Macroeconomics and Health (CMH)

MacroHealth Newsletter

Special Issue No. 7: Consultation on Macroeconomics and Health: December 2003


Key outcome messages from the Consultation were grouped according to the three themes of debate and include:

Theme 1: Effectiveness of Delivery Systems and Monitoring Outcomes

  • Countries and their partners must set realistic national health priorities based on strong evidence base. Priority setting is backed by strong political commitment, reflecting concerted multisectoral efforts while ensuring that health delivery systems reach the poor with priority interventions.
  • For more effective health systems, countries and their partners must direct efforts to district planning and monitoring, ensuring an optimal mix of fixed and outreach services to the poor, while working towards increasing the number, correcting the maldistribution, providing incentives, improving the skills of health care human resources, and involving the private and voluntary sectors in the provision of health services.
  • Monitoring and evaluating outcomes through effective mechanisms must be pursued with the help of information systems and quality data collected through an integrated approach under government leadership, while at the same time establishing systems to track accountability at all levels.

Theme 2: Health in the Macroeconomic Framework and Allocation of Resources

  • Countries and their partners must work towards integrating pro-poor health investments into national development plans, ensuring that the right mix of policies runs across all sectors that impact health and considering ambitious goals reflecting their urgent needs and the innovative ways for realizing them.
  • Countries should strengthen domestic resource mobilization for health either through tax reform, increased revenue efforts and reallocation of budgetary expenditures, while working closely with international financial institutions to ensure informed policy choices within the national macroeconomic environment and also focusing spending on the poor.
  • The involvement of public and private partnerships and external partners is vital to ensure financing and provision of health services to the poor, as well as sustained and predictable donor funding, preferably through grants and debt relief for the low-income countries.

Theme 3: Predictability of External Funding and Increased Coordination

  • Although Official Development Assistance for Health has increased in the last decade, particularly to finance efforts against HIV/AIDS, a dramatic increase in funding is still required to meet the priority needs of developing countries. Tracking development assistance trends and the timely translation of donors’ commitment to disbursements are necessary to achieve predictability.
  • Approaches to build uniformity in tracking efficiency of donor funding mechanisms need to be built in recipient countries, while donors should invest in strengthening health systems and capacity building. Countries’ macroeconomic frameworks must become more flexible to the needs of investing in health, and national priorities should be pro-poor and transparent, while external assistance should be more in the form of grants and less conditional.
  • Better coordination with partners should be based on inter-sectoral assistance, with a focus on those sectors with a direct impact on health. Collaboration with multilateral international organizations is important, as is harmonization of external assistance with national and pro-poor priorities and policies. These efforts will be indispensable to achieving the Millennium Development Goals.

For details visit: [pdf 113kb].

The final session of the Ministerial Consultation saw the presentation and discussion of a draft Declaration. Incorporating major outcomes from the three working groups, the Declaration concluded that countries should continue to be supported in the preparation and implementation of national macroeconomics and health investment plans. Countries pledged to establish and strengthen appropriate national and sub-regional mechanisms and to give attention within investment plans to human resource constraints. Please see the final Declaration on the Consultation website

Press conference and media attention

...Ghana and other poor sub-Saharan countries do not, and cannot, make it on their own. They need financial infusions from the west for health care and other basic investments that would set the stage for growth. Given an initial boost, Ghana's pro-growth attributes could take over. But Ghana needs that boost. If the west, smugly clinging to nostrums of boot-strap capitalism, sits back and watches Ghana fail, its neighbours will fail as well. Ghana is one of sub-Saharan Africa's best shots at success. Ghana's shot at success will remain remote until rich countries come to its rescue.
Financial Times, 10 November 2003

A press conference was held on 29 October 2003. Podium speakers included LEE Jong-wook, WHO Director-General; Mr Baledzi Gaolathe, Minister of Finance and Development Planning of Botswana; and Mr M.N. Khan, Minister of Health of Pakistan. Dr Lee noted the importance and significance of bringing together at the Ministerial Consultation such a large number of ministers from different sectors. Mr Gaolathe stated his commitment to working together with the Minister of Health of Botswana to address issues like HIV/AIDS, while Mr Khan emphasized the critical importance of peace for any effort to improve the health of the poor.

The "Global Consultation on Increasing Investments in Health Outcomes for the Poor" was featured in the global media, including the Financial Times and the Voice of America News.
Please see for a full list of media coverage.

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