Where are we in Achieving Good Health For All? An Initial Stocktake

by Rupert Francis Mangilit, JP-INFF Communications Officer

April 7, 2023

 

As we observe World Health Day today (7 April), the Joint Programme on INFF takes stock of the country’s progress in meeting SDG 3 (Good Health and Well-being) and how we can collectively close the P600-billion financing gap to achieve it. 

A healthy population keeps the economy strong. This is a fact COVID-19 has laid bare for the Philippines and the rest of the world—and in a hard way.

As millions of Filipinos fell ill during COVID-19's peak, many businesses struggled to keep afloat. Revenues shrank by 6 percent after a long period of steady growth, resulting in a deficit to fund the pandemic response and public health priorities at large. The fiscal deficit widened to twice its pre-pandemic levels. Borrowings rose 15 percent to cover the ballooning deficit. As the country tackled COVID-19's impacts on human and economic health, other priorities suffered.

The country joined the rest of the world in this predicament. Human development stalled globally as the pandemic languished. Four times more countries slid back in their human development indices than during the 2009 financial crisis. 

The adverse impact of this global crisis was also deeply felt in the Philippines. At its current pace, achieving the Sustainable Development Goals, including Goal No. 3 on Good Health and Well-being, will take immense effort and resources. According to Philippine Statistics Authority data, only one target for SDG 3—Universal Health Coverage—is on track. Reducing child deaths and communicable diseases reached some progress, but not enough to lead to desired outcomes by 2030. Targets on noncommunicable diseases (NCDs) and road traffic accidents regressed. 

The next seven (7) years are critical for pursuing Goal 3 and other SDGs. But how wide are the gaps, and how much will it cost to close them? 

The Joint Programme on Integrated National Financing Framework (JP INFF), supported by the Joint SDG Fund and co-implemented by the United Nations Development Programme as the lead UN agency, in partnership with UN Children’s Fund and UN Population Fund, collaborated with the National Economic and Development Authority and other government agencies to scope the gaps in SDG 3 outcomes and find financing opportunities to bridge these gaps.

Particularly, the JP INFF embarked on a new edition of the Development Finance Assessment. In a nutshell, the Assessment provided a snapshot of public and private resources for financing health and other development priorities. Dr. Celia Reyes, former Philippine Institute for Development Studies president, authored the assessment. 

Available data on public resources showed a five-fold rise in the health budget over a decade. From Php 52.4 billion in 2012, it doubled to Php 133 billion in 2016 and further grew to Php 321 billion in 2022. Meanwhile, sin tax revenues from 2019-2021 expanded Universal Healthcare coffers by Php 200 billion. Of this amount, Php 130 billion went to insurance for poor families and informal workers. 

Meanwhile, private sector data from 2017 identified Php 7 billion in SDG 3-aligned investments. This is 17.2 percent of all disclosed investment data gathered by UNDP. As top publicly-listed companies invested in healthcare portfolios in the last five years, this number could have grown many folds by now. In 2021 alone, Ayala and Metro Pacific each invested Php 10 billion and Php P15 billion from hospitals to e-consult apps. 

Whether the whole breadth of investments in health is enough to achieve SDG 3, we do not know yet. This is not because few are willing to chip in. Rather, because most information is not available in real-time, if at all.

 

Despite the limited information, the 2022 Development Finance Assessment estimated the country will need at least Php 600 billion in the next seven (7) years for ongoing health-aligned programs. This will include, among others:

  • Php 114 billion for Smoking Cessation Program, to help tackle one major risk factor for most NCDs; 
  • Php 127 billion to reduce maternal and infant deaths under the Safe Motherhood and Newborn Screening programs; and 
  • Php 80 billion for the National Family Planning Program, to help increase women’s economic and reproductive empowerment.

Closing the Php 600-billion health financing gap is a tall order. But the 2022 Assessment and the multi-sector dialogues that followed had solutions to offer. At least three things emerged as factors that can determine the close this gap:

Data. We have put a nagging emphasis on the power of data to drive agility in achieving the 2030 Goals. In the context of meeting SDG 3 and other SDGs, this power needs harnessing now. 

Our Policy Dialogues stressed the need not only for unlocking greater volumes of data but also welcoming as many sources. Non-traditional data, from satellite images to sentiment analyses, can complement official data.

It is also high time to invest in data infrastructure. The pandemic forced the world, and for a good reason, to devise systems that tracked case logs and vaccination rates in real time. We can scale these systems that have emerged to track the various health outcomes related to SDG 3.

Capacities. Investing in data systems should go hand in hand with capacity building. Government and other sectors should generate data that can inform strategic action. After all, as the old business adage says, “you can only manage what you can measure.” 

The JP INFF developed a tool to tag Budget items aligned with SDG 3 and other Goals. It can help create a common language among development priorities, line items in the Budget, and performance targets.

Another area for capacity building entails the improvement of agencies’ absorptive capacity. The SDG Budget tagging exercise noted a yawning gap—64 percent—between allocated amounts for health programs and agencies’ actual spending. The government can handhold agencies to tackle procurement challenges and other bottlenecks to spending.

Partnerships. Ensuring a healthy future for people and the planet under the SDGs does not fall on the government alone. UN Deputy Secretary-General Amina Mohammed recently stressed: The SDGs will fail without the private sector. The need for forging partnerships to leverage private capital and expertise is urgent.

Members of the private sector wanted to help. But many of them don’t know where help is most needed, or how to put a cost to what they are doing now. This is where spaces for dialogue will help. Particularly, there is a proposal to revive previous government-led conferences to discuss opportunities for convergence and collective action.

The country, and the world at large, has struggled to get SDG 3 back on track amid a poly-crisis worsened by COVID-19. But seven years is still enough time to catch up. When all hands are on deck, and with the needed data, capacities, and financing strategies in place, the country can see a future where Good Health for All transcends from buzzword to reality.