Download - PRESENTATION: Health Financing Innovation
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8/18/2019 PRESENTATION: Health Financing Innovation
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Health Financing InnovationThe case for Epidemic Financing
Saumya Kailasapathy - SDAS
Disclaimer: The views expressed in this paper/presentation are the views of the author and do not necessarily reflect the views orpolicies of the Asian Development Bank (ADB), or its Board of Governors, or the governments they represent. ADB does notguarantee the accuracy of the data included in this paper and accepts no responsibility for any consequence of their use.Terminology used may not necessarily be consistent with ADB official terms.
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Outline
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1. The Health Financing Landscape
Innovative Finance & the “right tool”
3. Health Security as a key public health issue
4. The region’s burgeoning Epidemic costs
5. The ADB Epidemic Financing Proposal
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Health financing is evolving: new financingsolutions are now needed for public health
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The Challenges Solutions
Donor funding halting
DFAT, UK, & US ring-fences international aid
Global Fund Round 11 cancelled
GAVI exiting
Increasing cost of NCD’s Domestic health budgets insufficient
Recurring cost of Epidemics
Long term financing
Target large scale
projects to transform
infrastructure and
systems
Target underfunded
public health concerns
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Outline
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1. The Health Financing Landscape
Innovative Finance & the “right tool”
3. Health Security as a key public health issue
4. The region’s burgeoning Epidemic costs
5. The ADB Epidemic Financing Proposal
2.
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Several innovative finance mechanismsexist, but we should target the “right”instruments for public health
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• TargetUnderfunding
– Epidemics… – Health Systems…
• Target Scale &Sustainability
– Low incentives tofocus on RPGs
– System
transformation
• Target Long TermFinancing
– Sustainability – Bridge financing
Taxes and Levies Philippines “sin tax”$2.3bn:subsidization ofhealth insurance.
UNITAID’s airlinelevies raised anaverage ofUS$208m per yearfrom 2007 -2011
Blended Loans
• Incentivizeborrowing viagrants
Bonds
• Social ImpactBonds – mobilizefunding fromprivate sectors
Private sector
• Public privatecollaboration
Public Sector
• Increasepublichealth
spending• Eg HI
The region needs the right instruments
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Outline
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1. The Health Financing Landscape
Innovative Finance & the “right tool”
3. Health Security as a key public health issue
4. The region’s burgeoning Epidemic costs
5. The ADB Epidemic Financing Proposal
2.
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Health security is a key public health concern:Asia Pacific is an epicenter for health securityrisk, and breeding ground for zoonotic outbreaks
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Epicenter forantimicrobial
resistance
Remergingdiseases like TB
Unplanned Urbanization
Mobile population
Natural disastersUnregulatedprivate sector
Weakhealth
systems
Climate change
Human-AnimalInterface
Mosqu itos
Low qualitydrugs andvaccines
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Outline
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1. The Health Financing Landscape
Innovative Finance & the “right tool”
3. Health Security as a key public health issue
4. The region’s burgeoning Epidemic costs
5. The ADB Epidemic Financing Proposal
2.
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The economic cost of epidemics in AsiaPacific is enormous, and growing.
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Dengue
Ebola MERS
Zika Corona
Malaria
Tuberculosis
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Outline
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1. The Health Financing Landscape
Innovative Finance & the “right tool”
3. Health Security as a key public health issue
4. The region’s burgeoning Epidemic costs
5. The ADB Epidemic Financing Proposal
2.
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Why should ADB be involved in Epidemicfinancing?
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ADF IX2% for healthand eligibility
for all ADFDMCs
HIV/AIDS &Communi-
cableDiseases
SARS
GMS CommunicableDiseases Project
Avian Influenza Project
Malaria andother Communicable
Diseases ThreatsTrust Fund
ADB has experience in Health Security & Regional Cooperation
RCI
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Epidemic Financing Structure: structuringhealth financing for targeted impact
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Up to 2015 2016
Loans – demand driven
Epidemic Financing: support thedesign and implementation ofGovernment programs
Fragmented approachesto health financing
TrustFunds
ADF 9 TA –
wide scope
ADF GrantFinancing
HealthBond > OCR
TechnicalAssistance
Strategic health financing structure
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Epidemic Financing Structure: Use of Funds
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Product
EpidemicEmergency:Emergencyresponse financing
EpidemicPreparedness: TA
EpidemicPreparedness: Loan
RegionalPreparedness: TA
Use of Funds
TA or ADF Grant• Fund national epidemic preparedness• Support cross border initiatives
Health Bond• Earmark ADB OCR• Signal to the market that ADB is
“stepping up” epidemic risk mitigation • Earmark OCR for loans
Response Financing• Include Epidemic and Health
Emergencies within ADB’s Disaster RiskManagement Fund and Framework
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Epidemic Financing Structure: Why Bonds?
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The ADB Health Bond
Investors
Capital raised &earmarked
- Loan- Guarantee- Project/SIB Bonds
Thematic Bond Considerations • Investor appetite
• Building pipeline –
supporting resident
missions and regional
department
• Structure similar to ADB
Green or H20 Bonds
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Epidemic Financing Structure: role of PrivateSector and opportunities for collaboration
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•
Epidemics threatenmajor investments inmultinationals and smallbusinesses
• Business opportunity
• Protect corporatebusiness continuity &disaster risk
• Leverage CSR
•
E.g. Private health providersin rural areas, better crossborder access
• E.g. Mobile phone providerrapidly deploying
emergency financing• E.g. leveraging private
sector supply chains,logistics and datamanagement
Incentives Collaboration• Profitability• Business continuity
uncertain
• Profitabilityprotected
• Gov’trelations
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Thank you
…..
Q&A
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