This paper presents the most recent trends in government health spending (GHS) across 63 low- and lower-middle-income countries, offering critical insights as nations approach the decisive period for achieving the Sustainable Development Goals (SDGs). After the pandemic-induced surge, sustained declines in GHS per capita followed. While these declines might appear to be a logical consolidation, the resulting modest growth in GHS per capita and decreases in health's share of overall government spending between 2019 and 2023 pose significant challenges to the sustainability of government investment in health-compounded in many countries by contracting or stagnant government expenditure projected through 2029. These shifts cannot be ignored as countries need to restart progress toward Universal Health Coverage and other health-related SDGs after the COVID-19 setback, alongside building resilience to climate change and enhancing pandemic preparedness. Increasing the priority of health in spending is a key policy option, but it will not be sufficient on its own. Effective responses also require improving spending efficiency and addressing broader fiscal challenges. Without decisive action, many countries have little chance of achieving the health SDG.
Authors
Kurowski,Christoph, Schmidt,Martin, Mieses Ramirez,Julio Cesar, Gabani,Jacopo
- Disclosure Date
- 2024/11/05
- Disclosure Status
- Disclosed
- Doc Name
- Government Health Spending Trends Through 2023: Peaks, Declines, and Mounting Risks
- Pages
- 42
- Product Line
- Advisory Services & Analytics
- Published in
- United States of America
- Rel Proj ID
- 1W-Health Financing Global Pasa Subtask 1: Resource Mobilisation A -- P506692
- Series Name
- Double Shock; Double Recovery Paper Series;
- TF No/Name
- TF0C5213-WB IMF collaboration (BMGF),TF0C5318-HLNP - GAVI Sustainable financing (RM agenda),TF0C5295-Bangladesh: DAH transition and EPI financing strategy
- Unit Owning
- People - HNP Global Engagement (HHNGE)
- Version Type
- Final
- Volume No
- 1
Files
Table of Contents
- Government Health Spending Trends Through 2023 2
- Peaks Declines and Mounting Risks 2
- ACKNOWLEDGMENTS 5
- TABLE OF CONTENTS 7
- LIST OF FIGURES MAPS AND TABLES 8
- ACRONYMS AND ABBREVIATIONS 9
- EXECUTIVE SUMMARY 10
- Strong Advance Early Retreat 10
- INTRODUCTION 12
- Strong Advance Early Retreat 14
- TRENDS IN GOVERNMENT SPENDING ON HEALTH 15
- Countries with decreases in GHS per capita 16
- Countries with growing GHS per capita 16
- Countries with decreasing GHS-to-GGE ratios 19
- Countries with increasing GHS-to-GGE ratios 21
- CONCLUSIONS 23
- Health Financing in a Time of Global Shocks Strong Advance Early Retreat 23
- BIBLIOGRAPHY 26
- Macroeconomics and Health Investing in Health for 26
- Economic Development 26
- The Lancet 26
- Health Financing in a Time of Global Shocks Strong Advance Early Retreat 26
- Global Health Spending Outlook 2024 to 2029 Diverging Fiscal Pressures Defining Choices 26
- World Health Organization 26
- Health Economics Policy and Law 26
- The Lancet Global Health 26
- A System of Health Accounts 2011 Revised edition 26
- Tracking Universal Health Coverage 2023 Global 27
- Monitoring Report. 27
- Driving Sustainable Inclusive Growth in the 21st Century 27
- Health Budgets Repository. 27
- ANNEX 1 DATA 28
- Wages Goods and services Other current transfers Other current expenses Special contributions budget current transfers to special units 31
- Total central health budget Total regional and village-level health budgets 31
- ANNEX 2 ADDRESSING DATA LIMITATIONS 35
- 𝑐 𝑡 35
- 𝐺𝐻𝑆 𝑐𝑒𝑛𝑡𝑟𝑎𝑙 𝐺𝐻𝑆 𝑠𝑢𝑏𝑛𝑎𝑡𝑖𝑜𝑛𝑎𝑙 𝐺𝐻𝑆 35
- 𝐺𝐻𝐸 𝐺𝐻𝑆 𝑠𝑝𝑒𝑛𝑑𝑖𝑛𝑔 𝑓𝑟𝑜𝑚 𝑆𝐻𝐼 𝑐𝑜𝑛𝑡𝑟𝑖𝑏𝑢𝑡𝑖𝑜𝑛𝑠 35
- 𝐺𝐻𝑆 𝑐𝑒𝑛𝑡𝑟𝑎𝑙 𝐺𝐻𝑆 𝑠𝑢𝑏𝑛𝑎𝑡𝑖𝑜𝑛𝑎𝑙 𝐺𝐻𝐸 35
- 𝐺𝐻𝐸 𝐺𝐻𝑆 𝑠𝑝𝑒𝑛𝑑𝑖𝑛𝑔 𝑓𝑟𝑜𝑚 𝑆𝐻𝐼 𝑐𝑜𝑛𝑡𝑟𝑖𝑏𝑢𝑡𝑖𝑜𝑛𝑠 35
- 𝑇 𝐶 36
- 𝜀 𝑁0 𝜎 𝑖. 𝑖. 𝑑 36
- 𝐺𝐻𝑆 𝑝𝑒𝑟 𝑐𝑎𝑝𝑖𝑡𝑎 𝑒𝑥𝑝𝑙𝑜𝑔 𝐺𝐻𝑆 𝑝𝑒𝑟 𝑐𝑎𝑝𝑖𝑡𝑎 37
- 𝑠𝑢𝑏𝑛𝑎𝑡𝑖𝑜𝑛𝑎𝑙 𝐺𝐻𝐸 𝑠𝑢𝑏𝑛𝑎𝑡𝑖𝑜𝑛𝑎𝑙 𝑠ℎ𝑎𝑟𝑒 38
- 1 𝑠𝑢𝑏𝑛𝑎𝑡𝑖𝑜𝑛𝑎𝑙 𝑠ℎ𝑎𝑟𝑒 38
- 𝑐𝑒𝑛𝑡𝑟𝑎𝑙 𝐺𝐻𝑆 38
- 𝑠𝑢𝑏𝑛𝑎𝑡𝑖𝑜𝑛𝑎𝑙 𝐺𝐻𝐸 𝑠𝑢𝑏𝑛𝑎𝑡𝑖𝑜𝑛𝑎𝑙 𝐺𝐻𝐸 𝑠𝑢𝑏𝑛𝑎𝑡𝑖𝑜𝑛𝑎𝑙 𝐺𝐻𝐸 𝜀 38
- 𝜀 𝑁00.1 i. i. d 38
- 𝑠𝑝𝑒𝑛𝑑𝑖𝑛𝑔 𝑓𝑟𝑜𝑚 𝑆𝐻𝐼 𝑐𝑜𝑛𝑡𝑟𝑖𝑏𝑢𝑡𝑖𝑜𝑛𝑠 𝑆𝐻𝐼 𝑠ℎ𝑎𝑟𝑒 𝐺𝐻𝑆 𝑖𝑓 𝑡 2019 2021 38
- 𝑠𝑝𝑒𝑛𝑑𝑖𝑛𝑔 𝑓𝑟𝑜𝑚 𝑆𝐻𝐼 𝑐𝑜𝑛𝑡𝑟𝑖𝑏𝑢𝑡𝑖𝑜𝑛𝑠 𝑠𝑝𝑒𝑛𝑑𝑖𝑛𝑔 𝑓𝑟𝑜𝑚 𝑆𝐻𝐼 𝑐𝑜𝑛𝑡𝑟𝑖𝑏𝑢𝑡𝑖𝑜𝑛𝑠 39
- 𝑠𝑝𝑒𝑛𝑑𝑖𝑛𝑔 𝑓𝑟𝑜𝑚 𝑆𝐻𝐼 𝑐𝑜𝑛𝑡𝑟𝑖𝑏𝑢𝑡𝑖𝑜𝑛𝑠 𝜀 𝑖𝑓 𝑡 2021 39
- 𝜀 𝑁00.1 i. i. d. 39
- 𝐺𝐻𝑆 𝑝𝑒𝑟 𝑐𝑎𝑝𝑖𝑡𝑎 𝑐𝑒𝑛𝑡𝑟𝑎𝑙 𝐺𝐻𝑆 𝑝𝑒𝑟 𝑐𝑎𝑝𝑖𝑡𝑎 𝑠𝑢𝑏𝑛𝑎𝑡𝑖𝑜𝑛𝑎𝑙 𝐺𝐻𝐸 𝑝𝑒𝑟 𝑐𝑎𝑝𝑖𝑡𝑎 39
- 𝐺𝐻𝐸 𝑝𝑒𝑟 𝑐𝑎𝑝𝑖𝑡𝑎 𝑐𝑒𝑛𝑡𝑟𝑎𝑙 𝐺𝐻𝑆 𝑝𝑒𝑟 𝑐𝑎𝑝𝑖𝑡𝑎 𝑠𝑢𝑏𝑛𝑎𝑡𝑖𝑜𝑛𝑎𝑙 𝐺𝐻𝐸 𝑝𝑒𝑟 𝑐𝑎𝑝𝑖𝑡𝑎 39
- 𝑠𝑝𝑒𝑛𝑑𝑖𝑛𝑔 𝑓𝑟𝑜𝑚 𝑆𝐻𝐼 𝑐𝑜𝑛𝑡𝑟𝑖𝑏𝑢𝑡𝑖𝑜𝑛𝑠 𝑝𝑒𝑟 𝑐𝑎𝑝𝑖𝑡𝑎 39
- 𝐺𝐻𝑆 𝑝𝑒𝑟 𝑐𝑎𝑝𝑖𝑡𝑎 1 40
- 𝐺𝐻𝑆 𝑝𝑒𝑟 𝑐𝑎𝑝𝑖𝑡𝑎 40
- 𝑆𝐷 1 40
