Lately,
when watching the global health happiness around the GAVI replenishment and
also the EC hosted #UnitedAgainstCoronavirus funding efforts – both of
which are much appreciated and needed – I couldn’t help but think that “global
health” (whatever that means) is wasting the current corona moment.
Most of us,
while we do dream of a more sustainable way of financing Global Public Goods, still
seem happy to think and work within the usual ‘global health financing’ box “in
the real world”, not daring to venture out. Certainly not calling a spade a
spade.
Meanwhile,
some economists (like Gabriel Zucman, or in my country for example, Paul de Grauwe) are showing the way, but in global health we
still seem, by and large, happy with the usual ‘replenishments’ and “global”
fundraising efforts (with a bunch of stars to add some glamour to it),
basically going for the public money that is left after the corporate sector
has had its typically “not so fair” share.
Maybe this
is felt differently in countries like Holland or Germany who still have more financial
room, but in countries like mine (where we are all anxiously waiting for the
“financial corpses” in the corona closet that will need to be cleaned up, when
we will at last have a government 😊) most citizens hope that the ‘strongest
shoulders’ will help finance the way out. Not that it will happen, but at least some
experts and political parties are trying to make that case.
Along the
same lines, when “global health” is asking for billions, like at GAVI/Global
Fund replenishments, or now for ACT-Accelerator, why can’t we just argue for a wealth tax on
the strongest shoulders, say, the 0.00001 %, to help finance these? Tens of
billions will be needed, so why not just tax the ones who are probably
shareholders of Big Pharma in the first place, so it might even just amount to “robbing
Peter to pay Paul” !
Yet, I’m
not reading that, so far. Global health observers
seem happy to continue to work within the global health financing box, basically
in line with a “centre-right” world view (see Ursula von der Leyen,
Macron, Merkel, …), with an AMC here, and some replenishments there (where
usually from the private sector not much more is expected, in terms of financing
of GPGs, than “peanuts” (which then invariably sparks lavish “global health” praise
anyway, for reasons not entirely clear to me)).
I don’t get
it. At a time when some economists are showing the way, and Ann Pettifor rightly
argues for thorough reform of the financial
sector, the ones in
global health who actually “have the ear” of (some) people with real power, stay
silent, by and large.
I’m not
talking here about Seth Berkley or Peter Sands, let alone Larry Summers (on
whom I’ve long given up) - people who are “regulars” in Davos will surely not
come up with centre-left recipes for the 21st century – regardless
of how many “agreements” the World Economic Forum still strikes with WHO. No, I’m
talking here about the likes of Gavin Yamey, Amanda Glassman, Ilona Kickbusch
and Peter Piot (after he has fully recovered from Covid, obviously 😊). Just some examples, I’m sure there are more
like them, who are being listened to at the highest levels, yet I don’t see
them making these obvious cases.
You could
even link these wealth taxes to the “winners” of corona (Amazon etc), or to MNCs
in the business of global public bads that need to go soon, for planetary
health reasons. The “powers that be” usually have no trouble (nor moral qualms)
whatsoever to ‘target’ the lowest ranks in society, but when it comes to taxing
Bezos & other Ma’s, ‘targeting’ doesn’t seem to work anymore. Perhaps because
they’re afraid of the bunch of lawyers that would go after them, if they just tried?
Anyway, perhaps
Yamey, Glassman & other Piots don’t think it’s (politically) feasible in
the current circumstances, or economically (I’m well aware we don’t have global
taxation yet), or maybe some are happy to see Europe (and Germany) “take the
lead”, or perhaps they’re worried they might lose some of their “impact” at
these high-level tables if they actually started making cases like this. Or
perhaps they just don’t think it’s part of their role as observers. I don’t
know. Regardless, it’s deeply disappointing. Mind you, I don’t even read much
about a FTT anymore these days.
It also renders
global health lamenting about vaccine nationalism, populist leaders tearing up
the multilateral order, or the geopolitical battle affecting global health a
bit cheap. To put it bluntly, if even “global health” fails to put its ‘equity’
mantra into practice, demanding that the strongest shoulders pay for this
corona moment (including a People’s Vaccine), why would we expect Trump &
Xi to do otherwise?
Or even
more bluntly: who would still dare to expect a cosmopolitan moment, if “global
health” itself seems to have resigned to “the world as it is”?
It’s time
global health joins the #BuildBackBetter movement. So far, that’s not happening. Certainly not
enough.
