As the High Level Political Forum Discusses the Health Targets, We Call For More Strategic Resources for Health
This week’s High Level Political Forum on the Sustainable Development Goals (SDGs) has the theme of “Eradicating poverty and promoting prosperity in a changing world”. One of the causes of poverty, as well as fear and suffering, is the failure to ensure that all people have access to quality healthcare without being expected to pay large amounts of cash for it. There are 150 million people each year pushed into poverty or further into poverty due to high out-of-pocket costs for healthcare and 400 million people do not have access to essential health services. Universal health coverage (UHC) in Target 3.8 of the SDGs promotes a framework to stop these injustices.
Health advocates know that public investment in health is the key to genuine UHC. However, despite the many commitments to increase spending on health systems that would lead to achieving UHC, we find that governments of low and middle-income countries are reducing, not increasing, their spending on health. A recent report from the World Health Organization shows that between 2000 and 2014, public funds from domestic sources to finance health stagnated in low and middle-income countries. Domestic budget prioritisation towards health sharply declined and was highly volatile between 2000 and 2014 in LICs. Despite the strong consensus, there is no evidence that the replacement of private expenditure with public financing has started, especially not in low-income countries. No country has achieved significant progress towards UHC without investing public money in the health system. Progress also takes time and with two years of the SDGs already behind us, governments urgently need to prioritise their national health spending by committing at least 5% of GDP in public spending. This needs short-term action rather than vague aspirations for the future.
As non-governmental organisations that are part of the UHC2030 civil society constituency, we want to see UHC reforms drive improvements in health systems so that all the SDG targets can be achieved. We are calling on this High Level Political Forum to confirm that a bottom-up approach to UHC, building universal primary health care as the bedrock towards resilient and secure national health systems. While the priority is that governments collect and spend 5% of their GDP on health, donors need to achieve their promise of 0.7% GNI to Official Development Assistance (ODA). The WHO report also shows that aid actually has a negative impact on domestic resources. This should make donors review whether the way they are giving aid is causing fragmentation and chaos and undermining the will and capacity of national governments to build universal primary health care.