Ed note. The Nobel Peace Prize will be awarded on Friday. I wrote the following post this past April for World Malaria Day. I argued that the Nobel committee should award this year’s peace prize to a global health organization–specifically, Unitaid. This group does very important though somewhat unrecognized work to sharply drive down the costs of life saving medicines in the developing world. It has pioneered the concept of “innovative financing for development” which has spurred incredible gains in global health over the past half decade. In the face of shrinking foreign aid budget, we need to some creativity in how we fund global health. That’s where Unitaid comes in. Read on.
It is World Malaria Day today. The theme this year is “Sustain Gains, Save Lives: Invest in Malaria,” which is a distressing acknowledgement that funding for malaria control and treatment is quite precarious. From the Roll Back Malaria partnership:
Investments in malaria control have created unprecedented momentum and yielded remarkable returns in the past years. In Africa, malaria deaths have been cut by one third within the last decade; outside of Africa, 35 out of the 53 countries, affected by malaria, have reduced cases by 50% in the same time period. In countries where access to malaria control interventions has improved most significantly, overall child mortality rates have fallen by approximately 20%. However, these gains are fragile and will be reversed unless malaria continues to be a priority for global, regional and national decision-makers and donors.
They are right to be worried that these impressive gains may be reversed. Funding for malaria, and global health more broadly is slowing down. The Global Fund to Fight AIDS, Tuberculosis and Malaria had to cancel a round of grants this year because donors simply did not contribute enough money. What’s worse, for the first time in over a decade, inflation reduced the value of aid from donor countries last year by nearly 3%. In all, donor countries gave $133.5 billion in all forms of official development assistance last year, but when inflation was taken into account, this actually amounted less than what they could buy with similar funds in 2010.
There is simply less money available for the global fight against infectious diseases. This is why groups like Roll Back Malaria are so concerned about keeping up the impressive progress that has been made in humanity’s fight against this terrible disease.
We need to diversify how we fund the global fight against diseases like Malaria. The term of art for this is “innovative financing for development.” The world’s laboratory for innovative financing is located in Geneva, in a small outpost of the UN family called Unitaid. The world’s top evangelist for finding new sources of funding to fight global diseases is the medical doctor-turned politician-turned diplomat, Philippe Douste-Blazy.
Douste-Blazy is a former foreign minister of France and currently serves as the UN undersecretary general for innovative financing and chairman of Unitaid. In 2006, he convinced the French and Brazilian governments to impose a small levy on the purchase of commercial airline tickets–just a dollar or two per ticket (or more if you fly business class) — and turn that money over to Unitaid to invest in global health programs. Today, nine countries participate in the airline levy program. Unitaid has raised over $2.5 billion for global health since 2006 though millions of these tiny contributions from airline passengers.
This year, Unitaid took me to Liberia and Cameroon to see the results of their work. I saw how investments in rapid diagnostic tests for malaria help patients access effective drugs. I met a woman who developed resistance to first line HIV drugs, but lives a healthy and productive life thanks to (more expensive) second line therapies provided through Unitaid; and I met health officials who relied on UNITAID ability to drive down the price of malaria, TB and HIV medicines, so they can buy more medicines at cheaper costs.
UNITAID was able to accomplish this though the tiny contributions of airline passenger in just a few countries around the world. But if we want to not just contain malaria, HIV/AIDS, or TB–but effectively eliminate these diseases, we will need to think bigger. So, Douste-Blazy has been actively pursuing a micro-tax on financial transactions, including the buying or selling securities or derivative products. Unitaid conducted a feasibility study last year which found that if a levy on financial transactions of about 0.001% were applied across every G-20 country, over $260 billion could be raised.
To Americans, the idea of a redistributive financial transaction tax seems far off, (despite the best efforts of the Occupy Wall Street movement!) But, to much of Europe there is nothing particularly controversial about it. The UK has had such a tax for decades and it is still among the strongest economies in the world. Some countries are on the verge of considering a FTT, including France and Germany. If just France adopted a tiny financial transaction task, Unitaid predicts it could yield 12 billion euros per year.
These are game changing numbers. But in order to actually change the game, we need an extra push from outside.
This is where the Nobel Committee could make a huge difference.
Granting the Peace Prize for Unitaid’s pioneering work in innovative financing would introduce the concept to everyday people around the world. It would give innovative financing for development the spotlight it deserves as a way to sustain a more healthy and productive planet. This is what occurred after the Nobel Committee gave its 2006 Peace Prize to Mohammed Yunus and Grameen Bank for micro-finance. The prize helped bring the concept of micro-finance to the mainstream. A prize for Unitaid could have a similar effect on the innovative financing movement.
Another, perhaps more immediate impact of conferring the prize for innovative financing, would be to give some political heft and backing to debates ongoing in parliaments across Europe as they consider imposing a Financial Transaction Tax. Several Europe countries, (and even the European Parliament) are discussing using an FTT as a mechanism to cover countries’ burgeoning debt crises. It is only a matter of time before Europe’s largest economies, like Germany or France, impose some sort of FTT. A Nobel Prize for Unitaid would put momentum behind the idea that at least a portion of funds levied by an FTT should support the world’s most vulnerable people.
The UN, the IAEA, the UN Refugee Agency, UNICEF, UN Peacekeeping, have all won Nobel Peace Prizes for facing the most pressing challenges of their era. There is no more urgent cause today than bringing effective, life saving health care to millions of people around the world who suffer from easily preventable and treatable illness. It is a shame that on World Malaria Day we have are worried about how we will raise the next dollar to purchase a bed net to prevent the disease, a microscope to diagnose it, or Artiseminin Combination Therapy to treat it.
This need not be the case. Innovative financing schemes like the ones devised and used by Unitaid offer the kind of stability that donor-driven aid does not provide. It is well past time that we become more creative in how we fund the fight against Malaria and other preventable diseases.