Public opinion — a game changer for health systems financing?

Patients and medical staff at the San Juan de Dios Hospital in Guatemala. Majority of respondents in a World Bank-commissioned survey support investments in health systems strengthening in developing countries. Photo by: Maria Fleischmann / World Bank / CC BY-NC-ND

The Ebola crisis in West Africa thrust health systems into the spotlight. But spotlights have a tendency to move quickly, from one front-page priority to the next.

Public opinion has a big role to play in focusing attention. Strengthening health systems and preventing future epidemics are goals more likely to rise on the political agenda when citizens in donor countries think they are important. A new poll commissioned by the World Bank suggests that’s exactly what people think.

Ebola has faded from the headlines, and many within the global health community feared public support for epidemic prevention would decline alongside infection statistics. Rarely has a disease ever shed such clear light on the systemic factors of a health disaster, and global health professionals seized the opportunity to press for health systems investment in under-resourced countries.

But as has been the case with many outbreaks in history, success in combating crisis can be its own worst enemy. The crisis ends, and so does the attention to it — but maybe not this time.

According to the World Bank-commissioned poll carried out last month by the consulting firm Greenberg Quinian Rosner Research in France, Germany, Japan, the United Kingdom and the United States, the majority of respondents support investments in health systems in developing countries in order to prevent the spread of future pandemics.

The poll surveyed 4,000 people across the five donor countries. It included participants from the general public as well as so-called opinion elites — those with university degrees who closely follow global news.

Eighty percent of elites and 77 percent of total participants felt investments in clinics and medical personnel in developing countries help prevent the spread of epidemics to their own countries. Two-thirds of elites and 58 percent of total participants felt that in order to protect their countries from future pandemics, their governments need to invest in developing countries. And 76 percent of elites and 69 percent of total participants said investing in health care in developing countries saves the world money by containing or preventing epidemics.

“We find these findings extremely important,” Tim Evans, senior director for the Health, Nutrition, and Population Global Practice at the World Bank, told journalists Wednesday.

Evans explained that understanding how the public perceives infectious disease threats is critical when approaching policymakers about financing.

“I think these results suggest the public would support policymakers — and those who make decisions on finances — to have a more continuous, focused look at these episodic events,” he said.

In addition to suggesting public opinion remains favorable to health systems strengthening, the poll showed that respondents are concerned about future disease outbreaks and believe their own countries and the international community at large is not well-prepared enough to respond.

In a list of 10 global concerns, “global health and epidemics” ranked behind only “terrorism” and “global climate change.”

“This survey shows that the public sees global infectious disease outbreaks as a serious threat, and they want leaders to take action to prepare for the next potentially deadly epidemic,” World Bank President Jim Yong Kim said.

Donors have directed funds to health systems strengthening in Ebola-ravaged West Africa. The United Nations established a High-Level Panel on the Global Response to Health Crises, and the World Bank, World Health Organization and others have partnered on a Pandemic Emergency Facility.

As attention shifts toward the sustainable development goals — and how the international community can finance their implementation — public opinion could prove a valuable piece of supporting evidence to wield. For the time being, health systems strengthening continues to pass the popularity test.

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About the author

  • Jeff Tyson

    Jeff is a former global development reporter for Devex. Based in Washington, D.C., he covers multilateral affairs, U.S. aid, and international development trends. He has worked with human rights organizations in both Senegal and the U.S., and prior to joining Devex worked as a production assistant at National Public Radio. He holds a master's degree in journalism from Columbia University and a bachelor’s degree in international relations and French from the University of Rochester.