Macroeconomics and Health (CMH)

How countries are moving forward

Focus of WHO's Macroeconomics and Health support

Though cost-effective prevention and treatment tools are available for controlling major diseases (e.g. TB, HIV/AIDS, and malaria), insufficient resources, coupled with a diverse range of systemic constraints, continue to obstruct national efforts to reach the poor. WHO supports governments’ leading role in the development of pro-poor investments and policies for health to help achieve national targets and the MDGs using the findings of the CMH as a starting point. Substantial progress is occurring in those countries that have initiated CMH follow-up work. This includes promotion of pro-poor strategies, expansion of developmental alliances across sectors and instigation of new research and analysis.

The CMH Report highlights the destructive impact of HIV/AIDS as a unique challenge to growth and poverty reduction. AIDS significantly lowers economic growth and drives more families into deepening poverty, whilst causing great suffering and loss of life. There is a growing disruption to the economic and social fabric that has increased the risk of political and community instability, particularly in low-income countries. The WHO and UNAIDS global initiative ('3 by 5') seeks to provide life-long antiretroviral treatment to 3 million people living with HIV/AIDS in poor countries by the end of 2005. Core principles include urgency, equity and sustainability, and a concerted and sustained action by many partners. MH's integrative approach helps place the response to such socially and economically devastating diseases into a broader context of pro-poor health policy and development. For example, HIV/AIDS initiatives and programmes need to be a part of long-term government socioeconomic reforms, especially concerning the poor, and part of the government’s overall health investment plan.

Leveraging the opportunities presented by other sustainable development mechanisms (e.g. Poverty Reduction Strategy Papers and Medium Term Expenditure Frameworks), governments are assisted in building domestic macroeconomic and public sector modelling capacity so they can implement an investment plan for health. As countries attract additional sources of funds, the MH process builds institutional capacity to effectively absorb increased funds and strengthen primary health care. The aim is to extensively increase access by the poor and disadvantaged to essential and cost-effective health interventions, greatly improve health outcomes and contribute to sustainable socioeconomic growth.

Over 40 countries have expressed interest in adapting the CMH Report's findings to their growth and development agendas. The initial focus is to strengthen a country's ability to carry out sound macroeconomic analysis so as to develop evidence-based and equitable health policies. Several countries are designing national Health Investment Plans that scale up cost-effective interventions while addressing the multi-sectoral determinants of health.