The U.S. Chamber of Commerce wants to spearhead a global private-public effort to ensure universal health coverage throughout the world by 2030.
In a white paper, the chamber outlines the daunting challenges that such an undertaking would face but also makes recommendations about how those challenges could be met.
The main hurdle will be raising the $176 billion needed to achieve the goal, especially for low- and middle-income countries (LMICs) that will need to raise $108 billion of those funds.
“Even if LMICs were to implement strong fiscal measures and increase government spending on health to recommended levels of 15%, the funding gap would only be cut down by one-third,” the white paper said.
There would need to be close cooperation between the public and private sectors as a well as generous contributions from donor organizations to make this happen, but, even then, success could prove elusive. “Innovative finance will likely not be the only solution to this problem, but attempting to overcome its barriers remains an important step forward,” the white paper states.
The chamber lobbied for movement on this front during the 78th session of the United Nations General Assembly, which ended Friday.
"The Chamber knows firsthand how the private sector remains underleveraged when it comes to the promise of innovative financing which has been recognized by organizations like the [Organization for Economic Co-operation and Development] as a solution to bridge funding chasms," said Varnee Murugan, the chamber’s executive director of the global initiative on health and the economy, in a press release. "This critical white paper delves deep into the nature of innovative finance and how to overcome the challenges hindering its potential to close the UHC funding gap.”
The barriers to innovative financing include the costs associated with launching such efforts, questions about getting value for investment, national regulatory systems that don’t welcome novel financing efforts, charges that financing mechanisms can be too complex and the inability of public stakeholders to understand innovative financing.
Barriers to private sector participation include a lack of clarity about motivations leading to mistrust by policymakers, different expectations between the private sector and policymakers, lack of essential information needed for due diligence and lack of an organized approach in the private sector toward innovative financing.
To address these challenges, the white paper encouraged policymakers to develop a standardized process to engage private stakeholders from the beginning, use not only private sector funding but also private sector know-how and insights, deal with private sector companies as one group—which should allow for a more inclusive approach—ensure transparency and create a multilateral participatory forum in which to discuss these matters.
The white paper suggests that the private sector encourage alignment around common principles of engagement, anticipating problems such as high transaction costs and legacy regulations.
The white paper concludes that “ultimately, the recommendations in this report can only materialize if high-level leadership of both the private and public sectors proactively call for alignment and better cooperation, and this call is both structurally and ideologically supported. Public sector leaders must set a clear policy direction for greater public-private cooperation while breaking down internal barriers to do so.”