Commercialising the health sector and leaving healthcare up to the markets is “dangerous” and “really amoral” the World Health Organization’s (WHO) Director-General Dr Tedros Adhanom Ghebreyesus told the launch of a brief on measuring value in the economy on Tuesday. 

The policy brief, produced by the WHO Council on the Economics of Health for All, proposes a new system of value and measurement based on valuing planetary health, diverse social foundations and activities that promote equity, rather than Gross Domestic Product (GDP).

Value the right things to take right actions

The use of GDP as a “monolithic monetary measurement metric” of value for health was condemned by panellists at the launch. Instead, they proposed that the world should move toward a more holistic data measure that abandons purely monetary indices. 

“It’s all about ensuring that we value the right things because we need to take the right actions. And sometimes a focus on GDP, on increasing economic activity at all costs, leads us away from valuing those rights actions,” said economics professor Jayati Ghosh, from the University of Massachusetts in US.

“We need this holistic approach because Health for All has all these different dimensions…Governments have to move away from the single-minded focus on economic activity as the resolution of all the other problems.”

Value women’s work

Using GDP as a metric of development also does not take into account the value of care and unpaid labour – work that is mainly done by women, who spend two and a half hours per day more than men on unpaid work, according to the brief.

The brief thus proposes the inclusion of new metrics that value goods and services that remain unaccounted for, such as growing food, cooking, cleaning, childcare and other unpaid household and community activities including environmental conservation – all predominantly performed by women.

“The contribution that women around the world make to sustaining human and planetary health is constantly undervalued. The most meaningful celebration of International Women’s Day would be to initiate a radical re-evaluation of these contributions, and drive economic policies that benefit communities, families and individuals,” said Tedros.

The brief talks about the creation of a dashboard instead of using GDP to measure the multifaceted health system. Panellists also brought to light the need to have a dashboard.

Professor Mariana Mazzucato, chair of the WHO Council on the Economics of Health for All, pointed out that countries’ GDP cannot be interpreted as a good sign.

“When we go to war, things have to be produced to go to war and that increases GDP. When we pollute, GDP goes up, because someone has to go and clean it up,” Mazzucato said. 

Governments invested 40 times more in war than health, while attempts to re-imagine GDP were marginal and insufficient for the radical change needed to achieve Health for All, according to the brief.

Lessons in pandemic preparedness

A business-as-usual approach to health, implying that the health sector can single handedly tackle a pandemic, would be “a catastrophic mistake – and a missed opportunity – that would leave the world once more unprepared for the next health crisis,” the brief said, advocating for investing in long-term preparedness. 

“By measuring the wrong things or by not measuring certain things at all, we are actually endangering our response, and we are endangering our livelihood,” said Professor Ilona Kickbusch,  Chair of the Global Health Centre at the Graduate Institute of International and Development Studies in Geneva.

“Our understanding of social determinants of health has actually expanded through the pandemic. And we neglected the one factor that turned out to be in short supply: Trust.

“We don’t measure and value what actually keeps our societies running,” she added. “And what was it during the pandemic that kept our societies running? Women’s work; women’s work in the healthcare sector…and at home.” 

Image Credits: WHO, Aishwarya , WHO Council on Economic Health For All .