Innovative financing refers to a range of non-traditional mechanisms to raise funds for development aid through "innovative" projects such as micro-contributions, taxes, public-private partnerships and market-based financial transactions. [1]
As of the beginning of 2010, most of the existing innovative financing mechanisms were allocated for the health care sector in developing countries. [2] By 2010, Innovative financing mechanisms had raised US$2 billion for health care systems. [3]
The concept "innovative financing for development" was first mentioned and introduced at the International Conference on Financing for Development in 2002. The Conference led to what is now called the Monterrey Consensus where signatories acknowledged "…the value of exploring innovative sources of finance provided that those sources do not unduly burden developing countries." Innovative financing mechanisms were born out of a need to reach the Millennium Development Goals (MDGs) that 192 United Nations member states and at least 23 international organizations agreed to achieve by the year 2015. They include reducing extreme poverty, reducing child mortality rates, improving maternal health and combating HIV/AIDS, Malaria and other diseases such as Tuberculosis. [4] So far, most donor states have failed to meet their 0.7% commitment from the Monterrey Consensus of their Gross National Income (GNI) dedicated to Official Development Assistance. Furthermore, in most developing countries the budget allocated for the social, and especially the Health sector, has been insufficient as it fails to meet the 15% Gross National Product (GNP) requirement dedicated to the Health Sector stated in the Abuja declaration of African leaders in 2001.
Innovative financing mechanisms emerged at the beginning of the twenty-first century [5] as alternative mechanisms to help bridge the development financing gap.
Innovative financing mechanisms can be assessed regarding the following principles:
Scaling-up: Innovative financing mechanisms should significantly increase funding in order to bridge the financing gap necessary to achieve the MDGs.
Additionality: Since these mechanisms were created to fill this gap, innovative financing mechanisms cannot replace Official Development Assistance nor will they be sufficient if certain countries decide to renounce the commitments that they have made.
Complementarity: The role of innovative financing mechanisms is to raise new funds for existing organizations and not to add new actors and complexities to the development landscape.
Sustainability: In order to have a significant and sustainable impact on the MDG's, innovative financing mechanisms should have the objective and ability to finance long-term programs in coordination with other countries. Finally, innovative financing mechanisms should be designed to comply with the other principles of the 2005 Paris Declaration on Aid Effectiveness and the 2008 Accra Agenda for Action.
Unitaid, an international facility for the purchase of drugs against HIV/AIDS, Malaria and Tuberculosis, is supported by a so-called "air ticket solidarity levy," or a tax on airline tickets. As of 2009, 13 countries apply such a domestic tax on airline tickets. UNITAID funds projects through implementing partners across the three diseases based on the market impact criteria (making medication prices affordable for developing countries).
The International Finance Facility for Immunisation (IFFIm) issues bonds in the capital markets, converting long-term government pledges into immediately available cash resources. The pledges are used to repay IFFIm bondholders. So far, IFFIm has raised US$3.7 billion in the bonds markets backed by US$6.3 billion in government pledges. These funds are collected for the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunisation). Since IFFIm's founding in 2006, it has provided close to half of GAVI's overall funding.
The Pneumococcal Advance Market Commitment (AMC) is a mechanism that supports the work of the GAVI Alliance by providing a financial incentive to manufacturers to invest in R&D and expand manufacturing capacity for new vaccines. Governments or organizations commit to buy or subsidize the purchase of a certain number of vaccines at a given price. The AMC has been implemented for pneumococcal vaccines to demonstrate both the feasibility of the AMC mechanism and its impact on accelerating the introduction and mass-production of these vaccines. As of summer 2012, the AMC had supported the introduction of pneumococcal vaccine in 17 developing countries.
Product RED is a mechanism supporting The Global Fund to Fight AIDS, Tuberculosis and Malaria. Thanks to the mechanism, global companies contribute a share of their profits on goods from sales branded with the Product Red trademark.
Debt2Health is a mechanism supporting the Global Fund to fight HIV/AIDS, Tuberculosis and Malaria. Through this mechanism, the Global Fund facilitates debt negotiation between creditors and debtors. Creditors agree to forgo part of the repayment of the money due to them against the commitment of the debtor to invest an agreed-upon amount on Global Fund-approved programs. So far, €200 million has been pledged by the end of 2009 and €50 million had been disbursed in October 2008.
Voluntary Contributions on travel and tourism products funds are collected by the Millennium Foundation through a donation to MASSIVEGOOD which lets travellers make an optional $2, £2 or €2 "micro-contribution" every time they purchase a travel services. All funds go to UNITAID in its fight against HIV/AIDS, tuberculosis and malaria. Additional funding will go towards improving maternal and child health in the developing world.
De-Tax is a "proposal to earmark a share of VAT Taxes generated by participating businesses for health systems development". De-Tax is being discussed by the G20 countries. [6]
Among some potential future innovative finance mechanisms:
Currency Transaction Levy (CTL) is a potential mechanism that would let governments apply a tax on foreign exchange transactions. An expert working group is underway to assess the feasibility of the proposed levy of 0.005%. The tax would be managed through computerized payments made in connection with the settlement of every trade. Auctioning of permits to emit greenhouse gases could be one of the first innovative financing mechanisms earmarked for environmental purposes. Germany announced that it would allocate €225 million from the 2009 proceeds of these auctions to fund development activities. [7]
The development process of new innovative financing mechanisms has been improved thanks to the contribution of various players. Interagency initiatives such as The High Level Taskforce on Innovative International Financing for Health Systems and The Leading Group on Innovative Financing for Development have facilitated coordination processes between actors and is also a platform for introducing new innovative financing mechanisms. [8]
LSL World Initiative is another company focusing on innovative financing. They assist governments to put in place micro-surcharges, taxes and public-private partnerships as mechanisms to raise additional funds and finance development projects. They focus specifically on the Information and communications technology (ICT) and telecoms sector, harnessing diaspora flows. [9]
Another example of innovative (ocean) financing ″is the issuing of Blue Bonds by the Government of the Seychelles, an innovative approach to promote the African islands’ Blue Economy (The Blue Economy) investment strategy.″ The intention of the bond is to finance and enhance the local fishery management in order to secure the marine ecosystem. [10]
Key publications have helped shaping the Innovative Financing framework. Among these key publications are: the Landau report, the report of Working Group 2 from the Task Force for Innovative Financing in Health Systems, a report by Brookings Institution and the World Bank.
Innovative Financing has received support from the United Nations through international conferences on Financing for Development and the Doha Declaration on Financing for Development.
In the United Nations, the Millennium Development Goals (MDGs) were eight international development goals for the year 2015 created following the Millennium Summit, following the adoption of the United Nations Millennium Declaration. These were based on the OECD DAC International Development Goals agreed by Development Ministers in the "Shaping the 21st Century Strategy". The Sustainable Development Goals (SDGs) succeeded the MDGs in 2016.
An International Finance Facility (IFF) is a bond issued against the security of donor government guarantees to maintain future aid flows for the purpose of international development.
An advance market commitment (AMC) is a promise to buy or subsidise a product if it is successfully developed. AMCs are typically offered by governments or private foundations to encourage the development of vaccines or treatments. In exchange, pharmaceutical companies commit to providing doses at a fixed price. This funding mechanism is used when the cost of research and development is too high to be worthwhile for the private sector without a guarantee of a certain quantity of purchases.
The Global Fund to Fight AIDS, Tuberculosis and Malaria is an international financing and partnership organization that aims to "attract, leverage and invest additional resources to end the epidemics of HIV/AIDS, tuberculosis and malaria to support attainment of the Sustainable Development Goals established by the United Nations". This multistakeholder international organization maintains its secretariat in Geneva, Switzerland. The organization began operations in January 2002. Microsoft founder Bill Gates was one of the first donors to provide seed money for the partnership. From January 2006 it has benefited from certain US Privileges, Exemptions, and Immunities under executive order 13395, which conferred International Organizations Immunities Act status on it.
Sir Richard George Andrew Feachem, KBE, FREng is professor of global health at both the University of California, San Francisco, and the University of California, Berkeley, and director of the Global Health Group at UCSF Global Health Sciences. He is also a visiting professor at the University of London and an honorary professor at the University of Queensland.
Pneumococcal vaccines are vaccines against the bacterium Streptococcus pneumoniae. Their use can prevent some cases of pneumonia, meningitis, and sepsis. There are two types of pneumococcal vaccines: conjugate vaccines and polysaccharide vaccines. They are given by injection either into a muscle or just under the skin.
Unitaid is a global health initiative that works with partners to bring about innovations to prevent, diagnose and treat major diseases in low- and middle-income countries, with an emphasis on tuberculosis, malaria, and HIV/AIDS and its deadly co-infections. Founded in 2006, the organization funds the final stages of research and development of new drugs, diagnostics and disease-prevention tools, helps produce data supporting guidelines for their use, and works to allow more affordable generic medicines to enter the marketplace in low- and middle-income countries. Hosted by the World Health Organization (WHO) in Geneva, Unitaid was established by the governments of Brazil, Chile, France, Norway and the United Kingdom.
Awa Marie Coll-Seck is a Senegalese infectious diseases specialist and politician who served as Minister of Health of Senegal from 2001 to 2003 and again from 2012 to 2017. She also served as former Executive Director of the Roll Back Malaria Partnership and is on the board of directors of several notable global health organizations. She is an agenda contributor of the World Economic Forum.
Action for Global Health was formed by 15 non-governmental organisations and charities in 2006. Current partners are based in Brussels, France, Germany, the Netherlands, Italy, Spain and the UK and has over 30 member NGOs across these countries. Interact Worldwide provides the overall co-ordination for the network.
The Millennium Foundation for Innovative Finance for Health is an independent, non-profit Swiss organization, established in November 2008 in order to create new ways to finance health systems in low- and middle-income countries. Based in Geneva, Switzerland, the Millennium Foundation aims to ensure that international commitments on improving health care are met through the development of innovative financing projects. Its first such project – called MassiveGood – was launched on 4 March, and will give travelers the possibility to add a $2, £2 or €2 micro-contribution to the purchase of a travel reservation, with all proceeds going to the fight against HIV/AIDS, malaria and tuberculosis.
Global Health Initiatives (GHIs) are humanitarian initiatives that raise and disburse additional funds for infectious diseases – such as AIDS, tuberculosis, and malaria – for immunizations and for strengthening health systems in developing countries. GHIs classify a type of global initiative, which is defined as an organized effort integrating the involvement of organizations, individuals, and stakeholders around the world to address a global issue.
GAVI, officially Gavi, the Vaccine Alliance is a public–private global health partnership with the goal of increasing access to immunization in poor countries. In 2016, Gavi channeled more than half of total donor assistance for health, and most donor assistance for immunization, by monetary measure.
The Medicines Patent Pool (MPP) is a Unitaid-backed international organisation founded in July 2010, based in Geneva, Switzerland. Its public health driven business model aims to lower the prices of HIV, tuberculosis and hepatitis C medicines and facilitate the development of better-adapted HIV treatments through voluntary licensing and patent pooling. Its goal is to improve access to affordable and appropriate HIV, hepatitis C and tuberculosis medicines in low- and middle-income countries (LMIC). In May 2020, the MPP become an implementing partner of the WHO's Covid-19 Technology Access Pool (C-TAP).
Carole Presern has been executive director of The Partnership for Maternal, Newborn & Child Health (PMNCH) since January 2011.
This page is a timeline of global health, including major conferences, interventions, cures, and crises.
Robert Michael Hecht is an American global health policy and financing expert. Hecht is currently Founder and President of Pharos Global Health Advisors. He has previously held positions with the World Bank, UNAIDS, the International AIDS Vaccine Initiative, and Results for Development Institute. He serves as a lecturer at Yale University’s Jackson Institute for Global Affairs and is a clinical professor at the Yale School of Public Health. He has published on a range of topics in global health and development, with a special focus on the economics, financing, and policies for infectious diseases, nutrition, and broader health system reform. He has been an advisor to the President's Emergency Plan for AIDS Relief (PEPFAR), the World Health Organization, and UNITAID. Hecht holds a BA from Yale and a PhD from Cambridge University.
Dr. Winnie Mpanju-Shumbusho is a Tanzanian paediatrician and public health leader who until December 31, 2015, served as World Health Organization (WHO) Assistant Director General for HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases based in Geneva, Switzerland. From 2016 to 2019, she served as board chair of RBM Partnership To End Malaria. Before joining WHO in 1999, Mpanju-Shumbusho was Director General of The East, Central and Southern African Health Community (ECSA-HC) formerly known as the Commonwealth Regional Health Community for East, Central and Southern Africa (CRHC-ECSA).
COVID-19 Vaccines Global Access, abbreviated as COVAX, is a worldwide initiative aimed at equitable access to COVID-19 vaccines directed by the GAVI vaccine alliance, the Coalition for Epidemic Preparedness Innovations (CEPI), and the World Health Organization (WHO), alongside key delivery partner UNICEF. It is one of the four pillars of the Access to COVID-19 Tools Accelerator, an initiative begun in April 2020 by the WHO, the European Commission, and the government of France as a response to the COVID-19 pandemic. COVAX coordinates international resources to enable low-to-middle-income countries equitable access to COVID-19 tests, therapies, and vaccines. UNICEF is the key delivery partner, leveraging its experience as the largest single vaccine buyer in the world and working on the procurement of COVID-19 vaccine doses, as well as logistics, country readiness and in-country delivery.
The United States is the largest donor of multilateral global health funds. According to the Office of Management and Budget, the U.S. government contributes <1% of the federal budget for foreign aid including global health activities. In 2023, the U.S. contributed 12.9 billion USD towards global health activities across several health verticals including HIV, Tuberculosis, Malaria and COVID-19.