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<p>Nigeria&#8217;s former Finance Minister and Board chair of the Global Alliance for Vaccines and Immunisations Ngozi Okonjo-Iweala says economically, for every dollar invested in health, you get twenty dollars in return. She discussed the rate of return on investments in health and how the cost of delivering health care services to families in Africa can be reduced.</p>


How we can to reduce the cost of Africa’s health care delivery

<p>By Ngozi Okonjo-Iweala, Co-Chair, Global Commission on the Economy and Climate</p>
<p>The world is teetering on the cusp of a new economic era. This comes as major structural changes are shaping the global economy, like rapid urbanisation, major demographic transitions, increasing globalisation, a shift to service-based economies, and increasing automation. Can this tremendous shift deliver strong, sustainable and inclusive growth? Will it make people’s lives better? The decisions we make today will determine the answers to these important questions. </p>
<p>One thing should be clear to us all and especially to those who will gather next week at the Global Climate Action Summit in in San Francisco: we are all significantly underestimating the economic opportunity that can be gained from cleaner, climate-smart growth. New analysis is finding that bold climate action could yield a direct economic gain of $US26 trillion through to 2030, compared with business-as-usual. And we know that these numbers are likely to be conservative.</p>
<p>We are at a unique “use it or lose it” moment in history. Over the next 12-15 years, we expect to invest about US$90 trillion in infrastructure, more than the total current stock. Ensuring that the infrastructure we invest in is sustainable will be a critical determinant of future growth and prosperity. And the good news is that making it sustainable doesn’t need to cost more, on the contrary, it can lead to real cost savings. Significant technological and market progress over the last decade has already begundriving the shift to a new climate economy, proving that we can have strong growth, while acting on climate change. And we are already seeing real results: new jobs, economic savings, increased competitiveness and market opportunities, and improved wellbeing for people worldwide. </p>
<p>This period is also essential in terms of climate. The last 19 years included 18 of the warmest years on record. In 2017, weather- and climate-related disasters were responsible for thousands of deaths and US$320 billion in losses. Unless we act boldly on climate now, we will continue to see more frequent and more extreme weather events like these. </p>
<p>What will it take to unlock this opportunity? Among the most urgent priorities over the next 2-3 years are implementing carbon pricing and removing fossil fuels subsidies. This could generate more than US$2.8 trillion in government revenues in 2030, equivalent to the GDP of India today, for use toward other public priorities or to reduce distorting taxes. Other key priorities that can be catalytic are: accelerated investment in sustainable infrastructure, harnessing the power of the private sector and unleashing innovation, and ensuring a people-centered approach so that the gains are shared equitably and that the transition is just. </p>
<p>Women especially play a critical role in delivering and benefiting from inclusive, sustainable growth. Greater participation by women in the economy drives growth. And in countries where more women participate in political life, parliaments are more likely to set aside protected lands and ratify international environmental treaties. Given that women are often the most affected by a changing climate, and that they currently represent just 23% of parliamentarians worldwide, there is clearly an important opportunity to enhance women’s leadership in delivering this new growth agenda.  </p>
<p>Accelerating towards a strong, sustainable, inclusive economy requires decisive leadership. Finance Ministers, in particular, play a critical role in guiding investments and setting the right conditions to unlock much-needed private capital at scale. When I served as Finance Minister of Nigeria, for example, we worked to reform petrol subsidies in 2012. Some $13bn worth of petrol subsidieshad been burdening the Nigerian national budget, and we were able to redirect some of those funds to much more productive ends. Within a year, our programme to reinvest the savings from what was previously spent on subsidies meant we could finish renovation of a north-south national railway, as well as introduce improved maternal and childcare services in 500 primary healthcare centres. Others have found similar benefits: in Indonesia, fuel subsidy savings in 2015 were reallocated to major investments in social welfare and infrastructure through increased budgets for ministries, state-owned enterprise, and transfers to regions and villages. Using lessons learntfrom Nigeria, Indonesia and other countries, Finance Ministers can take bold steps to lead whole of government approaches to growth that can deliver development and climate objectives.    </p>
<p>We can eliminate extreme poverty, prevent dangerous climate change, and improve the lives and livelihoods of millions. But only if we set out to do so decisively. Fortunately, we still have a window of opportunity to deliver a better world with more efficient, livable cities;with low-carbon, smart energy, mobility and water for all;and through the restoration of degraded lands while protecting valuable forests. </p>
<p>There can be no kicking the can down the road. Each effort underway around the world must build on the last to tip the world over the cusp and into a better future for all. </p>


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Ngozi Okonjo-Iweala on why climate leadership is a new growth opportunity for the world

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<p>At the ongoing World Economic Forum in Davos, CNBC Africa&#8217;s Chris Bishop caught up with Ngozi Okonjo Iweala, Co-chair of Global Commission on the economy and climate for what the forum is doing about climate change.</p>


Ngozi Okonjo Iweala talks climate change at WEF

<p>One of the unfortunate consequences of more people surviving childhood and living longer lives is that you start to see cases of cancer steadily increase. But while medical advances are helping to improve survival rates of cancer patients in high-income countries, the limited access to screening and treatment across Africa means that a growing number of people are dying young from largely preventable and treatable diseases. Because of this Africa is now in serious danger of sleepwalking into a cancer crisis.</p>
<p>This is particularly the case with women and cervical cancer, which in many countries is the most common cancer affecting women. Currently 266,000 women die horrible deaths of this disease every year – one every two minutes – of which 87% are in low- and middle-income countries, with the eight highest rates of incidence all in Africa. In Nigeria alone more than 14,000 women are diagnosed with the disease each year, more than 8,000 of whom die. And yet, tragically most of these deaths could be prevented thanks to the existence of an affordable and effective vaccine. Human papillomavirus (HPV) vaccines targets the virus that is responsible for 70-90% of cervical cancers, depending on the vaccine. It is safe and one of the most effective and high-impact vaccines that exist, preventing 1,500 deaths for every 100,000 girls vaccinated. So then why aren’t African girls getting it?</p>
<p>Historically one of the major barriers was price. In wealthy countries, this relatively new vaccine can cost more than US$ 100 for each of the two doses required. Today it costs just US$ 4.50 per dose for poorer countries, bringing it within reach of those most in need, thanks to the efforts of Gavi, the Vaccine Alliance, of which I am Board Chair. In addition to this the age of the target population has also posed challenges. HPV vaccine is most effective when given to women before they become sexually active, so campaigns are aimed vaccinating adolescent girls, typically between 9-14 years old. Since this falls outside the age range when infants receive most of their vaccinations, it has meant finding reliable ways to reach these girls, such as working with civil society organisations, community health workers and youth friendly services to establish school-links and develop health platforms for adolescents.</p>
<p>Since 2013, this sort of approach has enabled more than 1 million school-aged girls in poor countries to be vaccinated against HPV, with more planned for 2017. However, progress so far has largely been achieved through dozens of relatively small-scale “demonstration projects”. If we want to make a long-term dent on mortality rates, and prevent cervical cancer from continuing to rise, to the point where it kills more women than childbirth, then HPV programmes need to be scaled-up to a national level. Countries like Rwanda and Uganda have already demonstrated that this can be achieved by first recognising the scale and severity of the problem, and then to acting on it. If other countries do the same, Gavi hopes to reach 40 million girls between now and 2020, preventing 900,000 deaths.</p>
<p>We saw a significant step in the right direction exactly one year ago, when on World Cancer Day, the then UN Secretary General Ban Ki-Moon issued a rallying cry to eliminate cervical cancer once and for all. Then this week the African Union, which is made up of 55 states, endorsed theAddis Declaration on Immunization, a commitment to ensure that all Africans – no matter who they are or where they live – can access the vaccines they need to live healthy and productive lives. The next step is for governments to earmark funds and commit to national HPV vaccine introductions.</p>
<p>Across Africa there remains a desperate need for cancer clinics offering women affordable screening and treatment, but compared to immunisation these are much more expensive to set-up. This is one reason why in Nigeria, for example, far more women die of cancer than men, even though Nigerian women tend to drink and smoke less, and are on average more physically active. So, prioritising HPV will not only contribute to the social and economic development of countries and help governments meet the Sustainable Development Goal of reducing premature deaths from non-communicable diseases, such as cancer, by one third, but it will also go a long way towards addressing the terrible gender gaps that exist across Africa.</p>
<p><em>A development economist and former Finance Minister of Nigeria, Dr Ngozi Okonjo-Iweala has served as Board Chair of Gavi, the Vaccine Alliance, since January 2016﻿</em></p>
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Ngozi Okonjo-Iweala

How we can to reduce the cost of Africa’s health care delivery

Ngozi Okonjo-Iweala on why climate leadership is a new growth opportunity for the world

Ngozi Okonjo Iweala talks climate change at WEF

Op-Ed: Africa is now in serious danger of sleepwalking into a cancer crisis

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Ngozi Okonjo-Iweala

How we can to reduce the cost of Africa’s health care delivery

Ngozi Okonjo-Iweala on why climate leadership is a new growth opportunity for the world

Ngozi Okonjo Iweala talks climate change at WEF

Op-Ed: Africa is now in serious danger of sleepwalking into a cancer crisis

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Advertise With Us

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