zondag 28 juni 2020

“Global health” is wasting the corona moment

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.

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