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Global Health Economics and
Sustainability
Innovating sustainable specialized healthcare

in the form of hospital beds, physiological monitors, and a pervasive lack of societal trust (Powell, 2010) undermine
ventilators instead of cash. External funding agencies are Jamaica’s fund of social capital and represent hurdles to
generally less comfortable making sustained investments success.
in business models in developing countries, preferring
one-off charitable donations. Local investors are more 4.3. Factoring in the rapid change in health
likely to understand the local context and the cultural and technology
logistical intricacies that might deter foreign entities. The rapid integration of technological advances into
Corruption is defined as the misuse of public office, healthcare includes telemedicine platforms and a host of
public resources, or public responsibility for private – digital endpoints for improving individual and population-
personal or group – gain (Szeftel, 2000). Studies have based health. Many of these advances, supported by
estimated that the cost of corruption is akin to a 20% artificial intelligence, will find applications in LMICs.
regressive tax that foreign investors must face (Christie, These technologies are not only capable of improving care
2017). Jamaica has improved its standing, ranking 44 out of quality, safety, and efficiency but, although initially capital-
th
180 countries (1 being Denmark) in the 2022 Corruption intensive and time-consuming to integrate, can ultimately
st
Perceptions Index of Transparency International (2022). be cost-saving (Ali & Clarke, 2023; Ali et al., 2021).
Ultimately, the impact of corruption is to increase the
cost of any endeavor, including philanthropic efforts. This 5. Putting it all together
results in a lowering of social capital, which has profound As presented in the GPEI information in Table 1, there is
implications for health care. room for further improvement in Jamaica’s philanthropy.
In Jamaica and similar economies, the challenge is how
4.2. Policy
to unite social entrepreneurialism or other models with
Recurring changes to policies on health-care funding in philanthropy in a way that motivates and incentivizes
Jamaica over the past 25 years underscore the economic funders. In contrast to traditional, hands-off charitable
vulnerability of smaller democracies to the effects of grants awarded to non-profit organizations, venture
inconsistent policies. There is a great need for smaller philanthropists generally enter into long-term relationships
countries to achieve consensus on long-term directions with social enterprises or non-profit organizations. They
for essential services such as healthcare, which should believe that these entities can benefit from sustained
not be used politically as leverage for winning elections. engagement, substantial financial investments, and
However, in the past decade, an overall alignment on strategic assistance. The investments in strategic assistance
macroeconomic policies between the two major political and capitalization are designed to build organizational
parties has led to improvements in policy consistency. systems and capacity (Van Slyke & Newman, 2006).
Policies that make philanthropy more feasible have been
and are being developed but need to be better known and A Venn diagram visually positions these mechanisms
used to mutual benefit. Under the Charities Act (Ministry of for increasing healthcare funding in relation to the key
Finance, 2013), there are 290 registered charities in Jamaica primary concepts discussed previously (Figure 1).
(Ministry of Finance, 2014b), some in healthcare. However, 6. Summary and conclusion
there is a dearth of foundations in specialized health care.
The poor performance of state-owned enterprises in general Jamaica’s recent favorable economic growth trajectory,
(Darcy & Russell, 2014) is emphasized by the International improving educational metrics, greater employment,
Monetary Fund’s report on Jamaica (IMF, 2015, p. 2), which more leisure time, and greater access to information
states that “.concrete efforts are needed to modernize the through rapidly growing internet connectivity are leading
public sector and improve the efficiency of public services.” to greater expectations from its population for better
This represents an opportunity, as consistently articulated healthcare. From the perspective of Jamaica’s health-
by Tufton, Jamaica’s current Minister of Health, for effective care providers, young doctors and nurses continue to be
PPPs to improve the quality and efficiency of healthcare and drawn to North America. This is not difficult given its
to facilitate innovations in specialized care in a sustainable proximity, the large Jamaican diaspora in North America,
way, driven by commercial levels of efficiency. Better and the commonality of a shared language, English. This
standards of corporate governance (Darcy & Russell, 2014) continuing brain drain remains a challenge in scaling and
and a fairly recently enacted document to support the role improving Jamaica’s healthcare. Another growing challenge
of PPPs in Jamaica (Ministry of Finance, 2014a) should is the economic impact of climate change and the effects of
make these partnerships feasible. However, old habits, more severe hurricanes and rising temperatures, as well as
longstanding social inequalities, lack of accountability, and direct impacts such as beach erosion, which have obvious

Volume 2 Issue 3 (2024) 7 https://doi.org/10.36922/ghes.2717