World Health Organization Publication : 9241590114: Mobilization of Domestic Resources for Health

By Jeffrey D. Sachs

Book Id: WPLBN0000212006
Format Type: PDF eBook
File Size: 0.8 MB
Reproduction Date: 2005

Title:	World Health Organization Publication : 9241590114: Mobilization of Domestic Resources for Health
Author:	Jeffrey D. Sachs
Volume:
Language:	English
Subject:	Health., Public health, Wellness programs
Collections:	Medical Library Collection, World Health Collection
Historic Publication Date:
Publisher:	World Health Organization


Citation APA MLA Chicago Sachs, J. D. (n.d.). World Health Organization Publication : 9241590114. Retrieved from http://gutenberg.cc/

Description
Medical Reference Publication

Excerpt
The Commission on Macroeconomics and Health (CMH) was launched in January 2000 by Dr Gro Harlem Brundtland, Director-General of the World Health Organization. Its mission was to analyse the impact of health on development and to examine ways in which health-related investments could spur economic development. The Commission worked to develop specific recommendations that would save lives, reduce poverty, and spur economic growth through a scaling up of investments in the health sector of developing countries. The final report of the Commission, Macroeconomics and Health: Investing in Health for Economic Development, was released in December 2001. The Commission focused its work on the world’s poorest people, in the world’s poorest countries. Millions of impoverished people die every year of conditions that are readily prevented or treated. Technologies exist to avert millions of deaths due to malaria, TB, HIV/AIDS, diarrhoeal disease, respiratory infection, and other killers. These tragic deaths—and the enormous economic and social costs associated with them—reflect the basic fact that essential life-saving health services are out of reach of hundreds of millions of the world’s poor. And yet, without extending these life-saving interventions, poverty is likely to be exacerbated and to be passed to the next generation. The economic costs of ill health, the Commission documented, are enormous and pervasive. The findings of the Commission are both stark and also encouraging. It will take a lot of money and much more political and organizational effort than has been seen in the past generation to accomplish the tasks at hand. Curbing the HIV/AIDS pandemic, or the resurgence of tuberculosis and malaria, or major killers of children such as diarrhoeal disease and vaccine-preventable diseases, will not happen by itself. Yet the task is feasible, with breathtaking achievements possible. The Commission calculates that if the donor countries contribute around 0.1% of their GNP—one penny for every $10 of income—and if that effort is matched by a suitable increase in effort within the low-income countries themselves, it should prove possible to avert 8 million deaths per year by the end of this decade. As of 2007, the donor contribution would be around US$ 27 billion per year, or roughly four times the current US$ 6 billion in official development assistance for health. The reduction in human suffer

Table of Contents
Contents Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 1. Objectives, Methods, and Sequencing of Health Financing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 1.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 1.2 Financing and health system outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 1.3 Financing methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 1.4 The context of health financing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 1.5 Efficiency gains: Allocation of resource and production of services . . . . . .16 1.6 A coherent financing strategy and conclusions . . . . . . . . . . . . . . . . . . . . .18 2. Data and Commentary on Health Financing . . . . . . . . . . . . . . .23 2.1 Scope of analysis and sources of information . . . . . . . . . . . . . . . . . . . . . .23 2.2 How much do countries spend on health? . . . . . . . . . . . . . . . . . . . . . . . .37 2.3 Paying beforehand or at time of need . . . . . . . . . . . . . . . . . . . . . . . . . . . .43 2.4 How is prepayment financed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46 2.5 How much of public spending goes on health? . . . . . . . . . . . . . . . . . . . . .49 2.6 Summing up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50 2.7 Some speculation: needs versus actual spending, total and public . . . . . . .54 3. Scope to Mobilize Additional Domestic Resources . . . . . . . .57 3.1 How much do countries raise by taxation and could they raise more to spend on health? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57 3.2 Macroeconomic considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59 3.3 Taxation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60 3.4 Earmarking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65 3.5 Other possible sources of revenue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .66 3.6 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73 4. Alternative Ways of Financing Health in the Informal Sector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75 4.1 Origins of social exclusion in health care financing . . . . . . . . . . . . . . . . . .75 4.2 Rich-poor differences in financial protection against cost of illness . . . . . .76 4.3 Role of communities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78 4.4 Assessment of impact, strengths, and weaknesses . . . . . . . . . . . . . . . . . . .82 4.5 Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84 4.6 Conclusions and recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . .99 5. Finance and Provision of Health Services in Middle-Income Countries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .101 5.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .101 5.2 Resource mobilization and provider compensation . . . . . . . . . . . . . . . . .102 5.3 In conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .110 6. Financing Health from the HIPC Initiative . . . . . . . . . . . . . . .113 6.1 De