The COVID-19 pandemic is the most pivotal event in our lifetime, already disrupting how we work,
socialise, travel and in some cases, changing the nature of relationships between state and citizen.
Apart from the staggering statistics on the number of deaths, particularly among the poor, vulnerable, women and ethnic minorities, it is having a toll on family violence, mental health, education opportunities and of course livelihoods.
While the extent of the economic damage is still unclear, a baseline forecast by the World Bank envisions the deepest global recession since World War II.
The challenge ahead In attempting to respond to the health emergency, governments have had to rapidly re-allocate financial and human resources to secure the drugs and equipment required to adapt control and treatment measures.
At the same time, businesses and households’ need for financial support to survive the resulting economic downturn continues to grow.
These competing needs are forcing governments to make difficult decisions about how to allocate limited public resources to best mitigate the health and socio-economic impacts of the pandemic, while retaining the confidence of their citizens.
It is clear COVID-19 hasand will- lead to serious fiscal stress within governments’ public finances and reduced revenue collections due to the contraction of productive sectors and overall GDP,
causing increased unemployment and necessitating massive budgetary reallocations to finance urgent expenses in health and other essential services.
For example, growth in Sub-Saharan Africa is predicted to fall to -3.3% in 2020,
pushing the region into its first recession in 25 years.
Projections suggest that COVID-19 could push 71 million people into extreme poverty in 2020,
40 million of whom would be living in SubSaharan Africa.
As a result, the global extreme poverty rate would increase for the first time since 1998 and progress made since 2017 would be wiped out.
Against this backdrop, identifying savings and maximising the effectiveness of all possible resources is key,
particularly for developing countries that do not have reserves for economic recovery.
But even before the pandemic, appropriate and efficient resource allocation,
particularly for health service delivery, was a challenge for many governments.
This article aims to share our experience of working with governments to build an evidence base
for effective allocation and expenditure of resources in health service delivery.
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