External Resources for Economic Governance

Global Health Governance and Financing Mechanisms -  Working Paper, May 2012 

The 2011 World Health Summit’s (WHS) session on “Governance for Health in the 21st Century” focused on the debate on stakeholder engagement in global health governance and health financing mechanisms through two forums, entitled “Democratising Global Health” and “Innovative Financing Models and Governance Principles”. The summit sessions resulted in a series of key messages on global health governance and financing which form the basis of this report.

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Lancet research summary – Healthcare financing: Paths to universal coverage 

Universal coverage of health care is now receiving substantial worldwide and national attention, but debate continues on the best mix of financing mechanisms, especially to protect people outside the formal employment sector. Crucial issues are the equity implications of different financing mechanisms, and patterns of service use. We report a whole-system analysis—integrating both public and private sectors—of the equity of health-system financing and service use in Ghana, South Africa, and Tanzania.

We used primary and secondary data to calculate the progressivity of each health-care financing mechanism, catastrophic spending on health care, and the distribution of health-care benefits. We collected qualitative data to inform interpretation.

Overall health-care financing was progressive in all three countries, as were direct taxes. Indirect taxes were regressive in South Africa but progressive in Ghana and Tanzania. Out-of-pocket payments were regressive in all three countries. Health-insurance contributions by those outside the formal sector were regressive in both Ghana and Tanzania. The overall distribution of service benefits in all three countries favoured richer people, although the burden of illness was greater for lower-income groups. Access to needed, appropriate services was the biggest challenge to universal coverage in all three countries.

Analyses of the equity of financing and service use provide guidance on which financing mechanisms to expand, and especially raise questions over the appropriate financing mechanism for the health care of people outside the formal sector. Physical and financial barriers to service access must be addressed if universal coverage is to become a reality.

European Union and International Development Research Centre.

African Development Bank: Fiscal policy for the HIV/AIDS response and economic wellbeing

TUNIS - Southern African governments could use public spending in their battle against the extremely high rates of HIV/AIDS in their countries and still achieve a positive economic impact, argues a new paper from the African Development Bank (AfDB).

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PEPFAR - US reveals nearly $ 1,5 billion in unspent AIDS money

US officials have confirmed that that $1.46 billion designated to fight AIDS has not been used because of inefficient bureaucracies; major reductions in the cost of AIDS treatment; delays due to long negotiations on realigning programs with recipient country priorities; and a slowdown in a few countries because the AIDS problem was much smaller than originally estimated.

World Bank Urges African Governments to Tackle Financial Impact of HIV/AIDS

A new World Bank (WB) report urges African governments and their development aid donors to do significantly more to prevent new HIV infections in the face of slowing growth and uncertain prospects in developed countries. Without a dramatic reduction in infections the World Bank says that existing national treatment programs for people living with HIV/AIDS could become unsustainable over the coming years.

SA health insurance expenditure highest

Private health insurance in South Africa was estimated to contribute 42% to national expenditure. South Africa was actually a global exception in this regard, People's Health Movement spokesperson Peter Benjamin said today. He was speaking in Johannesburg at the South African launch of the third Global Health Watch book, hosted by the SECTION27 non-governmental organisation. Benjamin said private health insurance in the US contributed about 40% to national expenditure, while the average in most other countries was between 10 and 20%. According to People's Health Movement's draft report, private health insurance generally covered middle and upper income groups and formal sector employees. Benjamin said 16% of South Africans had access to private health care, and 84% did not. – City Press.

The Africa Forum on Civil Society and Governance Assessments

The Africa Forum on Civil Society and Governance Assessments was held in Dakar from 10-12 November 2011, bringing together about 50 civil society and development practitioner participants from 20 countries and representatives of the UNDP. It was a unique learning and networking opportunity for delegates to interact with and learn from leading analysts of African civil society and governance assessment initiatives, and representatives of regional and global civil society organisations. The event focused on how more effective involvement by civil society actors in governance assessments can promote democratic governance, through increased accountability and more inclusive participation.

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