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Global Health Economics and
Sustainability
Innovating sustainable specialized healthcare

Development Plan, drafted in 2009, indicated that private with rapidly growing needs and expectations. Examining
hospitals in Jamaica only provided 5% of total hospital how healthcare has been funded in other parts of the
services, although this may have increased somewhat since world and the contribution of philanthropy (meaning
then (The Health Sector Task Force, 2009). “love of humankind” in Greek) in other countries
provides important potential models. In addition,
How, then, can countries such as Jamaica, which have
effective primary and public health-care systems and exploring whether home-grown philanthropy and other
have created environments that prolong life, deal with not-for-profit mechanisms can be feasible methods to
the health burdens associated with longevity when the help fund specialized health care in lower- and middle-
costs are multiples of the expenditure previously needed income countries (LMICs) such as Jamaica is essential.
International donors tend to concentrate their efforts on
to eliminate infectious diseases and substantially increase low-income regions, and as such, upper-middle-income
lifespan? (Table 1) Additionally, why should they do it
when the additional cost is so high? And who pays? One countries such as Jamaica do not tend to benefit as much
point that is not immediately apparent is that, in addition from these funding sources (McCoy et al., 2009).
to increasing the average lifespan by another 3 – 6 years, A general limitation identified in this review is the
there is a substantial improvement in the quality of life in marked paucity of relevant literature emanating from
these final years when health-care systems can meet these middle-income developing countries such as Jamaica.
needs. In this regard, a recently developed index, health- Consequently, most insights into local peculiarities are
adjusted life expectancy (HALE), represents the number gleaned from global PPPs between major foundations,
of years in full health that an individual, usually at birth such as the Bill and Melinda Gates Foundation, and these
or aged 60 years, should live if exposed to age-specific countries (Buse & Harmer, 2007; Nishtar, 2004).
mortality and currently existing health status (morbidity) Ultimately, the aim is to propose culturally and
conditions. The HALE index has greatly helped monitor economically appropriate ways of developing successful
trends and analyze health inequalities between populations. partnerships in Jamaica. The true innovation will lie in
HALE improved across the world between 1990 and 2013 the de novo participation of the wealthy in the arena of
by 5.5 years due to improving living standards, advances specialized healthcare and in scaling this to bring value to
in medical technology, health education, and public health all citizens in need of such care (Starr & Hattendorf, 2015).
interventions. Significant disparities, however, have been As discussed, the model of total access for all, as funded
identified across countries (WHO, 2020). For example, by developed welfare states – which, although nowadays
in South Africa, the HALE fell by 3.96 years during this under great pressure, typically puts healthcare at the
period (mainly due to HIV), and in Kenya, there was a center of their political agenda (Moran, 2000) – may not
gain of 1 – 2 years. In Jamaica, the gain was 0 – 1 years. be feasible or sustainable in less economically endowed
For comparison, during this period, the US had a gain of countries such as Jamaica.
3 – 4 years. To put these figures in context, in the US, the
average life expectancy is 84.1 years, and the average HALE 3. Relevant conceptual frameworks
is 78.9 years. Women live 2.6 years longer than men (85.3 vs.
82.7 years), on average, and enjoy good health for almost 3.1. Innovation
2 years longer (79.8 vs. 77.9 years). In the US, Caucasians Innovation is not solely technological; sustainable
live an average of 84.2 years, with 79.3 years in good health; innovation is required across policy, technology, finance,
Afro-Americans live an average of 83.1 years, but just service, and research. However, change is often difficult
76.1 years in good health (Stibich, 2020). In comparison, in regions where the status quo is strongly maintained.
Jamaica’s HALE is 66 years versus a life expectancy of For instance, in Ghana, which has a similar level of
74.5 years. It should be apparent that increasing HALE infrastructural development as Jamaica, deficiencies in the
means more years of potential productivity and fewer years health innovation environment have limited its potential
of being a burden on the health system and family. (Al-Bader et al., 2010). Innovation involves recognizing
Countries such as Jamaica need good fiscal leadership the wide variety of stakeholders in the process and the
and, given the rapidly growing cost of healthcare, potentially interactions and knowledge exchanges among them
significant philanthropic efforts to achieve HALE and life (Lundvall, 2010). It should be noted that impediments to
expectancy levels closer to those of developed countries. innovation in health care are not unique to the developing
While non-governmental organizations and charities world (McMahon, 2008).
have contributed to healthcare, including specialized It is necessary to explore innovation both as a single
healthcare, much more is necessary for Jamaica to keep up event (disruption) or as incremental advancement, as

Volume 2 Issue 3 (2024) 4 https://doi.org/10.36922/ghes.2717