PHOTO: Erick KAglan/World Bank
OFQ: How can countries make their health systems more equitable and more sustainable, ensuring that the most vulnerable like women and children are not left behind? MM: In the short term, it's still all about addressing COVID-19. Countries have to focus on acquiring and deploying vaccines and ensuring that national vaccine deployment plans are prioritized and inclusive. Programs should benefit vulnerable populations and help ensure gender equality. In the medium to long term, I think
it's extremely important to have well- resourced and well-staffed basic healthcare. We support countries to raise resources so that they can fund the basics adequately, but also to make sure that money is well spent and resources are reaching the targeted populations. We are very concerned that most developing countries do not have the resources to fight COVID-19 or to strengthen their healthcare systems. Their resources are insufficient to
prepare for the next pandemic and to expand health coverage. This is why we are making the case that healthcare needs to be prioritized within government spending. There is also a very strong role for external financing,
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especially in the short and medium term. Over time, we can expect countries to fund more of their healthcare with their own domestic resources.
OFQ: What should the countries focus on?
MM: Funds need to be focused on the building blocks of healthcare such as strong surveillance and monitoring, primary healthcare and robust supply chains. Surveillance and monitoring
systems are needed to detect a disease outbreak. Such systems need to scan for environmental factors, animal diseases, as well as human diseases. Ebola, Zika, or COVID-19 are zoonotic diseases that have leaped from animals to humans. Systems also need to function at national and regional levels. Pandemics don’t need passports to cross borders. Another fundamental building block is the decentralized manufacturing of medical equipment. The pandemic has taught us that this capacity is very concentrated. There have been serious supply chain issues when COVID-19 first struck with the supply of personal protective equipment, medical equipment and ventilators. Now, the global supply of vaccines is very uneven.
This is why it is very important that we increase capacities for manufacturing in a decentralized manner. This would strengthen resilience.
OFQ: In June, the G7 pledged US$2 billion to purchase doses of vaccine. How much of these have been deployed? MM: So far only about 15 percent of the pledges have been delivered. In sub- Saharan Africa vaccination rates are as low as five to six percent – compared to well over 50 percent in richer parts of the world. It is sobering. The two factors behind this inequity have been the limited supply and speed of donations. It is a big challenge that we have this huge inequity in access to vaccines. Initially the supply was limited, then the available supply was picked up by richer countries. We have set up a Multilateral Leaders
Task Force with partners such as WHO, International Monetary Fund and World Trade Organization and asked countries who made pledges to accelerate their donations. We're also asking them to favor low-income countries or vaccine procurement mechanisms like the COVID-19 Vaccines Global Access (COVAX) initiative and the African
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