Feature: Covid’s legacy could be more resilient healthcare systems – IFC

Elena Sterlin, Global Head of Health and Education at the International Finance Corporation

Elena Sterlin, head of health and education, IFC, argues that the legacy of the pandemic could be more resilient healthcare systems and greater understanding between the public and private sectors.

A year ago my professional life froze. On March 12 came the first notice: all mission travel suspended, effective immediately. A day later, we were ordered to work from home until further notice. Daily activities that had provided a framework and flow to my life – commuting to IFC headquarters in downtown Washington, DC, meeting clients and colleagues for lunch and coffee, travelling to different regions to explore new market opportunities – vanished overnight.

At the very same time, my life sped up. A hurricane of requests for financing descended upon IFC. Hospitals and clinics were haemorrhaging around 60% of their traditional patients and they needed to shift service offerings rapidly to support Covid patients. Pharmaceutical and medtech companies were scrambling to secure high-demand raw materials and parts while trying to figure out how to increase the output of products to diagnose and treat Covid. Vaccine manufacturers were looking for ways to grow capacity even before a Covid vaccine was approved by regulators.

As a global development organisation that provides funding and advice to the private health sector, IFC had to refocus too.

Our long-term strategy in healthcare has been oriented towards helping developing countries meet emerging health challenges, notably from non-communicable diseases, but here we were faced with the deadliest infectious disease pandemic in a century. While most of the 2.7 million deaths from Covid so far have been in advanced economies, the developing world has been hugely impacted too, both on the health and on the economic side. The sharp contraction of global output has stretched budgets, triggered massive job losses, and pushed as many as 120 million people into poverty.

IFC has been laser-focused on deploying what instruments it has at its disposal to help developing nations get through these difficult times.

Doing business in a pandemic certainly poses unique challenges. We have, however, tenaciously stuck to our mission, with the result that, with respect to our health sector investments, we have grown our portfolio by 30% over the past year. Concretely, that means providing US$750m in new funding to healthcare companies.

Where has this money gone?

A good example is Biological E Limited, one of India’s top vaccine manufacturers. IFC has provided the company with a loan to help it expand its capacity to manufacture various vaccines, including the newly approved Johnson & Johnson Covid vaccine.

But IFC’s work has extended far beyond vaccine funding. The World Health Organization (WHO) lists medical oxygen as an ‘essential medicine’ and we have seen especially in this pandemic just how lifesaving it can be.

There remain, however, wide gaps in access to medical oxygen in most low- and middle-income countries. To reduce these shortages, IFC provided funding to Yuwell, a Chinese medical equipment manufacturer, enabling it to double its capacity to produce oxygen compressors and ventilators. The funding is aimed specifically at increasing sales to countries in Africa and Asia where these products are in short supply.

Looking past the current crisis, the pandemic has underscored the need for the public and private sectors to work more closely together to make healthcare systems more resilient through improved supply chains for lifesaving health products and better contracting with private healthcare.

To this end, IFC in July last year launched a US$4bn global health platform.

The platform has spurred three main streams of activity. Firstly, with the aim of fostering more localised production in emerging markets, we are forging partnerships within the subsectors of active pharmaceutical ingredients, vaccines, and medical supplies and equipment.

The Japanese government, Norway, and others are working with us to support the transfer of health technologies to emerging markets and to improve the manufacturing quality of personal protective equipment.

Secondly, we are supporting governments’ efforts better to incorporate the private sector in health service delivery through contracting or private-public partnerships.

Several governments have already approached the World Bank Group for such support. In addition, we have begun to partner with the WHO – we recently co-produced a best practices document on how to contract health services with the private sector.

Thirdly, on the innovation front, IFC is supporting digital healthcare and artificial intelligence that addresses major market gaps and shortcomings such as data availability, sector transparency, ease of access to health services, and service quality.

For example, IFC funded 1mg, an Indian company that has made great strides in creating fast, safe, and reliable supply chains for the Covid-19 vaccine and other pharmaceuticals. We aim to ramp up our work in this space significantly.

Covid has taken a heavy toll on all of us. Like most, I am eager to move to a post-pandemic new normal, one where I can meet clients and colleagues in person again and resume my business development trips.

If there is any silver lining, it is that thanks to our response efforts, when the next health crisis comes, we will be better prepared and the public and private sectors will have a clearer understanding of how to work in tandem to beat it.