Innovative Financing for Global Health: Tools for Analyzing the Options

Amanda Glassman,
Chief Operating Officer and Senior Fellow, Center for Global Development
Amanda Glassman Former Brookings Expert, Chief Operating Officer and Senior Fellow - Center for Global Development
Charles C. Griffin,
Charles C. Griffin Former Brookings Expert
David de Ferranti,
David de Ferranti Former Brookings Expert
Gina Lagomarsino, and
Gina Lagomarsino
Gina Lagomarsino President and CEO - Results for Development
Maria-Luisa Escobar
Maria-Luisa Escobar Former Brookings Expert

August 31, 2008


Improving global health — and, in particular, achieving better health outcomes for the world’s poor people, including the more than 3 billion (half the planet’s total population) who live on less than US$2 a day — has become a prominent priority in development agendas. Heightened search for more effective ways to accelerate progress has spawned intense interest in exploring innovative ways of financing health services and products.

“Innovative financing for global health” (IFH) covers a multitude of things. New initiatives associated with new, or newly re-cast, financial instruments are the core of it. Examples of such initiatives include the International Finance Facility for Immunization (IFF-Im), the Airline Solidarity Contribution (ASC, or simply, “the airline tax”), and the Advanced Market Commitment (AMC). In addition, a wider array of other options — see Box 1.1 for a partial list — come up as well in public discussion of IFH ideas, including some that are not new (e.g., tax relief for donating key medicines) and others that have broader relevance than health alone (e.g., debt relief). Further, the new institutions in global health — such as The Global Fund for AIDS, Tuberculosis, and Malaria (GF), The Global Alliance for Vaccines and Immunization (GAVI), and UNITAID (the entity that receives and deploys the proceeds of the airline tax) — are also sometimes considered to be IFH initiatives.

With so many new concepts and proposals pouring forth, so many problems still to solve, and so many questions arising about how everything fits together (e.g., which options are right for which issues, and whether there are promising new ideas deserving of attention), the interested parties — in donor and recipient governments, foundations, the research community, etc. — have sought more conceptual clarity and analytical tools to help them find their way through the complexities as they are confronted with policy choices. The Bill and Melinda Gates Foundation has been at the forefront of this quest, conscious of the need for some sort of framework and guide that can aid all concerned to understand the options and make informed decisions about them. The study that led to this report was funded by them.