Daniela Pereira, Policy Assistant, EPHA
An economic crisis usually leads to general poor public health: not only do governments cut their spending in public health, but people also tend to adopt less healthy behaviours such as eating inexpensive, low quality food (e.g., high-calorie and nutrition-poor products) and spending less money on physical activity. In economic crisis situations, governments should actually invest even more in public health. Investing in public health gives economic returns not only to the health sector, but also to other sectors and the wider economy, with an estimated fourfold return on every dollar invested[1].
But most governments did not follow this path during the economic crisis. Indeed, concerns about upfront costs and the intangibility of outcomes are two key barriers when it comes to investing in public health.[2] But by not investing in public health, governments were starting a chain reaction that contributed to damaging entire economies: people became sicker and less productive.
More investments in public health are needed for sure. For this to become a reality, governments need to see the benefits from it, regardless of the years it might take to measure the outcomes. Prevention, for instance, is one of the most cost-effective policies, but reliable data about the outcomes of interventions and being able to quantify who and how many people would get sick without them could make a big difference in convincing governments to invest in public health. Furthermore, if governments have invested more in public health, would the economy be in a better shape to withstand the financial crisis?
Of course, governments are not the only actors involved in this process. If we look beyond Europe, we see that universal health coverage (UHC) cannot be achieved by “business as usual” A number of countries, from Rwanda to Angola, are embracing innovation and new partnerships, including with local NGOs, to provide basic, cost-effective healthcare services.
Boosting public health will involve new funding tools and relationships between governments, civil society, international funding institutions (e.g. the World Bank) and private sector investors pursuing ethical goals. The most important thing might be trust-building and risk-sharing between all relevant actors. While ethically driven investors take into account extra-financial factors such as corporate governance, human rights, occupational health and safety, climate change, community impacts, etc.[3], they are lacking information from trusted sources, including civil society.[4] An upcoming EPHA study will explore the potential of sustainable financing and investor disclosure to mobilise public health financing in Europe and globally.
[1] WHO, 2014, The case for investing in Public Health, Regional Office for Europe
[2] WHO, 2014, The case for investing in Public Health, Regional Office for Europe
[3] Radler Yelder (2012) The Value of extra-financial disclosure, What investors and analysts said, London: Radler Yelder.
[4] Radler Yelder (2012) The Value of extra-financial disclosure, What investors and analysts said, London: Radler Yelder.
