Working Group Paper

Project: Centre on Global Health Security

Riku Elovainio and David B Evans
  • In 2010 low income countries spent only $32 per capita on health including public and private spending and that received from external sources. But it is estimated that $60 per capita is required to provide a basic standard of health services to their populations. The nearly threefold rise in external funding for health since 2000 has not therefore been sufficient to bridge this gap. 
  • Most people in low incomes countries also rely heavily on private out of pocket healthcare spending which means many cannot afford services they need or suffer severe financial hardship as a result. Mechanisms are required through tax or insurance measures to remedy this situation. 
  • Some countries can have increased the amount of public expenditure on health by introducing measures to increase general tax revenues and thus the scope for more health spending. They have also implemented specific taxes, such as on alcohol and tobacco, and allocated a proportion of the revenues raised to health spending. 
  • Most health systems contain much inefficiency. There are a number of strategies countries have adopted which have improved efficiency, particularly those which provide incentives for prevention rather than reimbursement for treatment costs incurred irrespective of health outcomes.