The Only Wealth is Health

By Kelsi Wilsher and Joris Voorhoeve

 

The Corona crisis proves how important the UN’s Sustainable Development Goal (SDG) number 3 is for all of mankind. SDG 3 seeks to ‘Ensure healthy lives and promote well-being for all at all ages’ [1] by 2030 and has targets such as further research and development into affordable vaccines, ending AIDS, tuberculosis, malaria and neglected tropical diseases, increase health training, reduce global maternal mortality rates and achieve universal access to health care [1]. When the target was set by the UN, and agreed on by all governments in the world, nobody thought of a global pandemic like the Corona Crisis.

Health care and mental, physical and social wellbeing today has improved over the decades. For example, more people can get antiretroviral therapy for HIV compared to 2017, and there has been a fall in deaths related to AIDS. However, the fall in the number of people newly infected with HIV in 2018 compared to 2017 [2] ‘is not happening fast enough’ [3] . Furthermore, ‘at least half of the global population do not have access to essential health services’ [3] such as access to hospitals and doctors. Access problems prevents millions from getting the help they need whether this is due to lack of money, distance, condition/existence of roads, mobile service range etc [4]. Another factor affecting health care is availability, whether this be the limited hours of clinics, or the limited number of health workers available in the village or even country [4]. One solution which has been instrumental in extending health services to poor rural villagers in Samburu, Kenya is using camels as a means of sustainable transport to carry medical supplies and health workers (including 2 HIV counsellors). However, because the mobile camel clinics are funded by donors the number of trips per year is limited [5]. Aside from the lack of the money, access is also restricted to certain groups in society leaving vulnerable groups such as women and girls, migrants and refugees, with little chance of accessing healthcare.

There are many different estimates of the cost to achieve this SDG. In 67 lower-income countries (LICs) and lower-middle income countries (LMICs) two scenarios have been given to improve health and well-being [6]. The progress scenario seeks to achieve two thirds of all health targets and requires an initial $104 billion for new investments. This will rise to $274 billion per year by 2030. On the other hand, the ambitious scenario aims to achieve all health targets with a starting annual investment of $134 billion, reaching $371 billion a year by 2030. One source suggests that this scenario is the only one that will provide health care systems with the capacity to achieve this SDG [7].

Another study named the ‘SDG Health Price Tag’ estimated the need to invest $3.9 trillion from 2016 until 2030 to achieve health targets. Per capita this is $76 in LICs, $58 in LMICs, and $51 in upper middle-income countries (UMICs). The majority of this $3.9 trillion was planned for infrastructure and the health workforce. Overall the investments, if followed, will give an additional 8.4 extra years of life expectancy at birth by 2030 [8].

A 2019 study estimates costs in developing countries at an annual average of $224.9 billion between 2019 and 2030; 22% of the total costs for all the SDGs. Annual per capita costs are $85.7 in LICs and $136.9 in LMICs [9] . An older study estimates that it would have costed $210 billion per year between 2015-2030 for developing countries [10]. Despite the differences in years between all these studies, the estimates are all above $200 billion per year by 2030.

None of these estimates took the costs of a global pandemic into account. To meet these costs, a huge increase of domestic and international funding is needed. Whilst many middle-income countries are financially able to afford this [11], others are heavily dependent on international assistance to fill the large funding gap [7] which, even after ‘projected increases in health spending’, will still be around $20–54 billion per year in LICs and conflict afflicted countries [12]. For 54 countries an estimate of $176 billion is given for the ‘gap between the costs of financing an essential package of quality services for everyone and resources available’ [13]. Other financing solutions are in the forms of taxes, whether this be on fuel and tobacco or on sugary drinks [13]. Payments for ecosystem services, and better allocation of resources are other solutions [7]. One final solution, which applies to all other SDGS, is ‘Good governance’ and this ‘is a key determinant of good health’ [14].

Providing finances for good healthcare and well-being not only saves lives and eases pain and suffering, but it helps fortify societies [7] which is ‘essential to sustainable development’ [1]. For those who want more than the moral satisfaction of helping those in need, achieving this SDG will bring benefits to the national and global economy. Achieving global goals in 4 areas, which includes health and well-being, ‘could open 60 market “hot spots” worth an estimated US$12 trillion by 2030 in business savings and revenue’ [15]. Needless to say, now that a severe global recession is likely to follow the present health crisis: The only wealth that matters is good health.

 

[1] UN (no date) Goal 3: Ensure healthy lives and promote well-being for all at all ages. [ONLINE] Available at: https://www.un.org/sustainabledevelopment/health/ [Accessed 19 Nov 2019]

[2] UNAIDS (2019) Global HIV & AIDS statistics – 2019 fact sheet. [ONLINE] Available at: https://www.unaids.org/en/resources/fact-sheet#:~:targetText=37.9%20million%20%5B32.7%20million%E2%80%9344.0,became%20newly%20infected%20with%20HIV. [Accessed 21 Nov 2019]

[3] UN (2019) Economic and Social Council. Special edition: Progress towards the SDGs: Report of the Secretary-General.  [ONLINE] Available at : https://sustainabledevelopment.un.org/content/documents/22700E_2019_XXXX_Report_of_the_SG_on_the_progress_towards_the_SDGs_Special_Edition.pdf [Accessed 18 Nov 2019]

[4] Peters, D.H., Garg, A., Bloom, G., Walker, D.G., Brieger, W.R. and Hafizur Rahman, M., (2008) Poverty and access to health care in developing countries. Annals of the New York Academy of Sciences1136(1), pp.161-171.

[5] Oyaro, K., (2017) Taking health services to remote areas. Africa Renewal30(3), pp.22-23. https://www.un.org/africarenewal/magazine/december-2016-march-2017/taking-health-services-remote-areas [Accessed 23 Nov 2019]

[6] WHO (2017) Q&A: Sustainable Development Goals Health Price Tag. [ONLINE] Available at: https://www.who.int/features/qa/sdg-price-tag/en/ [Accessed 20 Nov 2019]

[7] UNDP (2019) Goal 3: Good health and well-being. [ONLINE] Available at: https://www.sdfinance.undp.org/content/sdfinance/en/home/sdg/goal-3–good-health-and-well-being.html [Accessed 19 Nov 2019]

[8] WHO (no date) SDG Health Price Tag. We have the numbers. Now how do we split the bill? [ONLINE] Available at: https://sdgresources.relx.com/sites/default/files/infographics_pdf.pdf [Accessed 19 Nov 2019]

[9] SDSN (2019) SDG Costing & Financing for Low-income Developing Countries. [ONLINE] Available at:                                                                                                 https://irp-cdn.multiscreensite.com/be6d1d56/files/uploaded/FINAL_SDG%20Costing%20%26%20Finance%20for%20LIDCS%2024%20Sept%20-%20Final.pdf [Accessed 20 Nov 2019]

[10] UNCTAD (2014) ‘World Investment Report 2014. Investing in the SDGs: An Action Plan’. [ONLINE] Available at: https://unctad.org/en/PublicationsLibrary/wir2014_en.pdf [Accessed 22 Nov 2019]

[11] Ogbuoji, O., Bharali, I., Emery, N., and McDade K, K., (2019) Closing Africa’s health financing gap. Brookings. [ONLINE] Available at:  https://www.brookings.edu/blog/future-development/2019/03/01/closing-africas-health-financing-gap/ [Accessed 19 Nov 2019]

[12] Stenberg, K., Hanssen, O., Edejer, T.T.T., Bertram, M., Brindley, C., Meshreky, A., Rosen, J.E., Stover, J., Verboom, P., Sanders, R. and Soucat, A., (2017) Financing transformative health systems towards achievement of the health Sustainable Development Goals: a model for projected resource needs in 67 low-income and middle-income countries. The Lancet Global Health5(9), pp. e875-e887. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30263-2/fulltext

[13] The World Bank (2019) High-Performance Health Financing for Universal Health Coverage. Driving Sustainable Inclusive Growth in the 21st Century. [ONLINE] Available at : http://documents.worldbank.org/curated/en/641451561043585615/pdf/Driving-Sustainable-Inclusive-Growth-in-the-21st-Century.pdf [Accessed 22 Nov 2019]

[14] WHO (2014) The health of the people. What works. The African Regional Health Report 2014. [ONLINE] Available at:
https://apps.who.int/iris/bitstream/handle/10665/137377/9789290232612.pdf?sequence=4  [Accessed 23 Nov 2019]

[15] BSDC (2017) Better Business Better World. Executive Summary. The report of the Business & Sustainable Development Commission. [ONLINE] Available at:http://report.businesscommission.org/uploads/Executive-Summary.pdf [Accessed 14 Nov 2019]