Global Health Risk Framework Pandemic Financing: Workshop Summary (2016) / Chapter Skim
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7 Financing Challenges In-Country
7 Financing Challenges In-Country
Pages 41-48
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From page 41... ...
(Bampoe, Biti, Kollie) • Weak institutions and technical capacity in developing coun tries impede aid effectiveness.
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From page 42... ...
James Kollie, deputy minister for fiscal affairs in Liberia; Gordon Liu, professor of economics at Peking University; Victor Bampoe, deputy minister of health in Ghana; and Tendai Biti, former minister of finance in Zimbabwe, discussed some of these in-country financing challenges, including the allocation of resources across activities and to short- and long-term needs. Kollie described how during the Ebola crisis Liberia faced twin problems: revenues were decreasing at the same time that the demand for expenditure increased exponentially.
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Learning from the experience of Nigeria and the United States, Ghana set up a major operations center to serve as a coordinating body between the government and the technical experts. Through a process called a sectorwide approach, all the development partners gather to discuss what to fund.
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He described the need for better coordination within the international community, where discord is "a permanent feature" and turf wars among agencies waste valuable time. In fragile states, the problem is exacerbated because donors do not want to give money directly to the government and must spend time deciding who will govern the trust fund.
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Pandemics and other crises will always bring chaos, but institutional policies can enable efficient catastrophe response. For example, in 2009, the Chinese government began to implement universal health insurance coverage for the entire population.
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In response to Liu's comments, Kollie and Biti addressed the issue of overreacting versus underreacting to epidemics and other crises, noting that in their countries the incentives tend to favor underreporting. As Kollie observed, reports of disease outbreaks can have negative consequences for economies and can create panic among the population.
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One priority that has emerged is the payment of health workers; partners can provide medicine and other supplies, but the government must ensure that health workers get paid. Bampoe observed that the Ghanaian ministry of health has been successful in acquiring resources directly from donors, which has given it some independence from the finance ministry.
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From page 48... ...
While donors demand transparency from recipient country governments, he saw no reciprocation of that openness. To counter this problem, Liberia decided to lead by example; in setting up their National Ebola Trust Fund, they have incorporated detailed accounting requirements and committed to publishing regular reports on how money was spent.
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