By MIKE MWANIKI
A new report by the World Health Organisation (WHO) has revealed that spending on health is growing faster than the global economy, accounting for 10 percent of global Gross Domestic Product (GDP).
The report reveals an upward trajectory of global health spending, particularly in low- and middle-income countries, where health spending is growing by six percent annually compared to four percent in high-income countries.
Health spending is made up of government expenditure, out-of-pocket payments, voluntary health insurance, employer-provided health programmes, and activities by non-governmental organisations.
According to the report, governments provide an average of 51 percent of a country’s health spending, while more than 35 percent of health spending per country is out-of-pocket expenses.
“One consequence of this is 100 million people pushed into extreme poverty each year,” the report notes.
The global health body highlights a trend of increasing domestic public funding for health in low- and middle-income countries and declining external funding in middle-income countries.
Reliance on out-of-pocket expenses, the report notes, is declining around the world, albeit slowly.
WHO Director-General, Dr Tedros Ghebreyesus said increased domestic spending is essential for achieving UHC and the health-related Sustainable Development Goals.
“Health spending is not a cost, it’s an investment in poverty reduction, jobs, productivity, inclusive economic growth, and healthier, safer, fairer societies,” he said.
In middle-income countries, government health expenditure per capita has doubled since 2000.
“On average, governments spend Sh6000 per person on health in lower-middle income countries and close to Sh27000 per person in upper-middle income countries.”
When government spending on health increases, the report notes, people are less likely to fall into poverty seeking health services.
“Government spending only reduces inequities in access when allocations are carefully planned to ensure that the entire population can obtain PHC,” the report notes.
In low- and middle-income countries, new data suggest that more than half of health spending is devoted to PHC yet less than 40 per cent of all spending on primary health care comes from governments.
The WHO Director for Health Systems, Governance and Financing, Dr Agnes Soucat said all WHO member states recognised the importance of PHC in their adoption of the Astana Declaration last year.
“Now they need to act on that declaration and prioritise spending on quality healthcare in the community,” she said.
The report also examines the role of external funding.
“As domestic spending increases, the proportion of funding provided by external aid has dropped to less than one per cent of global health expenditure. Almost half of these external funds are devoted to three diseases – HIV/AIDS, Tuberculosis (TB) and malaria.”
While the report clearly illustrates the transition of middle-income countries to domestic funding of health systems, external aid remains essential to many countries, particularly low-income countries.
The new WHO report points to ways that policy makers, health professionals and citizens alike can continue to strengthen health systems.
“Health is a human right and all countries need to prioritise efficient, cost-effective PHC as the path to achieving UHC and the Sustainable Development Goals,” observes Dr Soucat.