The head of the Bill and Melinda Gates Foundation has called for reforms to global financial architecture, saying they are vital if the world is to catch up on the UN Sustainable Development Goals (SDGs).
Halfway to the 2030 deadline for the SDGs, the foundation’s annual Goalkeepers report shows the world is off track on 18 indicators, including health, food security, education and climate.
Gates Foundation CEO Mark Suzman said many countries’ ability to tackle the SDGs was constrained by debt. “This is not just an African problem: we have well over 50 countries spending more on debt servicing than they do on health,” he said at the Gates Foundation’s annual Goalkeepers event in New York, which celebrates individuals working on the SDGs.
Earlier in 2023 the Gates Foundation released proposals for reforming development finance, including debt restructuring and increasing the scale of lending at concessional international development association rates.
Kenyan president William Ruto said the international financial architecture crafted in 1945 was no longer fit for purpose.
“Are we saying in the 21st century that we cannot figure out another [way] that is sensitive to the current situation — where we have the vagaries of climate (change), challenges of development, and many countries are in huge debt? I say we can figure out a different financial architecture that serves the purpose of our moment,” he said. Ten countries were in debt distress and another 52 were at risk of debt distress, he said.
Mavis Owusu-Gyamfi, executive vice-president of the African Centre for Economic Transformation, said Africa needed more concessional financing, and a debt framework “with fair interest rates and the ability to restructure and pause [repayments]”.
“We also need rich countries to release assets they are sitting on and not utilising, and put them through the African Development Bank,” she said.
Earlier this week, the Gates Foundation announced $200m in commitments for tackling the reversal in progress towards the SDGs for reducing maternal and child mortality. It follows the release on September 12 of the Goalkeepers report, which identified a series of cheap and simple innovations that could save the lives of 2-million mothers and babies in low- and middle-income countries by 2030, and help get the world back on track to meet the SDGs for maternal and child mortality.
These interventions include the provision of antibiotics during labour to prevent post-partum infection; using a specially designed drape to measure blood loss during and after labour; and preventing anaemia with a one-off infusion instead of a six-month course of iron pills. Innovations for protecting babies include portable ultrasound devices and giving pre-term babies a probiotic supplement.
Suzman said he was “hopeful and cautiously confident” that the US Congress would reaffirm its support for President’s Emergency Plan for Aids Relief (Pepfar) and re-authorise funding despite anti-abortion groups lobbying against its renewal.
Pepfar has historically had bipartisan support, but the renewal of its next five-year term has been delayed by Republican politicians demanding that re-authorisation be linked to new abortion-related restrictions. These include a prohibition on Pepfar providing funds to organisations that provide or make referrals to abortion service, or even just provide information about termination of pregnancy using funds from other sources.
Bill Gates said Pepfar had saved “tens of millions” of lives, by providing HIV prevention, testing and treatment in high-burden countries. “The idea that progress would not continue is quite scary. We don’t have a cure: if people do not get their medications they will have active Aids and will not survive,” he said.
Disclaimer: Kahn's attendance of the Goalkeepers event was sponsored by the Gates Foundation.
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