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The global economic crisis that began to unfold in 2008 has raised serious concerns about the ability of developing countries to meet targets for improvements in population health outcomes, and about the ability of developed countries to meet their
...
commitments to fund health programmes in developing countries. This uncertainty underscores the importance of tracking spending on global health, to ensure resources are directed efficiently to the world's most pressing health issues.
more
The COVID-19 pandemic has resulted in a double shock - health and economic. As of March 1, 2021, COVID-19 has cost more than 2.5 million lives and triggered an economic recession surpassing any economic downturn since World War II.
Part I of this p
...
aper explores the impact of this current macro-fiscal outlook on the three primary sources of health spending. Drawing on experiences from previous economic crises, scenario analyses suggest a fall in government per capita spending on health in 2021 and 2022 unless governments make bold choices to increase the share of health in general government spending.
Part II of the paper discusses policy options to meet the spending needs in health. These options encompass strategies to make fiscal adjustments work and channel funds where they are most needed, as well as policies to stabilize the balance sheets of social health insurance (SHI) schemes. The paper explains how the health sector can play an active role in expanding fiscal space, contributing to tax reforms, most importantly pro-health taxes, and mobilizing and absorbing external financing, including debt relief.
more
Policy Note #4: Myanmar Health Systems in Transition Policy Notes Series
Protecting people from financial hardship when they fall ill is one of the two key elements of universal health coverage ... (UHC). In practice, this means that the majority of health care costs have to be met from government revenues so that services are provided free or with a small affordable co-payment. The alternative is to rely on pre-payment through some form of insurance, where risks are pooled across all contributors.
The challenge in Myanmar is that at present neither approach is functioning. Government spending is too low to meet people’s health needs and the proportion of the population covered by insurance is negligible. As a result, families face a stark choice in the event of serious illness: either defer treatment and face the consequences, or incur what can amount to catastrophic expenses and a downward spiral of disinvestment and poverty. more
Protecting people from financial hardship when they fall ill is one of the two key elements of universal health coverage ... (UHC). In practice, this means that the majority of health care costs have to be met from government revenues so that services are provided free or with a small affordable co-payment. The alternative is to rely on pre-payment through some form of insurance, where risks are pooled across all contributors.
The challenge in Myanmar is that at present neither approach is functioning. Government spending is too low to meet people’s health needs and the proportion of the population covered by insurance is negligible. As a result, families face a stark choice in the event of serious illness: either defer treatment and face the consequences, or incur what can amount to catastrophic expenses and a downward spiral of disinvestment and poverty. more
This report aims to improve the assessment of mental health needs in the Americas by providing an updated and nuanced picture of: (a) the disability resulting from mental, substance use, and specific neurological disorders, plus self-harm, alone and
...
in combination with premature mortality; (b) the imbalance between mental health spending and its related disease burden; and (c) the inadequate allocation of the meager mental health spending by countries of the Region
more
Between 2012 and 2016, development assistance for HIV/AIDS decreased by 20·0%; domestic financing is therefore critical to sustaining the response to HIV/AIDS. To understand whether domestic resources could fill the financing gaps created by declines in development assistance, we aimed to track
...
spending on HIV/AIDS and estimated the potential for governments to devote additional domestic funds to HIV/AIDS.
more
The global prevalence, morbidity and mortality related to childhood asthma among children has increased significantly over the last 40 years. Although asthma is recognized as the most common chronic disease in children, issues of underdiagnosis and undertreatment persist. There are substantial globa
...
l variations in the prevalence of asthma symptoms in children, with up to 13-fold differences between countries. The rising number of hospital admissions for asthma may reflect an increase in asthma severity, poor disease management and/or the effect of poverty. The financial burden of asthma is relatively high within developed countries (those for which data is available) spending 1 to 2% of their healthcare budget on this condition. Established in 1989, the Global Initiative for Asthma (GINA) attempts to raise awareness about the increasing prevalence of asthma, improve management and reduce the burden of asthma worldwide. Despite global efforts, GINA has not achieved its goal, even among developed nations. There are multiple barriers to reducing the global burden of asthma, including limited access to care and/or medications, and lack of prioritization as a public healthcare priority. In addition, the diversity of healthcare systems worldwide and large differences in access to care require that asthma management guidelines be tailored to local needs.
more
Beating the DRUM in Lower-Income Countries: Domestic Resource Use and Mobilization for SDG3
The Governments of Burkina Faso and Norway, the Bill & Melinda Gates Foundation, and the World Bank Group
Global Financing Facility (GFF)
(2018)
CC
This paper has been prepared to inform discussion at the conference “Beating the DRUM - Domestic Resource Use and Mobilization for accelerating progress towards SDG3,”. Many countries face critical shortfalls in domestic resource use and mobilization (DRUM) for
...
health, threatening to push health goals out of reach. DRUM failures weaken human capital formation, a vital input to economic growth. Countries need more and better health spending. The first step is to apply already-proven DRUM solutions, adapting them to new contexts. However, in many countries, even the best achievable DRUM performance will not be enough. New solutions are needed, including private-sector engagement and a next generation of DAH. The “Beating the DRUM” conference offers a platform for countries and partners to dialogue and build joint strategy. While each country’s situation is unique, shared lines of action are emerging.
more
There is growing pressure on PEPFAR, the U.S. global HIV program, to increase its planning for sustainability, including through domestic resource mobilization and, ultimately, transitioning financing at
least in part to recipient countries. While this is connected to a broader push in global
...
health and development, driven by a constrained financing environment and desire to promote more countryownership of programs and services, there are specific questions facing PEPFAR’s future. A National Academy report from 2017, for example, recommended that PEPFAR look toward phasing down its spending and supporting countries in their transition from bilateral aid to domestic financing for HIV. At a
Senate hearing last year, PEPFAR was asked how it was working to increase domestic resources and under what conditions would it need less resources to accomplish its goals. Recent challenges in securing a five-year reauthorization of the program have only served to heighten the focus on
sustainability and domestic resource mobilization. How PEPFAR does this, however, remains an ongoing question.
more
Diabetes poses an increasingly serious health challenge in Africa. Currently, 25 million adults aged 20–79 are living with diabetes, and this figure is projected to increase by 142% to 60 million by 2050 — the highest regional increase worldwide
...
. However, 73% of cases remain undiagnosed, and healthcare spending is the lowest worldwide at just USD 10 billion (1% of global expenditure). In 2024, diabetes caused 216,000 deaths and had a significant impact on maternal health, affecting 1 in 7 births due to hyperglycaemia during pregnancy. Nigeria, Tanzania and the Democratic Republic of the Congo have the highest case loads. Without urgent intervention, the diabetes burden will continue to grow, putting further strain on already limited health systems.
more
The report showed commitments made three decades ago to protect the rights of children remain unfulfilled for millions. Violence still affects countless children. Discrimination based on age, gender, disability, sexual orientation and religion harms children worldwide.
Key factors include a lack
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of investment in critically important services. Most countries fall well short of spending the 5-6% of GDP needed to ensure universal coverage of essential health care. And foreign aid, which many lower income countries rely on, is falling short in areas such as health, education, protection and child care.
Another factor, the report said, is the lack of quality data. Governments tend to rely on data that reflects national averages, making it difficult to identify the needs of specific children and to monitor progress. Comprehensive data collection and disaggregation of data by gender, age, disability and locality, are increasingly important as rights violations disproportionately affect disadvantaged children.
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Frequent efforts to revise the official development assistance (ODA) accounting rules have raised important questions about the integrity and relevance of what currently “counts” as ODA spending. In this note, we outline a brief history of the e
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volution of the ODA accounting rules to date, highlighting how—and why—the ODA concept has changed since it emerged in 1969. Doing so provides a starting point for considering whether the current concept of ODA remains “fit for purpose” and whether, or how, the concept could reform to better meet current needs.
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The world is facing a sustainable development crisis. The 2024 Financing for Sustainable Development Report: Financing for Development at a Crossroads finds that financing challenges are at the heart of the crisis and imperil the SDGs and climate action. The window to rescue the SDGs and prevent a c
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limate catastrophe is still open but closing rapidly. Financing gaps for sustainable development are large and growing – the estimates by international organizations and others are coalescing around $4 trillion additional investment needed annually for developing countries. This represents a more than 50% increase over the pre-pandemic estimates. Meanwhile, the finance divide has not been bridged, with developing countries paying around twice as much on average in interest on their total sovereign debt stock as developed countries. Many countries lack access to affordable finance or are in debt distress. Weak enabling environments are preventing progress. Average global growth has declined, while policy and regulatory frameworks still do not set appropriate incentives. Public budgets and spending is not fully aligned with SDGs. Private investors are not incentivised to invest enough in SDGs and climate action. The world is at a crossroads. This is the last chance to correct course if we want to achieve the SDGs by the 2030 deadline. Only an urgent, large-scale and sustainable investment push can help us achieve our global goals. Next year’s Fourth International Conference on Financing for Development in 2025 will be a once in 80-year opportunity to support coherent transformation of financing.
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Four initiatives have estimated the value of aid for reproductive, maternal, newborn, and child health
(RMNCH): Countdown to 2015, the Institute for Health Metrics and Evaluation (IHME), the Muskok
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a Initiative, and
the Organisation for Economic Co-operation and Development (OECD) policy marker. We aimed to compare the
estimates, trends, and methodologies of these initiatives and make recommendations for future aid tracking.
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This brochure presents health expenditure data by households, public and private institutions for the 2012/13 fiscal year. The Namibia Health Accounts 2012/13 exercise was undertaken by Government o
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f Namibia with support from the United States Agency for International Development (USAID) Namibia Mission. Program management and support and funding for the health accounts estimation were provided by USAID through the Health Finance and Governance (HFG) project, implemented by Abt Associates Inc. under cooperative agreement AID-OAA-A-12 00080.
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he pandemic has produced an unprecedented economic and social crisis, and it could generate a food, humanitarian, and political crisis if urgent measures are not taken. The policy options for addressing the pandemic entail consolidating national plans and achieving intersectoral consensus. The respo
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nse should be structured in three nonlinear and interrelated phases—control, reactivation, and rebuilding—involving the participation of technical actors representing not only the field of health but also other social and economic areas. Measures implemented to control the pandemic as well as measures for the reactivation and rebuilding phases will require increased public investment in health until the recommended parameters are achieved.
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Lancet 2022; 399: 1155–200 Published Online March 15, 2022 https://doi.org/10.1016/
S0140-6736(21)02488-0
Strengthening resource tracking and monitorig health expanditure
To assess the impact of the COVID-19 pandemic on health and HIV expenditure, UNAIDS carried out a modelling study on fiscal space for health and HIV. From a sample of 28 countries, three countries
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the Democratic Republic of the Congo, Jamaica, and Lesotho—were selected to capture health and HIV expenditure impacts across countries with especially marked differences in burdens of disease (including HIV prevalence), HIV donor dependency, level of economic development, and geographic location. While the three-country sample is too small to permit findings to be generalized to other countries, these analyses are useful for informing UNAIDS’ work to identify some policy positions to minimize the COVID-19 pandemic’s impact on the HIV response.
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