Global push seeks greater spending to improve health
Andrew S. Ross
Published 4:50 pm, Wednesday, December 18, 2013
Lawrence Summers has a new mission.
The former U.S. Treasury secretary and chief economic adviser to President Obama is looking to improve the world's health dramatically over the next 20 years. Part of his job is to persuade governments - mostly in low- and lower-middle-income countries - to spend tens of billions of dollars a year to get there.
Summers was at UCSF Tuesday evening to present a report, "Global Health 2035," that recommends "a grand convergence" of the international health community "around infectious, child and maternal mortality; major reductions in the incidence and consequences of non-communicable diseases and injuries; and the promise of 'pro-poor' universal health coverage."
"It's a remarkable opportunity before us," Summers said. "It is not something that can be taken for granted. It is not something that will automatically happen. It will require resources, will and competence. But the argument of this report is that it is feasible."
The report was written by the Lancet Commission on Investing in Health, chaired by Summers and staffed by 25 economists and global health experts, including representatives from UCSF. Its goal: "scaling up new and existing tools" and health delivery systems to tackle HIV/AIDS, tuberculosis, tropical diseases, child and maternal maladies by 2035. Cost for the 34 countries targeted: about $70 billion a year.
Though substantial, the costs are bearable for an increasing number of countries, said Gavin Yamey, the report's lead writer and a senior member of UCSF's Global Health Group. "Given their anticipated economic growth, those amounts will account for just 1 percent" of their gross domestic product growth, he said. And the payoff should far exceed the cost. According to the report, one-quarter of the income growth in low- and middle-income countries between 2000 and 2011 resulted from health improvements. "There are astonishing rates of return," Yamey said.
But it will require a selling job, he acknowledged. Members of the commission will be dispatched beginning next year to brief health and development organizations, finance ministers and other stakeholders. Summers "will be discussing the report at many high-level meetings," Yamey said. "We all have work ahead."
And where do the United States and other developed nations come in? Chiefly by "providing global public goods, particularly health research and development and managing cross-border externalities, such as preparing for influenza pandemics," says the report, which recommends doubling the world's health-related R&D to $6 billion a year by 2020.
Some outside financial help will also be needed. "Eliminating malaria and combatting drug-resistant TB and the threat of drug-resistant malaria will in some cases require assistance to middle-income countries," the report says.
Coincidentally, the reported was presented on the same day that UCSF Chancellor Susan Desmond-Hellmann announced her departure to head the Bill and Melinda Gates Foundation, which happens to be a chief funder of the report.
Gates Foundation role
It's probably no stretch to suggest that with Desmond-Hellmann at its helm, both the Gates Foundation and UCSF - whose new Global Health Sciences hub opens on the Mission Bay campus next fall - will be playing an active role in the "grand convergence."
In an e-mail to colleagues Tuesday, Desmond-Hellmann wrote, "My passion for UCSF, our mission and my colleagues have made the decision to change very difficult. I know that many of you will be surprised, so I want you to know my reasons. The Bill & Melinda Gates Foundation teams up with partners around the world to take on some tough challenges: overcoming extreme poverty and poor health in developing countries and improving America's education system.
"The Foundation funds innovative ideas in order to remove barriers that prevent people from making the most of their lives. The Foundation's credo that 'every person deserves the chance to lead a healthy and productive life' resonates with my own life-long philosophy, and my hope is that my leadership can contribute to creating a more equitable world."
The Lancet Commission report can downloaded at www.globalhealth2035.org.