Spain’s Contribution to the Golden Era of Global Health

[This is the second in a series of five posts written by Gonzalo Fanjul (ISGlobal) and published in Spanish in Planeta Futuro-El País that will analyse the concept of Virtuous Circles in Cooperation and its importance for the future of Spanish development aid. Using examples from different sectors—energy, global health, food security—the series will illustrate the importance of knowledge and innovation in finding solutions to the complex problems of development. Virtuous Circles is a concept formulated jointly by the Innovation and Technology for Development Centre at the Technical University of Madrid (itdUPM) and ISGlobal].

Between 2000 and 2015, the international community managed to halt the extension of the global epidemic of malaria, HIV and tuberculosis

Between 2000 and 2015, the international community managed to halt the extension of the global epidemic of malaria, HIV and tuberculosis and achieve a reversal in the incidence of all three diseases. During the same period, infant mortality was reduced to half the rate recorded in 1990, and a similar reduction was achieved in the number of children under five suffering from malnutrition. The proportion of the world’s population with access to an improved drinking water source rose from 76% to 91%. During the final stage of that period, the agenda on chronic diseases, such as cancer and hepatitis, moved beyond the confines of the developed world in recognition of the fact that these diseases also affect hundreds of millions of poor sick people in emerging economies.

This golden era in global health took place in a context in which the funds available through international cooperation had increased threefold

This golden era in global health took place in a context in which the funds available through international cooperation—public and private—had increased threefold, reaching $36 billion in 2014. The growth in funding was the result of a creative revolution that brought together the efforts of states, philanthropic organisations and private corporations. But that was not the only innovation. Knowledge also played a critical role in the great leap forward in health that has characterised the 21st century, from the large scale introduction of medical products like antiretrovirals and vaccines to the development of remote diagnostic systems and the creation of open and plural scientific research and policy groups.

When knowledge enables us to tackle complex and interrelated problems on the basis of a partnership of diverse actors capable of implementing large scale solutions, we call the result a Virtuous Circle in cooperation. And health is an area that offers fertile ground for virtuous circles in Spanish Cooperation.

Let us look at the case of malaria. Although this ancient disease still represents a threat to 3.2 billion people living in 106 countries worldwide and continues to cause the death of over 400,000 people every year, between 2005 and 2010, mortality from malaria declined by an astonishing 29%. This reduction was achieved by the widespread application of preventive and palliative measures underpinned by research, which facilitated the implementation of new and improved responses.

Spain played an important role in those advances against malaria

Spain played an important role in those advances. Investment in health-related cooperation programmes—which began three decades ago but increased substantially between 2004 and 2009, when it reached €500 million—made possible numerous interventions aimed at controlling and fighting malaria on the ground. The most notable contributions, however, came from the field of science, where research and development carried out by Spanish teams has contributed to the development of new tools against malaria and to improving World Health Organisation recommendations and establishing priorities for the international scientific agenda. Spain has been responsible for introducing innovative mechanisms for mobilising resources and has built partnerships with a multitude of different public and private institutions, including the European Commission, the Gates foundation and the pharmaceutical company GlaxoSmithKline.

Key elements in the Spanish strategy are two research platforms set up in Equatorial Guinea and Mozambique

Key elements in the Spanish strategy are two research platforms set up in Equatorial Guinea and Mozambique, countries where malaria is endemic and where only solutions rooted in local capacities and institutions have any chance of enduring. The Manhiça Health Research Centre, for example, has developed thanks to the work of Mozambican scientists, many of who have trained abroad and returned to their country to consolidate and multiply the scope of original ideas. Today, these professionals are leading momentous projects, such as the introduction of the first vaccine against malaria and the work of MALTEM, a malaria elimination programme in an area covering three Mozambican provinces, where over 600,000 cases of the disease are reported every year.

Malaria is an excellent example of how virtuous circles work in Spanish health-related cooperation

Malaria is an excellent example of how virtuous circles work in Spanish health-related cooperation, but it is not the only one. In the case of the fight against Chagas disease, a parasitic infection that affects almost 7 million people in Latin America, Spanish investment has played a key role in several tangible achievements, including the launch of a paediatric formulation, new clinical trials, and an increase in treatment coverage in countries where the disease is prevalent.

The fact that almost 90,000 patients with Chagas disease live in Spain is an excellent illustration of the circular nature of such projects. With this investment, our cooperation is not only creating and sharing knowledge that is useful for poor countries, it is also supporting national talent and strategic sectors of our own economy. This approach is based on the belief that when it comes to global prosperity, we will all sink or swim together.

Knowledge, innovation, creative partnerships, and responsible interweaving of our own interests with those of others should be an inherent part of our strategy

If there is anything that illustrates the spirit of the Sustainable Development Goals (SDG) of the 2030 Global Agenda, this is undoubtedly it.  When the Spanish Government finally decides to get down to work and draw up a national plan to implement the SDGs, it will be important to remember that we are not starting from scratch. The same could be said about the 2017-2020 Master Plan for Cooperation, which will be implemented in a very different context from earlier plans. In both cases, knowledge, innovation, creative partnerships, and responsible interweaving of our own interests with those of others should be an inherent part of our strategy.

More information

Read the other posts in the series published in El País Planeta Futuro:

• Cooperation and Knowledge: Where the Right Thing Is the Smart Thing
• Una cooperación inteligente para lograr el acceso universal a la energía
• Innovar para comer
• Cooperación: inmolarse para sobrevivir

>>> Download the report 'Virtuous Circles in Spanish Cooperation"