Chaired by former UK Health Secretary the Rt. Hon. Stephen Dorrell, this session at the Healthcare World Festival offered valuable insight into the ‘aid and trade cycle’ and the ways in which aid funding can lead to longer term trading relationships, says Fabian Sutch-Daggett.
The challenge we face as a global community in restarting the world economy following the pandemic is stark. Particularly within the health economy, the relationship between aid and trade will be vital to enabling developing nations to deal with the longer-lasting impacts of the virus, and the future development at large.
The big question is, how do factors such as aid, trade, funding, development, and partnerships work together – and how can we take advantage of them to benefit healthcare post-COVID, or even as we continue to deal with it?
Chaired by the Rt. Hon. Stephen Dorrell, panellists from across the international and African healthcare sector joined to discuss and tackle the issues, including Dr Mwenya Kasonde; Dr Senait Beyene of the Ministry of Health Ethiopia; Professor Ged Byrne of Health Education England; Lucy Palmer of Mott MacDonald; Francis Omaswa of the African Centre for Global Health, Asma’u Abiola and Dr Shola Dele-Olowu of the Clinton Health Access Initiative, and Dr Isabel Maina and Dr Rebecca Kiptui of the Ministry of Health Kenya.
Effectiveness of aid in response to COVID
At this point in the pandemic, we can now see many nations ‘turning the corner’ in regards to COVID-19. However, this is not the case universally. Many developing nations are still struggling tremendously, and despite the vaccine rollout programmes which are now in place, it is not the immediate effects of the virus that will cause a lasting impact, but how quickly these nations will be able to recover from the pandemic at large.
Offering a perspective on how aid-funding has operated in response to the pandemic within Nigeria was Dr Shola Dele-Olowu. “The response in Nigeria is similar to that across other countries. There has been a lot of funding in response to COVID, but also towards health generally. Donor funding accounts for significant progress that we have seen in the health space, yet still accounts for only around 10 per cent of total health expenditure. However, with COVID, the dramatic and swift response we have seen has been very significant, and has played a key role in the early and late stages of the pandemic,” says Shola.
“It’s really critical, but in terms of the overall economic impact, due to so many people paying out of pocket for healthcare, it’s difficult to see the impact which this funding has had on the economy at large. Yet overall, these intensified efforts underscores the need for countries like Nigeria to do more with domestic mobilisation, especially as funding dwindles.”
Dr Mwenya Kasonde, joining from Zambia, also offered her perspectives on the effectiveness of aid and the steps that need to be taken moving forward to ensure that healthcare systems continue to develop. “In order for us to address our healthcare systems during and after COVID, we must realise what the system was like before COVID,” says Kasonde.
“There was a lot of difference across the world in regards to the maturity of different healthcare systems, and the baseline with which they tackled COVID. In regards to aid, it has a very important role to play – but it is simply not sustainable. For instance, in Zambia right now, our health system is about 50 per cent donor funded. In order to transition out of this method of healthcare systems, we need a very clear roadmap for how to do so.”
Clearly, aid is crucial at this point in time, but the unsustainability of it at this point is a key roadblock which many nations need to tackle – and one which can only be addressed through clear and determined efforts by governments and health services working together.
Individual contexts and issues
Following on, both Dr Isabella Maina and Dr Rebecca Kiptui presented to the panel the current situation regarding health financing within Kenya, providing valuable insights into where funding can be improved in order to develop health systems at large. Dr Isabella provided a list of recommendations, including:
– Increasing public spending on health to international and regional targets
– Mobilising domestic resources to ensure sustainability and the transition from donor aid
– Expanding health insurance to reduce high out of pocket premiums
– Exploring alternative financing methods, such as PPP’s
– Improving efficiency in the utilisation of existing resources
– Aligning spending to address health outcomes and disease burden
For the full presentations of Dr Maina and Dr Kiptui, please watch the recording of this session on youtube, which provides in-depth analysis of the financial model and structure of the health system within Kenya.
The relationship between vaccines and aid funding
The main worry with vaccination was always going to be the issue of rollout. Once the world developed a vaccine for COVID, it was inevitable that it would not be available to everyone on the planet on the same day, which raises the question of the role that aid plays in the rollout of coronavirus vaccines.
“It’s a clear example of some of the inequities that we see – vaccines is just one aspect of it. The vaccine issue clearly shows that developing countries cannot be fully dependent on aid and must be able to prepare for the transitions that will come,” says Shola.
“Obviously, it would have been impossible to give everyone the vaccine at the same time, but as we have seen from the rollout, there is still a disparity. If it was not for the GAVI alliance, there would have been very limited access to these vaccines for many nations.”
“The main issue for me is how we operate our relationship with the World Health Organisation. I don’t think that the western economies have really bought into the power of a pan-global response in notion or in concept. The underpinnings of the COVAX programme are robust and evidence-based, but I believe that the reason it has stuttered is due to the lack of buy-in from western economies and developed economies across the globe,” added Ged Byrne.
“None of us are safe until all of us are safe. I appreciate what the US government has done recently, but I believe that developing nations really need to focus on more issues – for instance in lower and middle income countries. We have the capacity; we have the raw materials; we have the skills and the business models, and we need to be doing more in this area. The conversation has moved on from just asking the West to help us – we need to focus on our partnerships and look inward,” said Isabella Maina.
In Conclusion
Overall, aid funding is a system that has been deeply ingrained into many developing nations health systems, and there is a genuine risk that if there is no change, and no development, these systems will begin to fail. The COVID-19 pandemic has been an enormous trial for nations around the world, but it also displayed how effective global healthcare responses can be when we face a common enemy. The most important lesson is to recognise the failures and successes which have occurred over the past two years, and implement what we have learned.