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This paper examines the implications of the IMF’s April 2024 macro-fiscal forecast updates on government health expenditure (GHE) across 170 economies through 2029, covering nearly all years remaining to achieve the Sustainable Development Goals (
...
SDGs). The findings reveal wide disparities in governments' capacities to increase health spending, with differences not only observed across income groups but also within them. Primary concerns focus to two groups of low- and lower middleincome
countries: the first group is projected to experience a contraction in real per capita GHE from 2019 and 2029, threatening to reverse progress toward the health SDG targets, while the other group faces stagnation in real per capita GHE, greatly limiting advancement. The insights presented are crucial for health policymakers and their external partners to respond to evolving macro-fiscal circumstances and stabilize investment growth in health. While increasing the priority of health in spending is a key policy option, 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 SDGs.
more
The 2020 Report analyzes global health spending for 190 countries from 2000 to 2018 and provides insights as to the health spending trajectory from the MDG era to the SDG era prior to the crisis of
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2020. The report shows that global spending on health continually rose between 2000 and 2018 and reached US$ 8.3 trillion or 10% of global GDP. The data also show that out-of-pocket spending has remained high in low and lower-middle income countries, representing greater than 40% of total health spending in 2018. We also report and summarize the data on expenditures for PHC, as well as by disease and intervention, including for immunization. The report also analyzes the available data on budget allocation in response to the COVID-19 crisis. In addition, we combine World Bank/IMF projections of the macroeconomic and fiscal impact of the crisis with an analysis of the historical determinants of health spending patterns and UHC indicators, and based on this, we draw out the likely implications of 2020 for future health spending, highlighting key policy and monitoring concerns.
more
We investigate whether and to what extent Chinese development finance affects infant mortality, combining 92 demographic and health surveys (DHS) for a maximum of 53 countries and almost 55,000 sub-national locations over the 2002-2014 period. We ad
...
dress causality by instrumenting aid with a set of interacted variables. Variation over
time results from indicators that measure the availability of funding in a given year. Cross-sectional variation results from a sub-national region’s “probability to receive aid.” Controlled for this probability in tandem with fixed effects for country-years and provinces, the interactions of these variables form powerful and excludable instruments. Our results show that Chinese aid increases infant mortality at sub-national scales, but decreases mortality at the countrylevel. In several tests, we show that this stark contrast likely results from aid being fungible within recipient countries.
more
One approach to development assistance for health, or health aid, emphasizes the ex ante selection of cost-effective health interventions, an appro
...
ach that began with the World Development Report (1993) on Investing in Health and has since been adopted by the Effective Altruism community. But just how much of health aid is cost-effective? In this paper, we examine projects in the Organisation for Economic Co-operation and Development (OECD) Creditor Reporting System, the standard dataset that measures and characterizes development assistance for health, for the
years 2019 to 2021, and count the number of projects that refer to interventions from a list of highly cost-effective interventions as defined by the Disease Control Priorities Project, third edition. This exploratory quantitative analysis indicates that 61% of projects used a key word/phrase of a costeffective intervention. There were 11.9 interventions mapped per project on average. There is little evidence that donors tailor the set of interventions to country income levels by cost-effectiveness.
Policymakers may benefit from reviewing the full portfolio of interventions covered by domestic and external resources.
more
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 climate 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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SDG Costing & Financing for Low-Income Developing Countries
Sachs, J.; G. McCord; N. Maennling et al.
UN Sustainable Development Solutions Network (SDSN)
(2019)
CC
The Sustainable Development Goals (SDGs) call for major societal transformations that will require significant fiscal outlays as well as private investments. The fiscal outlays cover public investments, the public provision of social services, and social protection for vulnerable populations. The ke
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y message of this paper, building on recent reports by the IMF and SDSN (IMF, 2019b; SDSN, 2018) is that the governments of Low-Income Developing Countries (LIDCs) will require a substantial increase in fiscal (budget) revenues, far beyond what they can achieve by their own fiscal reforms. For this reason, SDG financing will require substantial international cooperation to enable the LIDCs to finance their SDG fiscal outlays. One important source of increased revenues should be the globally coordinated taxation of ultra-high-net worth assets. Today’s ultra-rich should help to pay for the survival and basic needs of the world’s poorest people.
more
In an ambitious new era for health development under the 2030 Agenda for Sustainable Development, WHO and
its partners have a solid foundation of success on which to build.
...
Health plays a fundamental role in development
and is the central focus of Sustainable Development Goal 3, “Ensure healthy lives and promote well-being for all
at all ages”. It is also relevant to all the Sustainable Development Goals. Understanding the significance of the
role of health is a prerequisite for successful collective action on the social, economic and environmental
determinants of health
more
In sum, the goal is to understand the need to increase fiscal space for health as a prerequisite, but within the framework of efforts to transform the hea
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lth system. These changes should foster equitable and efficient expenditures and create or strengthen comprehensive integrated health systems with a first level of care capable of solving health problems and coordinating networks, based on a primary health care approach that offers not only curative care but also health promotion and disease prevention services.
more
The Commission on Macroeconomics and Health (CMH) was established by World Health Organization Director-General Gro Harlem Brundtland in January 20
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00 to assess the place of health in global economic development. Although health is widely understood to be both a central goal and an important outcome of development, the importance of investing in health to promote economic development and poverty reduction has been much less appreciated. We have found that extending the coverage of crucial health services, including a relatively small number of specific interventions, to the world’s poor could save millions of lives each year, reduce poverty, spur economic development, and promote global security.
more
Promoting and protecting health is essential to human welfare and sustained economic and social development. This was recognized more than 30 years ago by the Alma-Ata Declaration signatories, who noted that
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Health for All would contribute
both to a better quality of life and also to global peace and security
more
Background: Mental health has recently gained increasing attention on global health and development agendas, including calls for an increase in int
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ernational funding. Few studies have previously characterized official development assistance for mental health (DAMH) in a nuanced and differentiated manner in order to support future funding efforts. Methods: Data from the Organisation for Economic Cooperation and Development Creditor Reporting System were obtained through keyword searches. Projects were manually reviewed and categorized into projects dedicated entirely to mental health and projects that mention mental health (as one of many aims). Analysis of donor, recipient, and sector characteristics within and between categories was undertaken cumulatively and yearly.
more
In Kenya, 12.7 percent of sick Kenyans do not seek health care when they are ill with high cost of services being one of the major barriers that accounted for upto 21 percent of those who did not se
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ek care in 2013. Further, 2.6 million Kenyans (6.2 percent) of households were at risk of impoverishment as a consequence of expenditure on health care depleting household savings and were at a risk of falling into poverty (Republic of Kenya 2015b).
more
Mental disorders are a leading cause of the global burden of disease, and the provision of mental health services in developing countries remains very limited and far from equitable. Using the Credi
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tor Reporting System, we estimate the amounts and patterns of development assistance for global mental health (DAMH) between 2007 and 2013. This allows us to examine how well international donors have responded to calls by global mental health advocates to scale up evidence-based services. Although DAMH did increase between 2007 and 2013, it remains low both in absolute terms and as a proportion of total development assistance for health (DAH). The average annual DAMH between 2007 and 2013 was US$133.57 million, and the proportion of DAH attributed to mental health is less than 1%. Approximately 48% of total DAMH was for humanitarian assistance, education, and civil services. More annual DAMH was channelled into the nonpublic sector than the public sector. Despite an expanding body of evidence suggesting that sustainable mental health care can be effectively integrated into existing health systems at relatively low cost, mental health has not received significant development assistance.
more
Rehabilitation in health systems provides recommendations for Member States and other relevant stakeholders to strengthen and expand the availability of quality rehabilitation services. Currently, t
...
here is a significant unmet need for rehabilitation services and it is frequently undervalued in the health system. As populations age and the prevalence of noncommunicable diseases and injuries increases, and the demand for rehabilitation grows, strengthening rehabilitation in health systems becomes ever more paramount.
more
The majority of developing countries will fail to achieve their targets for Universal Health Coverage (UHC)1 and the health- and poverty-related Sustainable Development Goals (SDGs) unless they take
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urgent steps to strengthen their health financing. Just over a decade out from the SDG deadline of 2030, 3.6 billion people do not receive the most essential health services they need, and 100 million are pushed into poverty from paying out-of-pocket for health services. The evidence is strong that progress towards UHC, core to SDG 3, will spur inclusive and sustainable economic growth, yet this will not happen unless countries achieve high-performance health financing, defined here as funding levels that are adequate and sustainable; pooling that is sufficient to spread the financial risks of ill-health; and spending that is efficient and equitable to assure desired levels of health service coverage, quality, and financial protection for all people— with resilience and sustainability.
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The Lancet. 13 March 2022. doi: 10.1016/S0140-6736(21)02868-3. Previous Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) studies have reported
national health estimates for Ethiopia. Substantial regional variations
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in socioeconomic status, population, demography, and access to health care within Ethiopia require comparable estimates at the subnational level. The GBD 2019 Ethiopia subnational analysis aimed to measure the progress and disparities in health across nine regions and two chartered cities.
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The World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) was used to collect information on the mental health syste
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m in Ghana for the year 2011. The goal of collecting this information is to improve the mental health system and to provide a baseline for monitoring the change. This will enable Ghana to develop information based mental health plans with clear base-line information and targets. It will also be useful to monitor progress in implementing reform policies, providing community services, and involving users, families and other stakeholders in mental health promotion, prevention and rehabilitation.
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Childhood obesity is a major public health problem globally, which could undermine progress towards achieving the Sustainable Development Goals. Prevention is recognized as the most efficient means of curbing the epidemic; however, given the scale o
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f the problem and the many children who need professional support due to the severity of the disease and/or obesity-related complications, health systems all over Europe must take steps to develop obesity management systems. The aim of this project was to assess the response of health care delivery systems in 19 countries in the WHO European Region to the childhood obesity epidemic.
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