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    What we know about WHO's new €1.5B primary health investment platform

    The World Health Organization and three development banks are crafting a platform focused on strengthening primary health systems in low- and middle-income countries. This is what we know so far.

    By Sara Jerving // 26 March 2024
    Last year, the World Health Organization, African Development Bank, Islamic Development Bank, and European Investment Bank committed to making €1.5 billion ($1.6 billion) available for investments toward strengthening primary health systems in low- and middle-income countries. The financing will include grants and concessional loans — loans offered at rates that are more favorable than what countries could obtain in the marketplace. The details are currently being hammered out, but it’s expected that legal documents around how this new platform will operate will be signed in the second quarter of this year. Called the Health Impact Investment Platform, or HIIP, the program was launched last June and it will work with countries on developing national investment plans to bolster their primary health systems. This would include efforts to ensure they are strong enough to weather the next pandemic and have the resilience to withstand the impacts of climate change. Primary health care is the bedrock of any nation’s health system. Investing in primary health care is seen as the most cost-effective way countries can spend their health budgets. When people have regular access to this type of care, it can help prevent them from developing more serious and costly ailments. Some 90% of essential health services can be delivered in primary health systems. Front-line health care workers in these systems are also the first line of defense in detecting new outbreaks, which if not handled quickly and appropriately, could evolve into pandemics. But in a lot of low-resource settings, people can’t access these fundamental services. It is estimated that over 1 billion people are at risk of falling into poverty because they must spend 10% or more of their budgets on out-of-pocket health spending. It is also estimated that globally, an additional investment of $200 billion to $328 billion a year is needed for countries to reach targets around providing more comprehensive packages of primary healthcare services. Building an investment plan When the fund was announced at the Summit for a New Global Financing Pact last June in Paris, France, €1.5 billion was committed. Initially, the four founding partners are to contribute $40 million, which will be distributed to countries as grants. These funds will be managed by WHO. At the heart of this new platform is working to create strong national health investment plans — and then identifying specific projects. WHO and the banks will work with national ministries of health and finance to identify where the gaps exist within a country’s primary health systems and what strategies can help remedy these problems — particularly aiming to reach underserved populations. Projects that receive funding could include the buildup of infrastructure, investments in the health workforce, expanding access to medicines, and rolling out digital health technologies. When assessing whether to fund a project, the platform’s team will seek out “technically sound projects with strong social returns” that provide value for the money that governments take out as loans, a WHO spokesperson said. The partners have said that they will aim to reduce risk by blending concessional loans and investment grants, as well as aiming to increase coordination on health investments within countries so that these efforts are not fragmented. Moving forward, the founding partners also intend to expand this platform to draw in new financiers and to work to ensure that projects within countries align with other private sector investments. They aim to spur public spending but not send countries into unsustainable debt. The platform builds on experiences learned from prior collaborations. WHO, EIB, and the European Commission have worked in Angola, Ethiopia, and Rwanda on strengthening primary health systems through investments, grants and technical assistance. For example, WHO advised the Rwandan government on rebuilding the National Health Laboratory System with finances coming from the European Commission and EIB. 3-tiered structure In the structure of the platform, WHO serves as the convener of the founding partners and the multilateral development banks will finalize the investments. WHO will lead the secretariat, which will handle the administration of the platform. The steering committee, which is tasked with making decisions, will be composed of members of the four organizations. Staff from the partner organizations will also be part of a technical committee, which will review country requests for technical assistance, as well as their national health investment plans. Currently, the founding partners are finalizing operational and legal documents, as well as identifying countries interested in making these initial investment plans. WHO’s innovative finance team and technical teams are supporting this work. It’s expected the agreement around the new platform will be signed at the end of April, a WHO spokesperson told Devex. Following that, the founding partners expect the first round of grant funding will be disbursed midyear and be allocated for technical assistance, setting up of the secretariat, and initiating in-country work.

    Last year, the World Health Organization, African Development Bank, Islamic Development Bank, and European Investment Bank committed to making €1.5 billion ($1.6 billion) available for investments toward strengthening primary health systems in low- and middle-income countries.

    The financing will include grants and concessional loans — loans offered at rates that are more favorable than what countries could obtain in the marketplace.

    The details are currently being hammered out, but it’s expected that legal documents around how this new platform will operate will be signed in the second quarter of this year.

    This story is forDevex Promembers

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    • Global Health
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    About the author

    • Sara Jerving

      Sara Jervingsarajerving

      Sara Jerving is a Senior Reporter at Devex, where she covers global health. Her work has appeared in The New York Times, the Los Angeles Times, The Wall Street Journal, VICE News, and Bloomberg News among others. Sara holds a master's degree from Columbia University Graduate School of Journalism where she was a Lorana Sullivan fellow. She was a finalist for One World Media's Digital Media Award in 2021; a finalist for the Livingston Award for Young Journalists in 2018; and she was part of a VICE News Tonight on HBO team that received an Emmy nomination in 2018. She received the Philip Greer Memorial Award from Columbia University Graduate School of Journalism in 2014.

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