Publication: Health Financing in a Time of Global Shocks: Strong Advance, Early Retreat
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2023-05-01
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2023-06-08
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This latest paper of the Double Shock, Double Recovery series, Health Financing in a Time of Global Shocks, is a first attempt to comprehensively gauge how government health spending has fared in developing countries over the past three years – a period when the world faced shocks in swift succession. Throughout this challenging period, public investments in health have been critical to buffer their effects on human capital, most importantly, by controlling the COVID-19 pandemic. The study showed that real per capita central government health spending generally soared during the first two years of the pandemic. In 2020, it grew in per capita terms on average across all countries by approximately 21 percent, and in 2021, it stood at 25 percent above 2019 levels. The increase was primarily driven by governments prioritizing health in their spending. The initial strong advance in real per capita government health spending lost momentum in the third year of the pandemic, turning into an early retreat. On average, it contracted, from its peak of 25 percent to only 13 percent above the 2019 level, and close to its pre-pandemic trajectory. The reversal was even starker in the priority that governments gave to health. On average, the central health share in general government spending tumbled, from its maximum of 17 percent to only 5 percent above the 2019 baseline, falling back to its pre-pandemic trajectory. Hence, it was no longer the prioritization of health, but growth in general government spending that primarily helped bolster 2022 central government health spending above the 2019 level. The rapid decline of real central government health spending may have been a risky and costly retreat. In 2022, as governments were grappling with new spending demands – due to energy and food price hikes, and rapidly rising debt service costs, the Omicron caused another wave of COVID-19 infections and death worldwide, and many health systems struggled to cope with the backlog of non-COVID-19 services. The stark reversal in the priority given to health in government spending does not bode well for global health security and progress toward the health-related Sustainable Development Goals (SDGs), especially in countries where the macroeconomic outlook remains concerning, and the capacity to increase government spending limited. Rapid action of governments will be necessary in many developing countries to reverse this latest trend and secure the prioritization of health in government spending to put their countries and the world on a new, pandemic proof and sustainable development trajectory.
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“Kurowski, Christoph; Kumar, Anurag; Mieses Ramirez, Julio Cesar; Schmidt, Martin; Silfverberg, Denise Valerie. 2023. Health Financing in a Time of Global Shocks: Strong Advance, Early Retreat. © World Bank. http://hdl.handle.net/10986/39864 License: CC BY-NC 3.0 IGO.”
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