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Health financing

Total health expenditure per capital amounts to USD 1.251 in 2013. While total health expenditure has clearly increased significantly from 2002, most of the increase in absolute terms has been in HIC and UMICS. Vast differences in per capita spending between countries remain. On average, per capita spending in low income countries amounted to USD 102 in 2013 (more than doubling from USD 49 in 2002), as compared to USD 3112 in high income countries.

ODA to health increased significantly over the last 15 years. The focus of the MDGs on social development led to a large increase in aid to social sectors and to the health sector in particular. Within the health sector, the largest increase in ODA was dedicated to HIV/AIDS responses and, to a lesser extent, malaria, tuberculosis and other infectious diseases which pose cross-border risks, and are therefore of international concern. ODA to health stagnated between 2009 and 2014, but increased significantly again in 2015, to reach USD 28 billion overall and USD 12 billion in LDCs, largely thanks to a significant expansion of commitments on disease control (including HIV/AIDS, malaria and tuberculosis) by the Global Fund.

In addition, the share of out-of-pocket payments in total health expenditures is much larger in developing countries. It amounted to 42.3 per cent in low-income countries in 2013, compared to 29.7 per cent in upper middle income countries and 21.5 per cent in high income countries. Nonetheless, the share of out-of-pocket payments decreased over the period 2002 to 2013 across countries in all income groups. To monitor health financing, the System of Health Accounts (SHA) 2011 is the global standard for reporting health expenditures. It is now used in 60 lower income countries, that is over 70 per cent of low and low-middle income countries (SHA 2011 is least up taken among upper middle income countries, with only 40 per cent of them using it). A grand total of 120 countries are currently using SHA 2011.