1. Global Health Exchange Conference, Dublin – 6 November 2018
International financing for resilience: Impact bonds and innovative health financing structures.
Global Health Exchange Conference, Dublin – 6 November 2018
Lorcan Clarke, London School of Economics and Political Science

2. 17 Sustainable Development Goals (SDGs)

3. Common purpose via SDGs: Goals, targets, and indicators
Source: Clarke and Le Masson (2017)

4. SDG Financing Low income countries SDG investment requirements:
~ US$350bn/year (2015 estimate)
~ 40% private investment .
Debt risks.
Options:
Less ambition.
More effective development outcomes.
More ODA (official development assistance) with better distribution to LICs.
WHO estimates on SDG 3 (2017):
LMICs require additional US$274–$371bn/year of spending.
Ratio of GNI to external government debt
Year
Source: Schimdt-Traub (2015), Plant (2018), Stenberg et al (2017)

5. Financing for Resilience: Costs Clear, Funding Less So
Source: Clarke and Le Masson (2017)

6. Innovative Finance Instruments for Global Health (2002-2015)
Advance Market Commitments Pilot for Pneumococcal Disease (AMC)
Vaccines to prevent pneumonia, meningitis, and sepsis (GAVI)
Affordable Medicines Facility for Malaria (AMFm)
ACTs for malaria (the Global Fund)
Airline Solidarity Levy
HIV/AIDS, Tuberculosis and Malaria (UNITAID, Global Fund)
Children's Investment Fund Foundation
Improving the lives of children living in poverty
Debt2Health
HIV/AIDS, Tuberculosis and Malaria (World Bank, Global Fund)
GAVI Matching Fund
Vaccines for preventable diseases (GAVI)
International Finance Facility for Immunisation (IFFIm)
Japan International Cooperation Agency ODA Loan Conversion Program for Polio (ODA Loan Conversion)
Vaccines to prevent polio (JICA, Gates Foundation)
PRODUCT(RED)
World Bank Investment Partnership for Polio International Development Assistance Buy-Back Program (IDA Buy-Back)
Vaccines to prevent polio (World Bank, Global Polio Eradication Initiative)
Source: Atun et al (2015)

7. Financing for Response
United Nations Central Emergency Response Fund.
Ireland: US$9.5m (9th in 2018).
WHO Contingency Fund for Emergencies.
Pandemic Emergency Financing Facility (World Bank Group)
Cash Window.
Insurance Window (Pandemic Bond).
Sources: UN CERF (2018)

8. Development Impact Bonds

9. Development Impact Bonds for Health Outcomes
Name
Duration
(Months)
2017
2018
2019
2020
2021
2022
Utkrisht Impact Bond 36
India
Humanitarian Impact Bond 60
Mali, Nigeria, Democratic Republic of Congo
Cameroon Cataract Bond
Cameroon
Countries
Population (Minimum)
Upfront Investments
US$, 2017 PPP 5
321,000
$25.2m
Source: Clarke and Chalkidou (Forthcoming)

10. Final Thoughts
Thanks for listening!

11. References
Atun, R., Silva, S. and Knaul, F. M. (2017) Innovative financing instruments for global health 2002–15: a systematic analysis. The Lancet Global Health.
Clarke, L. and Chalkidou, K. (Forthcoming) Development impact bonds targeting health and wellbeing: A comparative overview. Working Paper. Center for Global Development.
Clarke, L. and Le Masson, V. (2017) Shocks, stresses and universal health coverage: pathways to address resilience and health. Working Paper 526. Overseas Development Institute.
Schmidt-Traub, G. (2015) ‘Investment Needs to Achieve the Sustainable Development Goals Understanding the Billions and Trillions’, SDSN Working Paper.
Stenberg, K. et al. (2017) Financing transformative health systems towards achievement of the health Sustainable Development Goals: a model for projected resource needs in 67 low-income and middle-income countries. The Lancet Global Health.
Plant, M. (2018) SDG Arithmetic. Available at:
United Nations Central Emergency Response Fund (2018) Our Donors - Contributions. Available at: