooperation. International economic integration has helped to drive global prosperity for more than two decades since 1990, but it has faltered. Restoring it is essential to catalyze trade, accelerate climate action, and mobilize the investments needed to achieve the Sustainable Development Goals.
Economic Diversification Away from Oil is Crucial for the Republic of Congo
Economic diversification away from oil is crucial for reversing recent economic setbacks in the Republic of Congo and put the country on a pathway to long-term prosperity, says the World Bank in its latest Country Economic Memorandum report on the country.
The cost of over-reliance on oil has been painfully apparent in the past decade. A seven-year recession, induced by the end of the last oil-boom cycle, has led to a dramatic drop in income per capita, shrunk the size of the economy and weakened long-term growth prospects. While oil prices have surged more recently, returning Congo’s economy to growth in 2022, the current development model is unlikely to deliver sustainable economic growth and productive jobs going forward.
Attaining sustainable development in Congo urgently requires efforts to diversify national assets, focusing on stronger institutions, development of human and physical capital, and a more balanced exploitation of natural resources, says the report, titled Congo’s Road to Prosperity: Building Foundations for Economic Diversification.
“Congo’s oil-driven growth model has run its course. In order to achieve its aspiration for a more diversified and inclusive model, it is crucial for Congo to strengthen its policy ambition and accelerate efforts to transition to a people-centered, diversified economy,” said Korotoumou Ouattara, World Bank Resident Representative for the Republic of Congo.
The report highlights the urgency of diversification actions. Congo’s oil production is expected to decline in the medium term due to the depletion of oil reserves and reduced external demand from the global transition to a low-carbon economy. While oil accounts for 40% of GDP, the sector employs only a fraction of the country’s workforce, with three-quarters of Congolese employed in the informal sector. Underinvestment in health, education, and physical infrastructure, as well as weak government institutions underscore the limits of fossil fuel-driven growth and the importance of economic diversification.
It identifies ways in which Congo can achieve its economic diversification objectives and recommends policy reforms and investments in the following priority areas:
- Remove barriers to competition by curbing state-owned enterprises’ market dominance, encouraging private sector participation in the electricity and telecommunications sectors, and modernizing competition law and enforcement capacity.
- Accelerate digital transformation by enabling private sector participation, developing regulatory and legal support for digital financial services and facilitating digital technology adoption, and building digital skills.
- Improve the supply of reliable electricity by restoring profitability, invigorating regulation, and investing in transmission and distribution.
- Enhance trade competitiveness and diversification by cutting tariffs, reviewing non-tariff measures, concluding regional trade negotiations, and strengthening local markets.
- Improve logistics efficiency by scrutinizing public-private partnership contracts and adopting unified information technology for maritime trade.
- Support ecotourism development by improving regulation and allocating funding to protect natural assets, strengthening regulatory and enforcement agencies, and expanding transport infrastructure and marketing.
“The recent oil price volatility is a strong reminder of the need for Congo to reduce its exposure to the boom-bust cycles of global commodity markets. Urgent policy actions to develop the non-oil sector, enable the private sector, and strengthen government institutions can help catalyze growth for a prosperous, resilient and sustainable future,” said Vincent Belinga, lead author of the report.
Solar Mini Grids Could Sustainably Power 380 million People in Africa by 2030
Solar mini grids can provide high-quality uninterrupted renewable electricity to underserved villages and communities across Sub-Saharan Africa and be the least-cost solution to close the energy access gap on the continent by 2030.
Climate action efforts can tap solar mini grids that offer a lower greenhouse gas emission alternative compared to diesel-fueled systems and kerosene-based appliances. The World Bank’s Mini Grids for Half a Billion People: Market Outlook and Handbook for Decision Makers notes that to realize the full potential of solar mini grids, governments and industry must work together to systematically identify mini grid opportunities, drive costs down, and overcome barriers to financing.
“Kenya has deployed mini grids to serve communities that are not connected to the main grid,” said Mr Davis Chirchir, Cabinet Secretary Ministry. “Currently we have about 62 mini grids that are fully operational and 28, which are under construction. We hope to deploy more mini grids to close the energy access gap and ensure universal access to electricity by 2030.”
In Sub-Saharan Africa, 568 million people still lack access to electricity. Globally, nearly 8 out of 10 people without electricity live in Africa. At the current rate of progress, 595 million Africans will remain unconnected in 2030.
“While Africa remains the least electrified continent, it also has the biggest potential for solar mini grid deployment,” said Gabriela Elizondo Azuela, Manager of the World Bank’s Energy Sector Management Assistance Program (ESMAP). “Solar mini grids can reach populations today that would otherwise wait years to be reached by the grid. They have the potential to transform the power sector in Sub-Saharan Africa. Through World Bank operations and advice to governments, ESMAP is helping take mini grids from a niche to a mainstream solution.”
The deployment of solar mini grids has markedly accelerated in Sub-Saharan Africa, from around 500 installed in 2010 to more than 3,000 installed today, and a further 9,000 planned for development over the next few years. This is the result of falling costs of key components, the introduction of new digital solutions, a large and expanding cohort of highly capable mini grid developers and growing economies of scale. In Africa, mini grids are on track to provide power at lower cost than many utilities. The cost of electricity produced by mini grids could be as low as $0.20/kWh by 2030, making it the least-cost solution for more than 60 percent of the population.
Important progress has been made in several African countries to accelerate the deployment of mini grids. In Nigeria, for example, a market-driven approach to mini grid development under the World Bank-supported National Electrification Project has catalyzed the deployment of more than 100 new solar-powered mini grids. In several countries such as Ethiopia and Zambia, new regulations and policy directives are making mini grids more attractive for private sector investment. In Kenya, a combination of geospatial planning, favorable policies and regulations, and a robust business model based on public-private partnership is underpinning the World Bank-supported Kenya Off-Grid Solar Access Project, which is targeting almost 150 new mini grids in areas with low electricity access rates.
Further acceleration is needed, however, to meet Sustainable Development Goal 7 (SDG7). Powering 380 million people in Africa by 2030 will require the construction of more than 160,000 mini grids at a cumulative cost of $91 billion. At the current pace, only around 12,000 new mini grids serving 46 million people will be built by 2030 at a total investment cost of approximately $9 billion.
The World Bank has committed more than $1.4 billion to mini grids over the next seven years, through 38 projects in 29 countries. The investment plans of the World Bank’s portfolio include the deployment of 3,000 mini grids by 2029, with the expectation of bringing electricity to more than 13 million people. This investment commitment is expected to crowd in more than $1 billion of co-financing from private sector, government, and development partners. In countries where the World Bank has an investment commitment in mini grids, the Bank’s investment represents on average about 25 percent of the total investment in mini grids in each country from governments, the private sector, and development partners.
Produced by the World Bank’s Energy Sector Management Assistance Program (ESMAP), the book, the Mini Grids for Half a Billion People: Market Outlook and Handbook for Decision Makers, identifies five market drivers that would help the mini grid sector achieve its full market and development potential:
- Reducing the cost of electricity from solar hybrid mini grids to $0.20/kWh by 2030, which would put life-changing power in the hands of half a billion people for just $10 per month.
- Increasing the pace of deployment to 2,000 mini grids per country per year, by building portfolios of modern mini grids instead of one-off projects.
- Providing reliable electricity service to customers and communities would generate the demand for 3 million income-generating appliances and machines and expand services at 200,000 schools and clinics.
- Leveraging development partner funding and government investment to “crowd in” private-sector finance, potentially raising $127 billion in cumulative investment from all sources for mini grids by 2030.
- Establishing enabling mini grid business environments in key access-deficit countries through light-handed and adaptive regulations, supportive policies, and reductions in bureaucratic red tape.
The handbook is the World Bank’s most comprehensive and authoritative publication on mini grids to date.
What does the Arctic Ocean hold for the world in changing global politics?
“The Revenge of Geography: What the Map Tells Us About Coming Conflicts and the Battle Against Fate”, a book by...
Northern Ireland: Peace in the province – still a pipe dream?
All eyes are currently – and understandably – on the bitter and still unfolding war in Ukraine. The first anniversary...
Impact of Multinational companies on Pakistan
Multinational companies (MNCs) have had a significant impact on Pakistan’s economy since the country’s liberalization and opening up to foreign...
Considerations on asteroids and dangers near and far
The solar system is the first stage in the human exploration of space. Observation and the desire to learn more...
Intelligence Deficiencies Hamper Togolese Security Forces Fight Against VEOs
The Togolese security forces’ lack of actionable and credible intelligence is fettering its response to the VEO attacks. On Friday,...
Bulletproof Panama: An Isthmus of Stability Becomes a Magnet for Migration
On the sidewalk along Vía Argentina, one of Panama City’s busiest streets, a Colombian bodybuilder passes digital nomads from the...
Communication as a realm of human enigmatic growth
In March 2023 UMEF Swiss University hosted a special guest Richard Hill, Ph.D. who is a former senior ITU staff...
Economy2 days ago
U.S. Is Threatening to Default China Debt Repayment, What Will Beijing Do?
New Social Compact4 days ago
Aurat March 2023 & Agenda Setting
Economy4 days ago
Unpacking the “China Debt Trap” Narrative: Nuances and Context
Intelligence4 days ago
Time for an International Cyber Court?
World News3 days ago
FT: Is France on the road to a Sixth Republic?
Economy3 days ago
Marriage of Sanctions Convenience: Russia Rethinking the EAEU Role
World News4 days ago
Confrontation between US and Chinese ships in South China Sea
Middle East3 days ago
How Beijing take advantage of US’s attempts to get rid of Netanyahu and expel him from power?