Thank you Guillaume and Michael; distinguished panelists, ladies and gentlemen.
Thank you for inviting me to join this fascinating discussion on “Health and Innovation: the Challenge of Accessibility”. Innovation and accessibility are at the forefront of our minds at the World Bank Group, in health and beyond.
We help developing countries build healthier, more equitable societies, as well as improve fiscal performance and country competitiveness—toward our twin goals of ending extreme poverty by 2030 and boosting shared prosperity.
In health, we’re calling for Universal Health Coverage by 2030 - to ensure that everyone has access to essential, quality health care, regardless of their ability to pay.
Universal health coverage is a triple win: It improves people’s health, reduces poverty, and fuels economic growth. The recent report of the Lancet Commission on Investing in Health chaired by Larry Summers attributed nearly a quarter of economic growth in developing countries to improved life expectancy and health outcomes.
And we are seeing that improving access to health care IS possible – and many countries have come a long way already
Over the past quarter century, more than half a million women worldwide died annually due to childbirth, and more than 12 million children perished before the age of five, mainly from preventable causes. Today, these numbers have been more than cut in half.
Canada’s leadership on maternal and child health through the Muskoka Initiative has been a key driver of this progress.
Yet too many mothers and children still die for lack of access to care, and the gap between rich and poor countries in access to care is still, quite simply, too large.
For example, the maternal rates in the least developed countries are about 30 times those in high-income countries, with half the global burden in sub –Saharan Africa.
This gap is unconscionable. As our World Bank Group President Jim Kim said in Toronto one year ago at Prime Minister Harper’s summit on maternal and child health, “A baby in Cameroon and a baby in Canada should have the same opportunity to be born safely, and to have her mother survive childbirth to care for her.”
There’s also large funding gap for these programs – an estimated US$33 billion in 2015 alone for high-burden, low- and lower-middle-income countries, equivalent to US$9.42 per capita per year. Closing this gap will require dramatic increases in financing from both domestic and international sources.
Another area where there’s still major gap in access is in protection against deadly infectious diseases – whether through access to vaccines and immunization, or the availability of sufficient diagnostic capabilities, trained health workers and equipped facilities to quickly contain an outbreak.
The Ebola epidemic in West Africa has been a wake-up call - demonstrating that the world needs to be much better prepared to respond to potential pandemics.
SO in order to end poverty and achieve universal coverage and “Health for All” - which is the new health goal that the world will set this September at the United Nations - we will have to tackle health and development finance differently.
As this forum suggests, the world will have to innovate – both within the public sector, and in closer partnership with the private sector.
These Innovations in health need to be need to be smart, scaled and sustainable.
And innovation needs to be embedded in a strong national health system – a system that can deliver effective prevention and care services across the full spectrum of public health needs, accessible to everyone, everywhere.
What’s also clear is that over next 10 years: Technology offers huge promise for digital health solutions that can transform the way health services are delivered and help close the gap both in access and in affordability of care.
These solutions can potentially address chronic supply side shortages in health personnel as well as gaps in health care infrastructure.
Digital data is coming to health care. This means potentially more personalized care, but of course it also raises challenges in the way that this data is managed and issues of personal data security.
A variety of mobile diagnostic devices connected to mobile phones are likely to become the norm for frontline health workers. For example, there are efforts underway now awaiting FDA approval to diagnose Ebola BEFORE any symptoms emerge. Just think where West Africa would be today if this technology had in place when the Ebola outbreak first happened.
There are also a variety of primary diagnostic tools that can be used by lower skilled health workers in remote settings where the diagnosis results from algorithms embedded in the digital program or by a connected solution where a more skilled provider in a different location can confirm the result and diagnose and monitor care.
Other solutions are platforms and portals allowing for faster flow of information and knowledge sharing. Some of these solutions are in fact appearing first in emerging markets, while others have the ability to be adapted and implemented globally.
There are also a variety of digital payment solutions and big data-derived insurance models that will make their way into health care.
The private health sector in emerging markets are early adopters of these solutions but telecoms and pharma companies are also driving the change – and these are technologies that can benefit the public sector.
The private sector arm of the World Bank Group – the IFC -- through its Early Stage Investment Program - -has been active in identifying and investing in some of these emerging opportunities in health care.
IFC has already invested in several technology enabled health services businesses bringing higher quality but affordable care to middle and lower income patients in ways that previously were not feasible such as [Eye Q and Nephropulus in India] and is actively looking at other opportunities in the digital and connected health space.
So technology can make a huge difference. But going to scale and improving access by developing countries requires innovations in health financing as well as in service delivery – and changing the incentives to promote smarter investments in health.
Over the years, the World Bank Group has worked with its development partners to design and roll out a number of innovative and game-changing financing initiatives in the area in global health. One such initiative, on which we have partnered closely with Canada, is the pilot Advance Market Commitment (AMC) for vaccines against pneumococcal diseases. The pilot AMC was launched in 2009 with donor commitments of US$ 1.5 billion from the Governments of Canada, Italy, the United Kingdom, the Russian Federation, Norway and the Bill and Melinda Gates Foundation. The objective is to create a viable market for pneumococcal vaccines so that developing countries can access these at affordable prices. The AMC is now in its fifth year of implementation; it has already financed 1.46 billion doses of vaccines since 2009 at prices significantly below those quoted in other markets. A total of 50 countries have introduced these life-saving vaccines.
To advance the post-2015 global health agenda, the World Bank Group is working with a number of countries and international partners both public and the private sector to develop three complementary and path-breaking innovative finance mechanisms:
The first is the Global Financing Facility for Every Woman Every Child (or GFF).
The GFF, designed in consultation with a wide array of development partners, will help mobilize additional domestic and international financing from public and private sources.
GFF will support country plans to scale up and sustain essential, quality health services for women, children, and adolescents and end preventable deaths by 2030.
I want to acknowledge in particular the leadership of Prime Minister Harper and Minister Paradis of Canada in the establishment of the GFF, which will be launched at the UN Financing for Development Conference in Addis this July.
The second is the Power of Nutrition, (PON) a new UK-based charity established in partnership with the Children’s Investment Fund Foundation, UBS Optimus Foundation, DFID, UNICEF and the World Bank Group.
The PON will scale up support for early childhood nutrition. PON aims to leverage up to a billion dollars by 2020 to tackle child undernutrition in the poorest countries in the world.
The first country to benefit was Tanzania receiving $20 million thru a new 55 million multi-donor trust fund (MDTF) to implement the PON.
The third is the Pandemic Emergency Financing Facility (or PEF).
The World Bank Group is working closely with WHO and other partners, including the private sector, to develop and implement the PEF.
The PEF aims to channel funds swiftly to governments, UN agencies, civil society organizations and others to finance efforts to contain dangerous epidemic outbreaks and help prevent costly pandemics.
The PEF will be designed to promote better coordinated and more efficient national and global preparedness efforts and incentivize country investments in pandemic preparedness and prevention. And it will leverage private resources and help create a new market for pandemic insurance in developing countries.
Earlier this week, G7 leaders endorsed the creation of the PEF – and so together with our partners we will accelerate our efforts with partners to launch this new financing facility before the next deadly, and potentially much worse, outbreak occurs.
Working together - and alongside existing development financing mechanisms such as IDA, the World Bank Group’s fund for the poorest countries - and IBRD - the GFF, PON and the PEF will constitute a powerful new set of global financing tools to realize the post-2015 global health agenda and help prevent the next pandemic.
As we look beyond 2015 to 2030, access, equity and innovation must drive the agenda.
Let’s realize the promise of global health advances to give everyone, everywhere access to the affordable, quality care they need - to end extreme poverty and boost shared prosperity within a generation.
I look forward to our conversation today.