The economy of well-being
Health is at the very foundation of how our societies function. Being able to provide a secure, equitable system involves a truly comprehensive, multisectoral approach, covering everything from the air we breathe to the food we consume, and focusing on prevention and preparedness as much as access
Since the turn of the century, global gross domestic product has more than tripled. This growth has delivered many benefits, including for health. But it has also come at a cost. Increased urbanisation, industrialisation and consumerism have produced more pollution, climate change, unhealthy diets, increasing rates of cancer, diabetes and heart disease, antimicrobial resistance, and more.
In addition, the benefits of growth have not been shared equally. At least half the world’s population still lacks access to at least one or more essential health services, and two billion people face financial hardship from out-of-pocket health spending.
Health is the foundation for growth
The Covid-19 pandemic was a painful reminder that when health is at risk, everything is at risk. In addition to the death and disease it caused, the pandemic caused severe social, economic and even political disruption. One of the most important lessons of the pandemic is that health is not a cost, but an investment in more resilient, more productive and more stable societies.
Reflecting this realisation, World Health Organization member states at this year’s World Health Assembly adopted a resolution on the Economics of Health for All, urging all countries to incorporate an ‘economy of well-being’ perspective into national policies. Such a shift would have benefits for both health and economies.
Building societies and economies that put health at the centre requires decisive action in three key dimensions: promoting, providing and protecting health.
First, promoting health means an emphasis on preventing disease and addressing its root causes. The Dutch philosopher Erasmus said that prevention is better than cure; some 500 years later, we are still learning how right he was. Health is not created primarily in hospitals or clinics, but in homes and communities, streets and markets, workplaces, and our environment – in the air people breathe, the food they eat, and the conditions in which they live and work.
Second, providing health means ensuring that when people do need care, they have equitable access to the essential health services they need, without facing financial hardship. This involves reorienting health systems towards primary health care, as the foundation of universal health coverage. In turn, that entails strengthening the health workforce, improving the quality and safety of health services, increasing access to essential medicines and vaccines, and reducing out-of-pocket health spending.
Third, protecting health means making populations safer from epidemics and pandemics by strengthening health emergency preparedness and response, nationally, regionally and globally. Much work has been done in this area since the Covid-19 pandemic to strengthen the many dimensions of health security: financing, surveillance, accountability, emergency workforce, equitable access to vaccines and other tools, and more. The new WHO Pandemic Agreement and the amended International Health Regulations are vital instruments of international law to ensure a more coordinated and equitable response to future pandemics.
A political choice
These three priorities are at the heart of the new four-year strategy for global health that WHO member states adopted at this year’s World Health Assembly in the 14th General Programme of Work.
Achieving these priorities is fundamentally a political choice. At the national level, it is a choice that is made in policy decisions across many sectors: agriculture, commerce, education, energy, trade, transport, taxation and more. At the international level, it is a choice that is made in bilateral and multilateral forums to prioritise health as fundamental to development and security. In their declaration this year, G7 leaders once again expressed their strong support for global health and recognised the central role of the WHO. The WHO is also hosting the G20 Joint Finance and Health Task Force, to improve coordination between health and finance in addressing pandemic preparedness and response.
To support countries to promote, provide and protect health, the WHO is making a historic investment in our 153 country offices, strengthening our on-the-ground presence to provide more tailored support to deliver better health outcomes. To mobilise the predictable and sustainable funds we need to provide that support and implement our four-year strategy, we have also launched the first WHO Investment Round, a series of pledging events that will culminate at the G20 summit in November, chaired by President Lula da Silva of Brazil.
We estimate that if implemented, the 14th General Programme of Work could save at least 40 million lives. Ultimately, health is not a cost to be contained, but an investment to be nurtured in healthier populations, and in more equitable, more stable, and more secure societies and economies.
