In a landmark development aimed at investing in and strengthening essential, climate and crisis-resilient primary health care (PHC) services in low- and low-and-middle-income countries (LICs and LMICs), three multilateral development banks have joined with WHO to launch the new Health Impact Investment Platform.

The Platform, launched during the Summit for a New Global Financing Pact being held in Paris, will make an initial €1.5 billion available to LICs and LMICs in concessional loans and grants to expand the reach and scope of their PHC services, especially for the most vulnerable and underserved populations and communities.

The African Development Bank (AfDB), European Investment Bank (EIB), Islamic Development Bank (IsDB) and WHO are the Platform’s founding members. As this is a global challenge, the Inter-American Development Bank (IDB) is also considering joining this partnership in view to extending this initiative to Latin America and the Caribbean region.

WHO will act as the Platform’s policy coordinator, responsible for ensuring the alignment of financing decisions with national health priorities and strategies. The Platform’s secretariat will support governments to develop national health and prioritize PHC investment plans. The Platform will also aim to catalyse wider PHC investments in support of government health strategies.

Dr Tedros Adhanom Ghebreyesus, WHO Director-General, said a PHC approach offers the most effective means to improve health and well-being, including through the delivery of essential health services to all people. It is a driver of universal health coverage, one of the United Nations Sustainable Development Goals (SDGs). World leaders committed in 2015 to achieve access to essential healthcare services and affordable essential medicines and vaccines for all people by 2030.

“Around 90% of essential health services can be delivered through PHC – on the ground, in communities, via health professionals, doctors and nurses, in local clinics. The broad spectrum of services that PHC provides can promote health and prevent disease, avoid and delay the need for more costly secondary and tertiary services, and deliver rehabilitation,” said Dr Tedros. “PHC serves as the ‘eyes and ears’ of a country’s health system, reaching to the very communities where people live. The new Health Impact Investment Platform will strengthen the development of such services, serving as an invaluable investment in the health of populations today and in the future.”

EIB President Werner Hoyer said the partner development banks were committed to supporting countries to strengthen their primary healthcare services, to both promote the health of their communities and protect against the impacts of future health emergencies.

“COVID-19 demonstrated the great human and economic suffering that can occur when we fail to invest in essential health services,” said Dr Hoyer. “Cooperation among multilateral development banks through the new Health Impact Investment Platform will ensure countries in need are better able to build resilient primary health care services that can withstand the shocks of future health crises, and safeguard communities and economies for the future. We already proved that in earlier collaborations with the WHO. The platform will facilitate access to crucial international financing for the most vulnerable. It is a concrete deliverable of President Macron’s call to increase international financial solidarity with the Global South.”

Before the COVID-19 pandemic, WHO estimated that to reach the health-related Sustainable Development Goals (SDGs), LICs and LMICs needed to increase their health spending significantly and require an additional US$371 billion annually combined by 2030. This funding would allow populations to access health services, contribute to building new facilities and train and place health workers where they need to be. It has also been estimated that preparing for future pandemics will require investment in the order of US$ 31.1 billion annually. Approximately one-third of that total would have to come from international financing. The Health Impact Investment Platform’s catalytic financing is also designed to promote the mobilization and coordination of broader financing flows through national PHC investment plans.

The new Platform builds on experience gained through cooperation between countries, multilateral organizations and development banks proved fruitful during the pandemic. For example, WHO, the EIB and the European Commission worked closely with Angola, Ethiopia and Rwanda to strengthen their health systems. Initially launched as stand-alone programs or as part of the countries’ response to COVID-19, these interventions mobilized technical assistance, grants and investments with advantageous terms to build up primary health care.

Muhammad Al Jasser, chairman of the Islamic Development Bank, said: “To achieve universal health coverage by 2030, Development Financial Institutions (DFIs) and nations must prioritize investing more in health. The Islamic Development Bank (IsDB) is committed to working collaboratively to generate impactful results and ensure access to quality and affordable primary healthcare for all.”

“Our cooperation will help guide investments by national governments to strengthen primary health care and their overall health systems, increase universal health coverage and improve their ability to prepare for, prevent and respond to health emergencies. We will work with countries individually to identify gaps in national health systems, design interventions and investment strategies, find funding, implement projects and monitor their impact,” said African Development Bank Group President Dr Akinwumi A. Adesina.

Ilan Goldfajn, President of the Inter-American Development Bank, said: “Good health and well-being are common goals that bind the world together. To achieve these goals, countries and institutions must collaborate. We are convinced that cooperation – not only between nations but also between governments and the private sector – is critical to achieving universal health coverage. Recognizing the global nature of this investment platform, we are already in discussions with other stakeholders to expand these efforts across Latin America and the Caribbean. We extend an open invitation to our partners to join this global investment platform.”