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1. An mRNA technology transfer programme and economic sustainability in health care/Programme de transfert de la technologie ARNm et durabilite economique dans le domaine des soins de sante/Un programa de transferencia de tecnologia de ARNm y la sostenibilidad economica de la atencion sanitaria

Author

Dutt, Devika, Mazzucato, Mariana, and Torreele, Els

Subjects
Sustainable development -- Health aspects -- Economic aspects, Epidemics -- Economic aspects, Messenger RNA -- Analysis, Health
Abstract

The World Health Organization (WHO) set up the messenger ribonucleic acid (mRNA) technology transfer programme in June 2021 with a development hub in South Africa and 15 partner vaccine producers in middle-income countries. The goal was to support the sustainable development of and access to life-saving vaccines for people in these countries as a means to enhance epidemic preparedness and global public health. This initiative aims to build resilience and strengthen local vaccine research, and development and manufacturing capacity in different regions of the world, especially those areas that could not access coronavirus disease 2019 (COVID-19) vaccines in a timely way. This paper outlines the current global vaccine market and summarizes the findings of a case study on the mRNA technology transfer programme conducted from November 2022 to May 2023. The study was guided by the vision of the WHO Council on the Economics of Health for All to build an economy for health using its four work streams of value, finance, innovation and capacity. Based on the findings of the study, we offer a mission-oriented policy framework to support the mRNA technology transfer programme as a pilot for transformative change towards an ecosystem for health innovation for the common good. Parts of this vision have already been incorporated into the governance of the mRNA technology transfer programme, while other aspects, especially the common good approach, still need to be applied to achieve the goals of the programme. [phrase omitted] L'Organisation mondiale de la Sante (OMS) a lance le Programme de transfert de la technologie de l'acide ribonucleique messager (ARNm) en juin 2021, assorti d'un centre de developpement en Afrique du Sud et de 15 fabricants de vaccins partenaires dans des pays a revenu intermediaire. Lobjectif consistait a soutenir la perennisation et l'acces a des vaccins d'importance vitale pour les populations de ces pays en vue d'ameliorer la preparation aux epidemies et la sante publique mondiale. Cette initiative vise a accroitre la resilience et a renforcer la recherche vaccinale locale, ainsi que les capacites de conception et de fabrication dans differentes regions du monde, en particulier dans celles qui n'ont pas pu obtenir des vaccins contre la maladie a coronavirus 2019 (COVID-19) en temps utile. Le present document decrit l'actuel marche mondial des vaccins et resume les resultats d'une etude de cas consacree au Programme de transfert de la technologie ARNm et menee de novembre 2022 a mai 2023. L'etude s'inspire de la vision du Conseil de l'OMS sur l'economie de la sante pour tous, qui consiste a construire une economie allant dans le sens de la sante selon quatre axes de travail: valeur, finances, innovation et capacite. En nous fondant sur les resultats de l'etude, nous proposons un cadre strategique oriente vers un but precis: soutenir le Programme de transfert de la technologie ARNm en tant que projet pilote afin d'evoluer vers un ecosysteme d'innovation en matiere de sante dedie au bien commun. Certains aspects de cette vision ont deja ete integres dans les principes de gouvernance du Programme de transfert de la technologie ARNm tandis que d'autres, en particulier l'approche liee au bien commun, doivent encore etre appliques pour atteindre les objectifs du programme. [phrase omitted] La Organizacion Mundial de la Salud (OMS) creo el programa de transferencia de tecnologia de acido ribonucleico mensajero (ARNm) en junio de 2021 con un centro de desarrollo en Sudafrica y 15 productores de vacunas asociados en paises de ingresos medios. El objetivo era apoyar el desarrollo sostenible y el acceso a las vacunas que salvan vidas para la poblacion de estos paises como medio para mejorar la preparacion ante epidemias y la salud publica mundial. Con esta iniciativa se pretende crear resiliencia y reforzar la capacidad local de investigacion, desarrollo y fabricacion de vacunas en distintas regiones del mundo, especialmente en aquellas areas que no pudieron acceder oportunamente a las vacunas contra la enfermedad por coronavirus de 2019 (COVID-19). Este documento describe el actual mercado mundial de vacunas y resume las conclusiones de un estudio de caso sobre el programa de transferencia de tecnologia de ARNm realizado entre noviembre de 2022 y mayo de 2023. El estudio se guio por la vision del Consejo de la OMS sobre la Economia de la Salud para Todos de crear una economia de la salud utilizando sus cuatro lineas de trabajo: valor, financiacion, innovacion y capacidad. A partir de las conclusiones del estudio, ofrecemos un marco politico orientado a la mision para apoyar el programa de transferencia de tecnologia de ARNm como piloto para un cambio transformador hacia un ecosistema de innovacion sanitaria para el bien comun. Algunas partes de esta vision ya se han incorporado a la gobernanza del programa de transferencia de tecnologia de ARNm, mientras que otros aspectos, en especial el enfoque del bien comun, aun deben aplicarse para alcanzar los objetivos del programa., Introduction The coronavirus disease 2019 (COVID-19) pandemic exposed the global imbalance in vaccine production, supply and access. Through financial, political and technical support of domestic biopharmaceutical companies, governments in high-income [...]

Published
2024
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2. Reframing the relationship between the economy and health

Author

Sadana, Ritu, Illeri, Serife Genc, Obrizan, Maksym, Huitron, Alberto, Dutt, Devika, and Duran-Fernandez, Roberto

Subjects
Epidemics -- Economic aspects -- Social aspects -- Turkey, Health promotion -- Methods, Health
Abstract

The World Health Organization (WHO) Council on the Economics of Health for All asserts that investing for health is key to creating an inclusive economy and that, if health for [...]

Published
2024
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5. Social policy advice to countries from the International Monetary Fund during the COVID-19 crisis: Continuity and change

Author

Razavi, Shahrashoub, Schwarzer, Helmut, Durán Valverde, Fabio, Ortiz, Isabel, and Dutt, Devika

Subjects
social health protection, Sustainable Development Goals (SDGs), domestic resource mobilization, disability benefits, social security contributions, developing countries, social security systems, social protection, official development assistance (ODA), H6, child allowances, I3, social protection floors, maternity benefits, social pensions, ddc:330, H53, H55, fiscal space, public expenditure
Abstract

The COVID-19 pandemic has caused massive disruptions to the global economy and forced policymakers to respond to the newly created challenges. Many policy institutions have therefore had to rethink their established approaches and their usual policy responses. @This paper explores whether there has been a change in International Monetary Fund (IMF) policy advice and conditions in its loan programmes and Article IV surveillance by examining the 148 country reports for IMF programmes in 2020, in the context of significant shifts in its global macroeconomic policy framework during the COVID-19 pandemic. It documents the policy recommendations made in these reports and finds that the IMF has supported increased expenditure on health care and cash transfer programmes, often on a temporary basis, even when it meant higher fiscal deficit and public debt. However, it also finds that the IMF has supported fiscal consolidation and reduction of public debt even more frequently, in 129 of the 148 reports examined. This seems to corroborate the findings of a number of recent studies. Given the pronounced gaps in social protection coverage, comprehensiveness and adequacy across all countries, it is essential that the measures taken to cope with the emergency do not remain a mere stopgap response, but progressively lead to the establishment or strengthening of rights-based national social protection systems, including floors. To do so, countries can and should pursue diverse financing options that are equitable in order to mobilize the financial resources needed for social investments, including investments in social protection systems and quality public services.

Published
2021

6. The Political Economy of the Cost of Foreign Exchange Intervention

Author

Dutt, Devika

Abstract

Central Banks around the world increasingly intervene in the foreign exchange market for a variety of reasons, such as maintaining exchange rate stability and maintaining a buffer against the impact of capital flight. In fact, research shows that central banks can lean against the macroeconomic policy trilemma through maintaining reserves and intervening in the foreign exchange market, and thereby secure policy space. However, securing this policy space can come at substantial cost. This dissertation explores the political economy of these costs of foreign exchange intervention. Chapter I discusses the concept of the direct cost of intervention, calculates these costs for several countries over the period 1990–2015, and shows the trends in this cost across countries and over time. This essay shows that foreign exchange intervention and the cost associated with it has increased substantially since the 1990s. Moreover, this cost is higher for developing and emerging economies, countries with more open capital accounts, and countries with less access to a de facto international lender of last resort. Chapter II shifts focus to the indirect costs of foreign exchange intervention. Accumulation of foreign exchange reserves by central banks has meant that they have some capacity to act as a lender of last resort, even when emergency liquidity required is not denominated in their own currency, thereby reducing the probability of default by borrowers in their country in the event of a financial crises. This chapter examines whether the accumulation of reserves due to foreign exchange intervention can be counterproductive by encouraging the inflow of volatile capital flows that are linked to the occurrence of financial crises. Using panel data regression analysis, this chapter finds that episodes of high reserve accumulation are likely to be followed by surges in inflows of capital within one year and five years, and a heightened probability of the occurrence of a currency crisis within five years. However, a higher level of foreign exchange reserve accumulation is associated with a lower probability of systemic banking crises. Finally, Chapter III revisits the importance of institutions that form the global financial safety net in mitigating the costs of foreign exchange intervention. Chapters I and II highlight the importance of access to the global financial safety net, particularly the role played by central bank swap lines with the Federal Reserve in mitigating the costs of foreign exchange intervention. Therefore this Chapter explores the factors that explain the differential access of countries to the global financial safety net, specifically to provision of emergency liquidity by the US Federal Reserve and the Exchange Stabilization Fund of the U.S. Treasury. Specifically, it examines the relative importance of economic and political factors in determining which countries secure access to these de facto lender of last resort operations. This chapter finds that in addition to economic factors like US bank exposure and trade links, political factors like capital account openness, US unemployment rate, defense cooperation agreements, and the party composition of the US government plays an important role in determining access to these International Lender of Last Resort institutions.

Published
2021
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7. Social policy advice to countries from the International Monetary Fund during the COVID-19 crisis: Continuity and change.

Author

Razavi, Shahra, Schwarzer, Helmut, Durán-Valverde, Fabio, Ortiz, Isabel, and Dutt, Devika

Subjects
SOCIAL policy, COVID-19 pandemic, PUBLIC debts, MEDICAL care
Abstract

This paper explores whether there has been a change in International Monetary Fund (IMF) policy advice and conditions in its loan programmes and Article IV surveillance by examining the 148 country reports for IMF programmes in 2020, in the context of significant shifts in its global macroeconomic policy framework during the COVID-19 pandemic. It documents the policy recommendations made in these reports and finds that the IMF has supported increased expenditure on health care and cash transfer programmes, often on a temporary basis, even when it meant higher fiscal deficit and public debt. However, it also finds that the IMF has supported fiscal consolidation and reduction of public debt even more frequently, in 129 of the 148 reports examined. This seems to corroborate the findings of a number of recent studies. Given the pronounced gaps in social protection coverage, comprehensiveness and adequacy across all countries, it is essential that the measures taken to cope with the emergency do not remain a mere stopgap response, but progressively lead to the establishment or strengthening of rights-based national social protection systems, including floors. To do so, countries can and should pursue diverse financing options that are equitable in order to mobilize the financial resources needed for social investments, including investments in social protection systems and quality public services. [ABSTRACT FROM AUTHOR]

Published
2021

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