The COVID-19 pandemic has brought the world to its knees and shone a light on critical gaps in health infrastructure.
Investing in health infrastructure not only saves lives but is also crucial to the wider economy. Ill-health impairs productivity, negatively impacts gross domestic product and adversely affects human capital development—and that is under ordinary circumstances. During an extraordinary event such as a pandemic, the first line of defense is the health system—to detect, prevent, test and treat disease—and policies to guide the best course of action. An inadequate health system results in major loss of life because of not only the pandemic but also other unmet health needs that cannot be met by an overwhelmed health system. An inadequate health system results in curtailed movement, impacting travel and trade and sending ripples through the economy.
All health services depend on basic infrastructure. Every public health program—such as immunization, infectious disease monitoring, cancer and asthma prevention, diabetes management, drinking water quality, injury prevention—requires a mix of hard (physical infrastructure) and soft (people and policies) infrastructure as well as connective tissue (systems) to make it function.
Global public health infrastructure has remarkable and long-standing gaps. Many fragile health systems that were stretched before the pandemic are crippled under the strain.
In response to this humanitarian and economic disaster, however, incredible achievements have presented opportunities. Sharing of data and information has been extraordinary, from early access to the virus’ genetic code, to efficacy data gathered from multiple clinical trials, to an approved vaccine in eight months. Industry and government are collaborating in an unprecedented way, ministries of health and finance are deeply engaged and there is a common realization that global governance for health technology has become essential. The pandemic has impacted world views and attitudes, creating an understanding that health infrastructure is critical.
There are unique opportunities to better rebuild health infrastructure: developing multi-use supply chains that utilize blockchain technology for more efficient vaccine distribution and management, building up regional manufacturing hubs for local production of health products, utilizing artificial intelligence to train and expand the health workforce, establishing standards for interoperable digital health applications and expanding, upgrading and digitizing health registries and databanks to provide more robust analysis, among others.
Major gaps in public health infrastructure investment are undermining health and placing global security and economic development at risk. COVID-19 will not be the planet’s last pandemic, and we would do well to build health infrastructure that is prepared for tomorrow.
Focus on the Long Term
While our proactive and adaptive responses require increased flexibility during these special circumstances, they do not represent a change in AIIB’s strategic direction. AIIB will keep a long-term focus on investments in infrastructure and other productive sectors and remain within the Bank’s broad mandate of focusing on financial sustainability.
Infrastructure has social and economic dimensions and encompasses physical and organizational structures and facilities and basic systems and services. Infrastructure, therefore, extends to the facilities, systems and services that support health systems, including hospital buildings and other physical assets such as ambulances and emergency healthcare equipment. Infrastructure may include the training and protection of healthcare professionals and managerial and process improvements, among others. AIIB investments in these areas are consistent with investment in productive sectors. To support this approach, the Bank created the Social Infrastructure Department in 2020 to signal our increased involvement in this area.