The World Health Organization’s World Health Report 2010, launched in Berlin today, reveals that out-of-pocket payments are by far the greatest obstacle to achieving universal health care. But the good news is that all countries - no matter how poor - can take immediate steps to increase investments in health and make health care free and accessible to all their citizens.
The WHO report says:
- Millions of poor people miss out on health care altogether because they can’t afford to pay for it.
- Each year, 100 million people are pushed into poverty because they have to pay directly for health services, and are too ill to work.
- 3 million additional lives could be saved before 2015 if all donors met their aid promises to poor countries. But half of all OECD donor countries are off track on meeting their aid targets.
Oxfam spokesperson Anna Marriott said: “It’s appalling that hundreds of millions are denied life saving health care because they can’t afford it. Rich countries must not stand aside and watch - if they stick to their aid promises and support free public health care, three million deaths could be averted by 2015. The stakes could not be higher, and this report is a wake-up call for all governments, rich and poor, who need to do more.”
Oxfam welcomed the WHO’s recommendation that a tax on the global financial sector be used to raise funds for health systems. “The WHO support for a tax on the financial sector is fantastic. It’s the best and fairest option to deliver resources to give a huge boost to hiring doctors and nurses, buying medicines, and building clinics and hospitals,” said Marriott.
“This report puts the World Health Organization back at center stage, setting the international health agenda. Now major donors, including the World Bank, must put their full weight behind it and make sure that no poor person should ever have to choose between seeing a doctor or feeding their family.”
Notes to editors
The WHO report is available at http://www.who.int/en/
According to the WHO report (page 32): “…about half of the countries reporting their development assistance disbursements to OECD are on track to meet the targets they have committed to internationally (for overall development, including health).The other countries are failing to meet their pledges, some by a long way. Slow progress towards fulfilling these commitments comes at a huge human cost; three million additional lives could be saved before 2015 if all donors met their promises”. Only eight low-income countries have any chance of generating from domestic sources alone the funds required to achieve the MDGs by 2015, according to the WHO. WHR (page xiii): “Global solidarity is required. The funding shortfall faced by these low-income countries highlights the need for high-income countries to honor their commitments on official development assistance (ODA), and to back it up with greater effort to improve aid effectiveness … if countries were to immediately keep their current international pledges, external funding for health in low-income countries would more than double overnight and the estimated shortfall in funds to reach the health MDGs would be virtually eliminated.”
The report states that recent studies show that out-of-pocket health payments pushed 100,000 households in both Kenya and Senegal below the poverty line in a single year; and that 290 000 people experienced the same fate in South Africa. Medical debt has been the principle cause of personal bankruptcy in the USA.
In 2001 the heads of state of the African Union promised to increase government spending on healthcare to 15%, but only three countries – Liberia, Rwanda and Tanzania – achieved this by 2007.
The World Bank plays a significant role in influencing the health agendas of low-income countries. The WHR report notes: 'A World Bank report in 1987 suggested that charging fees was not only a good way to generate additional revenue, but would reduce overuse'. Twenty years later the 2007 World Bank's Strategy for Health Nutrition and Population Strategy states: 'Upon client-country demand, the Bank stands ready to support countries that want to remove user fees from public facilities'. However, the strategy also states that 'user fees have a role to play as co-payment when there is evidence of excess demand'.
Anna Marriott is available for interviews.
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