No. 12, January 2005
Macroeconomics and Health work continues to provide a vital contribution to country health and development efforts. Featured in the December issue of the WHO Bulletin, MH work was also discussed at two separate high-profile events in late 2004. Publication this month of the Millennium Project's final report is an important spur to action for developed and developing countries alike as the world strives towards achievement of the Millennium Development Goals (MDGs) by 2015.
Macroeconomics and Health work in countries highlighted in December Bulletin
Macroeconomics and Health progress in countries was highlighted in an article entitled "Macroeconomics and Health Commission findings become reality" in the December 2004 issue of the WHO Bulletin, WHO's international public health journal. The article presented progress made by countries that chose to follow up on the recommendations of the Commission on Macroeconomics and Health, such as pledges for increased national health spending in Sri Lanka and Indonesia and the health investment plan in Ghana, where the work is focused on making health central in the poverty reduction strategy. The article highlighted the need for increased donor resources for health and accelerated debt relief to fill the funding gap in order to achieve stronger, more equitable health systems. To view the article, please see http://www.who.int/bulletin/volumes/82/12/en/news.pdf.
The Macroeconomics and Health process in countries has widened the scope of the Commission's 2001 recommendations as it has been adapted and shaped by individual country needs. Macroeconomics and Health follow-up work has resulted in targeted research on long-term health planning and financing that can influence and inform national health and development policy making. Other health and development initiatives, namely the Commission on Social Determinants of Health (see Foreword), are expected to build on this work in countries.
Millennium Project report launched, recommending best strategies for achieving the MDGs
On 17 January, the UN Millennium Project released its final report, “A Global Plan to Achieve the Millennium Development Goals,” which provides detailed recommendations on how the world must immediately and massively increase investment in health programmes to achieve the MDGs. The release of the report was followed on 18 January by a launch focused on health at the WHO Headquarters in Geneva. The Geneva launch brought together WHO, the world’s international health organization, with the lead health and science experts for the Millennium Project, and released recommendations associated with each health-related task force.
The UN Millennium Project is an independent advisory body to the UN Secretary-General that was commissioned in 2002 to develop a concrete action plan to meet the MDGs. The Geneva launch was one of several Europe-based launches with heads of agencies and government leaders planned in Italy, Germany, the Netherlands, Sweden, and Britain, as well as with the European Union in Brussels. Three of the eight Millennium Development Goals are directly related to health, as are eight targets and 18 indicators.
CMH participates at the International Medical Parliamentarians' Conference
The CMH Executive Secretary, Dr Sergio Spinaci, addressed parliamentarians on the Millennium Development Goals and their relationship to health and development policy, with the aim of fostering collaboration with parliamentarians' associations towards achieving health and development goals. The presentation was part of the International Medical Parliamentarians' Conference With Asian Focus, held in Kuala Lumpur, Malaysia from 13 to 14 December 2004.
Spinaci emphasized that all of the MDGs are related, and urged taking a broad look at the underlying causes of poverty and ill health and dealing with them in a comprehensive approach to health and development. He noted that parliamentarians have an important role to play, specifically in advocacy, supporting the mobilization of resources for health, reviewing and monitoring existing health policies and strategies, influencing legislation in support of pro-poor health policies, approving improved budgets to the health sector, and fostering a partnership between government and civil society. Response was very positive from the approximately 100 parliamentarians, most from the Asian region, who attended the meeting.
Feedback from Forum 8 and Ministerial Summit on Health Research sessions
Macroeconomics and Health work in countries was highlighted during two sessions at Forum 8, the annual meeting of the Global Forum on Health Research, and the Ministerial Summit for Health Research. Both events were held 16-20 November 2004 in Mexico City. At the Forum 8 session, the Mexican national commission (CMMS) presented its report, which is now being circulated to key stakeholders for comments. The report can be downloaded at http://ipd.udlap.mx/.
The working session at the Ministerial Summit reviewed progress in development of the national MH commissions in Mexico, India and China. It found similarities in each with respect to the creation of a national mechanism which is supporting analysis of central issues of macroeconomics and health and which will complete a report containing evidence for review of health policies. Issues that the national mechanisms are dealing with include the following:
- measuring the main health problems in the country
- analysing the relationships between health, growth, and poverty in their various dimensions (including the great similarities between the health situation of the poorest of these countries and that of the least developed countries)
- specific health issues confronting the absolute poor
- health financing and issues of universal health insurance programs
- the functioning of health systems and health research systems
- health as a public good in economic development
- formulation of new health goals for the country.
Attention was drawn to gaps in availability of data and other constraints to producing research to inform national planning and policy-making. It was agreed that the CMH report and follow-up process have helped shift the focus from health as an expenditure to health as an investment. This session was chaired by Julio Frenk, Secretary of Health of Mexico. Featured speakers included Nora Lustig, President of the Mexico Commission on Macroeconomics and Health; Sujatha Rao, Member Secretary of the India National Commission on Macroeconomics and Health; Ann Mills, Head of the Health Economics and Financing Programme at the London School of Hygiene and Tropical Medicine; and Sergio Spinaci, CMH Executive Secretary. A representative involved in MH work in China was not able to attend but a presentation was passed around to participants.
E-discussion raises key issues for civil society role in research
Prior to the November meetings in Mexico City, CMH hosted an electronic discussion on the topic, "Civil Society Organizations' (CSOs) research in economics and health: why, what and how?" The discussion, facilitated by the People's Health Movement and in which a number of local and international CSOs participated, brought out a strong resolve to listen to communities and to set research agendas based on peoples’ experiences and needs. It was noted that CSOs, many of which are field-based, are in a good position to identify issues and areas for research through community participation. The discussion was a follow-up to the recommendations that emerged from working group 4, "How Civil Society Organizations (CSOs) can contribute to analysis and strategic planning of Macroeconomics and Health issues through research", of the WHO-sponsored Asian Civil Society Conference on Macroeconomics and Health (Colombo, Sri Lanka, April 2004). The E-discussion report can be found at http://www.who.int/macrohealth/infocentre/ediscussion_nov04/en/.