Reorienting economies to deliver health for all

The council, created by WHO Director-General Dr Tedros Adhanom Ghebreyesus in November 2020 in response to the COVID-19 pandemic, and chaired by Professor Mariana Mazzucato (UCL Institute for Innovation & Public Purpose), has spent the last two years rethinking the economy from a "health for all" perspective, and pushing the principle that human and planetary health must be at the heart of how we design our social, health and economic systems and policies.

Launched in conjunction with the Seventy-sixth World Health Assembly, the report, entitled Health for All: Transforming economies to deliver what matters, draws on the council's previous work and provides a new narrative grounded in the latest economic wisdom to reorient economies to deliver health for all across four interrelated themes with specific recommendations under each:

1. Value - valuing and measuring what matters through new economic metrics
2. Finance - how to finance health for all as a long-term investment, not a short-term cost
3. Innovation - how to advance health innovation for the common good
4. Capacity - how to strengthen dynamic public sector capacity to achieve health for all

Professor Mariana Mazzucato, chair of the council, said: "Over the past two years, the WHO Council on the Economics of Health for All has worked to craft a new economic narrative - one that transforms financing for health from an expenditure to an investment. We have examined the changes needed - including to the structure of patents, public-private partnerships, and budgets - to design an economy that delivers health for all. In our final report, we call for new economic policy that is not about market fixing but about proactively and collaboratively shaping markets that prioritise human and planetary health."

Dr Tedros Adhanom Ghebreyesus said: "Two years ago, I asked a team of the world's leading economists and public health experts - all women - to create a paradigm shift. Now, instead of health for all being seen as the servant of economic growth, we have a roadmap for structuring economic activity in a way that will allow us to reach the goal of seeing all people with access to essential health services faster with better results."

Key recommendations include:

• The need to value and measure the things that truly matter - human and planetary flourishing - rather than pursuing economic growth and GDP maximisation regardless of the consequences. To achieve health for all, governments must rethink value and reshape and redirect the economy based on social and planetary well-being, guided by new metrics.
• A fundamental overhaul of national and international systems for financing health is needed, so that spending on health is treated as a long-term investment. Delivering health for all will require both more money, and higher quality financing.
• Innovation requires collective intelligence-it is never the fruit of just one company or government agency. But unless innovation is governed for the common good, many people remain excluded from its benefits. A new end-to-end health innovation ecosystem that prioritises the common good is needed.
• Re-investing in government capacity is crucial to delivering health for all. The COVID-19 pandemic has made clear, the quality and capacity of government matters. Effective governments are not the smallest, but those that are well-designed and properly resourced, both financially and in terms of their people and infrastructure.

The report also provides suggestions on what can be done in practice to implement the changes needed to reorient measures of economic value, the financing of health, innovation and building public sector capacity in the service of health for all. Among these, the report mentions several examples, including:

• The mRNA technology hub facility in South Africa: a values-driven system that tries to get the innovation, financing and capacity right from the start;
• Brazil's public investment in a health-industrial complex that serves the common good;
• Regional development banks as enablers of change in the Global South;
• The Wellbeing Economy Alliance - an alliance of several governments and over 600 other organizations working together to transform economic systems in the service of life;
• Approaches to financing national action plans (NAPs) on antimicrobial resistance through multi sector joint budgeting, given that most NAPs remain unfunded.

The recommendations included in the report could change the way countries view and finance health. With this report, the WHO calls on policy-makers, civil society, and members of the health and economics communities to give full consideration to the recommendations and use them as a compass to develop new economic policies and structures that can move us along the road to making health for all a reality.