『Redefining Global Health in the 21st Century, Chpt 4: Financing Global Health in an Era of Scarcity』のカバーアート

Redefining Global Health in the 21st Century, Chpt 4: Financing Global Health in an Era of Scarcity

Redefining Global Health in the 21st Century, Chpt 4: Financing Global Health in an Era of Scarcity

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In this episode of Redefining Global Health in the 21st Century, Ben chats with authors mike Reid and Eric Goosby about how funding shocks become life-and-death realities, starting with a case from Zambia after the January 2025 U.S. pause and cuts to PEPFAR that left many without antiretrovirals and destabilized HIV services in a system heavily dependent on U.S. support. They describe behind-the-scenes efforts to warn political leaders, on-the-ground resilience and improvisation, and the emotional toll of what they view as an abandonment of dialogue. The discussion explores whether donor dependency was a design choice, the roles donors should play (equity gaps, global public goods, and underwriting transitions), and options such as co-investment requirements, government-to-government funding, debt-to-health swaps, public financial management support, domestic resource mobilization (including sin taxes), and potential roles for development finance and sovereign wealth funds, while stressing the need to define a clear destination for health financing and country ownership. 00:00 Welcome and Book Intro 00:29 Zambia Funding Shock 02:26 Why Zambia Matters 05:58 Scrambling After PEPFAR Pause 07:58 Resilience and System Fragility 09:58 Eric Goosby Reaction 15:37 Dependency by Design 18:44 Colonial Debt Reality 22:25 What Solidarity Looks Like 26:10 Donor Funding Roles 30:21 Accountability and Oversight 32:50 Co Investment and Direct Funding 35:37 Debt Relief as Co Investment 36:46 Debt for Health Swaps 37:46 Modernizing Gavi and Global Fund 41:26 Local Accountability and Trust 45:26 Post Aid Era Roadmap 48:19 Building Country Ownership 53:46 Sovereign Wealth Fund Ideas 58:04 New Finance Tools and Taxes 01:00:04 Defining the Destination 01:04:03 Call to Action and Thanks Learn more about the book: https://bit.ly/redefining-global-health More from UCSF Institute for Global Health Sciences: https://globalhealthsciences.ucsf.edu Check Out mike Reid’s Substack: https://substack.com/@reimaginingglobalhealth Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! What would it take for global health to avoid decline? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health — and look out for a dedicated sub channel for Redefining Global Health in the 21st Century under A Shot in the Arm’s YouTube home. Redefining Global Health in the 21st Century: The Podcast (Playlist on Youtube) https://bit.ly/rgh-book A Shot in the Arm Podcast Youtube (Main Channel) https://youtube.com/@shotarmpodcast
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