PharmacoEconomics & Outcomes News 666 - 10 Nov 2012

Innovative health financingnot so new

An analysis of the contribution of innovative financingsources to development assistance for health, publishedin the Lancet, has shown that sources of internationalinnovative financing contribute a relatively modestamount compared with traditional sources of donorassistance.

Three integrated, international mechanisms ofinnovative financing, GAVI, Global Fund and UNITAID,were investigated. The value chain framework was usedto describe key steps transforming donor funding tooutcomes. Trends in innovative health financing from1990–2010 were then examined. Innovative financingwas considered to be that from private foundations andprivate companies; local currency bonds frommultilateral development banks were not included.

GAVI is primarily funded through the InternationalFinance Facility for Immunization (IFFIm). IFFImproceeds amounted to $US1.9 billion between 2006and 2010, and by 2010 GAVI had mobilised≈$43 million for pneumococcal disease through theAdvance Market Commitment (AMC). Between 2000and 2010, the largest contributions to GAVI came fromdonor governments and the European Commission, andIFFIm ($2.07 and $1.91 billion, respectively), followedby private donors ($1.27 billion) and AMC funds($0.52 billion).

The Global Fund received $31.3 billion in totalpledges by June 2011, of which 5% was from innovativesources. This 5% consisted of pledges from the privatesector and initiatives such as (PRODUCT)RED($162 million from Jan 2006 – Jun 2011) andDebt2Health ($37 million by 2011).

UNITAID raised ≈$1.3 billion by the end of 2010,≈70% of which originated from a small levy imposed onairline tickets in Chile, France, Madagascar, Niger,Mauritius and South Korea. UNITAID also receivedmulti-year contributions from the Gates Foundation,and Brazil, Spain, the UK and France; over 60% of totalUNITAID revenue has been contributed by the GatesFoundation and France. UNITAID and the ClintonFoundation have worked together to secure 25–50%reductions in the price of second-line AIDS treatmentsand pediatric antiretrovirals.

The authors conclude that there should be existingexploration into "how the existing integrated innovativefinancing mechanisms can be strengthened and usedeffectively" to increase both health gain and funding.Atun R, et al. Innovative financing for health: what is truly innovative? Lancet : 24Oct 2012. Available from: URL: http://dx.doi.org/10.1016/S0140-6736(12)61460-3 803079329

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PharmacoEconomics & Outcomes News 10 Nov 2012 No. 6661173-5503/10/0666-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved