The #FfD4 Outcome Document — Compromiso de Sevilla — calls on UN Member States to scale up and enhance the impact of debt swaps to finance critical investments and accelerate progress toward the SDGs. In response, The Global Fund, the Government of Indonesia, and the JLI Center for Global Health Diplomacy convened a high-level dialogue with country leaders to explore ways to streamline debt swaps, reduce transaction costs, strengthen country ownership, and improve transparency.
Solange Baptiste, Executive Director of ITPC, joined the panel to bring a community perspective, emphasizing the need for equity, accountability, and community leadership in how debt swaps are designed and implemented.
Unlocking the Power of Debt Swaps for Health, Climate & Development
Wednesday, 2 July 2025
8:30–10:00 AM
In this powerful intervention, ITPC brings the voice of communities to the heart of the debt and health financing debate. Speaking on an all-women panel, the statement calls for debt swaps to be reclaimed as tools of justice—not just finance. Drawing from real-time data gathered through community-led monitoring, it exposes how underfunded health systems are failing those most at risk, and how debt swaps—if designed with equity, transparency, and community leadership—can be a bridge from crisis to opportunity. Grounded in Global Public Investment principles, the message is clear: the real risk isn’t complexity or cost—it’s inaction.
Through community-led monitoring (CLM), we’re seeing in real time the impact of
under investment: clinics without medicines, new prevention technologies slowed,
unpaid health workers, key populations pushed out of systems. These are not just policy
gaps — they’re lives lost unnecessarily.
Today, more than 48 countries (many of whom signed the compromiso) spend more
servicing debt than on health or education. And every day, close to 7,000 people die
from HIV, TB, or malaria — mostly in communities that were promised they’d be left
behind no longer. These numbers get worse when you layer on climate impacts on
health outcomes.
Debt swaps, including Debt2Health, are not perfect. But they’re practical. In a world
where ideal justice is still delayed, practical tools matter. The global debt system
is colonial and punitive by design. We must name that. But while we work to dismantle
it, debt swaps offer a rare tool that restructures not just payments — but power.
In this moment, they offer a real way to redirect debt burdens into shared public goods
— particularly in health. Not just a fiscal solution, but a justice mechanism.
They also align powerfully with the principles of Global Public Investment — All Benefit,
All Contribute and All Decide. Debt swaps can embody this philosophy by transforming
creditor-debtor relationships into real partnerships for equity and accountability.
To work, swaps must be truly country-owned and rooted in affected community
realities. We already have the data. CLM and country coordinating mechanisms give us
a clear map of where needs are most urgent — and where lives can be saved
immediately. In too many cases, community voices are brought in at the end — for
feedback, not for direction. But this data should inform what debt swaps are used for,
not just track what happens after the money moves.
We don’t need to invent new programs. We can fund what’s already approved but under resourced — what the Global Fund calls Unmet Quality Demand (UQD). These are high impact programs, pre-vetted and shovel-ready.
And finally, we must not let “transaction costs” become the excuse. We’ve seen what
happens when people are told they’re not ready. The world once said Africans couldn’t manage ARVs because “they can’t tell time.” That was never about time. That was about power. Let’s not repeat that logic.
Let’s find a way — and use debt swaps to move from promise to practice.