Macroeconomics and Health (CMH)

Mobilizing health and finance to dampen disease and build systems

Keynote Address to Second Consultation Commission on Macroeconomics and Health World Health Organization, Geneva

Lincoln C. Chen, MD

29 October 2003

Introduction

It's an honor to speak at this second follow-up consultation of a Commission that galvanized the international community with a timely and path-breaking report. In commending the Commission, I want to make three points.

First, although this is an exciting time for global health -- more energy, actors, resources, public concern, and political engagement -- our health world is confronting a divisive and historically unprecedented "double crises" of devastating diseases overwhelming failing health systems in the world’s poorest communities. Divergence in health has intensified. Severe disparities in health are unsustainable, epidemiologically and morally, in our interdependent world.

Second, massive and sustained action over three decades -- one generation -- will be necessary to dampen disease and build health systems in the poorest countries. Urgent mobilization of social and financial resources is needed to curb immediately the spiral of preventable deaths, paving the way for steady improvements over the longer-run.

Third, success will depend in some measure on a "new alliance" between public health and public finance -- ministries of finance, planning and health, international financial and health organizations, and economists and health professionals. This is not a "love match" but a "marriage of necessity." Economists and health professionals live in different worlds: economists are from Mars, health professionals are from Venus! Economists believe in fiscal prudence, health in saving lives; economists shape behavior through incentives, health through the ethics of service. Bridging these divides and forging a new alliance among health and finance, I believe, will influence the future of world health.

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