Economics of Health For All: The Plan to Put Health at the Heart of the Global Economy

At the World Health Assembly in May, member states may endorse an unprecedented strategy declaring that health is not a cost – but the best investment an economy can make.

By WHO-Watch Team, Peoples Dispatch

For decades, finance ministers have viewed health spending the way homeowners view leaky roofs: a necessary nuisance, a cost to be minimized. Hospitals consume budgets. Doctors require salaries. Medicines drain foreign exchange. When economies tighten, health is often among the first cabinet ministers sent home with a smaller envelope.

But a quiet revolution might be underway in Geneva, and it threatens to flip this logic on its head.

This May, when Member States gather for the 79th World Health Assembly, they will be asked to approve something unprecedented: a formal strategy declaring that health is not a cost at all. It is, the World Health Organization (WHO) argues, the single best investment any economy can make.

Putting health before wealth

The WHO’s new “Economics of Health for All” strategy, six years in the making, begins with a startling premise. For generations, we have measured national success by GDP, the total value of stuff we make and sell. By that metric, a country that sells cigarettes and cancer treatment looks more successful than a country where nobody gets sick.

This is not just wrong. It is dangerous. And yet, this is the logic that drives globalization for decades, centuries even.

In the prevailing economic framework, health is treated as a residual. We grow the economy first, and then if there’s anything left, we spend a little on keeping people alive and productive. We’ve had it backwards.

The WHO’s approach insists that healthy populations aren’t a byproduct of wealth: they are the very engine that produces it. It sounds like common sense. But common sense, in global health politics, often collides with powerful interests.

From Alma-Ata to Geneva: a 50-year arc

To understand why this moment matters, we need to look back. In 1978, at Alma-Ata in present-day Kazakhstan, the world declared that “Health for All” would be achieved by the year 2000. That declaration was radical for its time. It explicitly linked health to economic justice, calling for a “New International Economic Order” that would redistribute resources from rich nations to poor ones.

This was a direct reference to the 1974 United Nations General Assembly resolution establishing the New International Economic Order (NIEO). The framework was designed to rectify the structural imbalances inherited from colonialism; a system sustained through resource extraction, labor exploitation, and the systematic appropriation of knowledge. Anchored in principles of sovereign equality and human dignity, the NIEO sought to secure permanent sovereignty over natural resources for developing states, reform global trade to ensure equitable pricing for raw commodities and transform international monetary arrangements. It further called for facilitated technology transfer and a binding code of conduct to govern transnational corporations, recognizing that political independence without economic sovereignty would remain incomplete.

It didn’t happen. The 1980s brought debt crises, structural adjustment programs, and the creeping privatization of health systems. The 2000s brought ambitious disease-specific programs: HIV treatment, malaria bednets, and vaccine campaigns that saved millions but neglected various other health needs, left health systems fragmented, underfunded, and commodified.

Now, a half-century later, a holistic vision is being resurrected. Its relevance and prescience are more obvious than ever.

What the strategy actually does

For all its lofty language, the draft strategy is surprisingly concrete. Its recommendations fall into five categories, each with specific tools that governments can adopt immediately. The first directs economic policy toward health by reforming tax systems, integrating health impact assessments into trade agreements, ensuring decent work and social protection, and recognizing unpaid care work.

The second moves beyond GDP by adopting progress dashboards that monitor health equity and community vitality, while applying equity standards to guide private investment. The third increases domestic financing through progressive taxation, earmarked health taxes, and outcome-focused budgeting, while using tax credits and intellectual property sharing to build local innovation ecosystems.

The fourth builds public sector capacity by embedding health economics expertise across government, integrating these competencies into medical education, and fostering coordination through multi-stakeholder observatories. The fifth secures evidence-informed implementation through a long-term research agenda, transparency protections, conflict-of-interest management, and civil society engagement to counter disinformation.

This February, at the 158th Executive Board meeting, developing countries expressed their enthusiasm for the strategy, though they approached it differently.

What’s missing: debt, austerity, and power

Even the staunchest supporters must acknowledge the strategy’s blind spots. It largely sidesteps the sovereign debt crisis crushing health budgets across Africa and Latin America. It mentions the growing dominance of financial markets in health care delivery without confronting it.

Nor does it name the geopolitical forces constraining its vision. Trade agreements that constrain domestic regulation, currency volatility that wrecks import-dependent health systems, the imperial architecture of global economic governance. These remain, for now, outside the frame.

The unfinished battle

Despite its limitations, the strategy is paving a way for a new kind of economics, one that is more humane. For fifty years, the global health menu has offered variations on the same theme: more aid, more efficient delivery, better metrics. The Economics of Health for All (EH4A) strategy offers something else entirely. It asks countries to redesign the economic order.

Whether the strategy can deliver on its vision depends on battles still unwaged. But for the first time in a generation, the question is no longer whether health belongs in economic policymaking. It is what kind of economy we are willing to build.

The strategy predictably will hit a wall of political tension that no clever policy wording can dismantle. Powerful players with a comfortable stake in how things work now are not about to just roll over. The real question isn’t whether they’ll push back (they already are). It’s whether the countries and communities who stand to gain can organize enough weight to push back harder. Without that, the most ambitious ideas in this strategy risk becoming fine print nobody ever acts on, yet again.

The WHO Watch is a program in global health governance for activists organized by the People’s Health Movement (PHM). To learn more about the program, visit this page.

People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.