Statement submitted to the United Nations Summit of the Future, 22-23 September 2024

Embedding Health Financing in a Future-Oriented Post-2030 Financial Structure

The impact of macroeconomic phenomena, such as inflation, on health is often underestimated in economic evaluations and policy decisions. Historical crises, like the HIV epidemic in the 1980s, demonstrated the devastating effects that neoliberal economic policies can have on national health systems, leading to their collapse and long-lasting repercussions. Many affected countries still experience these aftershocks today.

Health is both a driver and outcome of sustainable development, with proven, stable returns on investment. Strong, resilient health systems are vital not only for maintaining a productive workforce but also for fostering peace, stability, and climate resilience. They serve as buffers against systemic shocks, such as climate disasters, pandemics, and conflicts, all of which are expected to intensify as we progress through the 21st century.

However, building resilient health systems requires significant and sustained financial commitment from all stakeholders. Low-income countries often rely on development aid and international loans to fund their health budgets, while middle-income countries are increasingly experimenting with innovative financing mechanisms. While these financial streams may temporarily bridge budgetary gaps, they remain fundamentally unsustainable in the long term, often exacerbating existing challenges rather than providing durable solutions.

As we look towards the post-2030 agenda, there is an urgent need to rethink and reform the global financial architecture. The G4 Alliance, representing over 80 organizations in surgery, obstetrics, trauma, and anesthesia, calls on the international community to renegotiate financial structures and aid systems with a broader lens that transcends traditional budgetary considerations. The downstream implications for health systems—especially critical components like surgical services, which are essential to crisis resilience—must be at the forefront of this discourse.

Investing in surgical systems is not a luxury; it is a necessity. Surgical care is an indispensable pillar of strong health systems, crucial for responding to public health crises, mitigating the impact of climate disasters, and improving overall societal resilience. Yet, surgical systems are often overlooked in discussions about health financing, leaving significant gaps in crisis preparedness.

The international financial architecture must better account for the needs of low- and middle-income countries in developing sustainable health financing models. This includes providing comprehensive and long-term financing mechanisms that support the integration of surgical systems into health systems as part of broader climate adaptation and crisis resilience strategies. Failure to address these gaps will perpetuate inequalities, undermine health security, and limit our collective ability to achieve the Sustainable Development Goals.

Embedding health financing within the broader global financial framework is a critical step toward achieving equitable and sustainable development. Strengthening surgical systems is central to building resilient health systems capable of withstanding future shocks and safeguarding the health and wellbeing of all populations.

We also recognize the limitations that finance ministries and international financial institutions may face in understanding the full scope of policy decisions on health outcomes, including subdomains like trauma and infectious disease control. The global health community, with strong support from civil society and academia, stands ready to collaborate with governments and international organizations to ensure that no one is left behind, especially in times of crisis.