Why it's time for a Global Fund for Health

August 20, 2014 marked the 500-day countdown to the target date for the Millennium Development Goals (MDGs).

All around the world, governments, academics and health advocates are preparing to rewrite these goals. There is no doubt that health will remain a priority.

After all, as the Global Burden of Disease recently published in the Lancet showed, the world still loses 50 million people every year, deaths fuelled by emerging communicable diseases, an unfinished communicable disease agenda and economic disparities.

Global health emergencies such as the raging Ebola epidemic in West Africa and other diseases fuelled by climate change will continue to be challenging.

However, what disease priorities will be adopted in the next round of development goals will be subject to intense debate, in a battle of wit, intellect and strategy. In the heat of these discussions, a potential casualty will be the global plan for funding the new health-related goals.

And yet we have tremendous opportunities beckoning. That the world has the money to alleviate disease is not in doubt. Despite the economic crises in the US and Europe, other economies are booming.

A global community boasting of $70 trillion worth of wealth in GDP is not poor by any standards. But, we must do things differently. First, a new health financing mechanism is required.

Even from an equity perspective, a middle-aged man in Alabama afflicted with diabetes and hypertension or the young woman dying of childbirth in rural Mozambique, should have an equal opportunity for health as any HIV-infected person anywhere in the world.

That is why, a Global Fund for Health is an imperative.

We could expand the mandate of the Global Fund for HIV/Aids, TB and Malaria (GFATM) so that all diseases of global health importance including neglected tropical diseases can be funded.

The Ebola epidemic provides a vital lesson that countries need to access emergency funding for diseases of global health importance. Countries or other appropriate jurisdictions will then be given opportunities to apply for funding based on their burden of disease.

Additionally, the mindset that health funding should be disbursed as debt should be reviewed.

The roles of the Bretton Woods institutions may be re-defined in this respect. Second, we need to craft a new global partnership for health.

The United States has exhibited philanthropy of historic proportion through the US President's Emergency Plan for Aids Relief (Pepfar) and other initiatives.

However, these are new times and the G8, the BRICS (Brazil, Russia, India, China and South Africa) and indeed countries in resource-limited settings should be engaged strategically.

The days when African countries were net recipients of health aid are gone; in fact, they must make contributions to the Global Fund for Health. Third, we need to channel health finances to beneficiaries in an innovative, efficient and socially accountable manner.

In Rwanda for example, performance-based financing, a mechanism in which providers and health facilities are funded against pre-agreed targets has shown significant improvements in the quality of care.

More importantly, the world needs to invest upfront in health systems to support service delivery.

As the world prepares for the UN summit in 2015, it should be clear in the minds of policy makers, political leaders and advocates that the success of the next set of MDGs will depend largely on how we mobilise and disburse financial resources.

The Global Fund for Health may be the bridge we need to fill the resource gap. We owe this to future generations.