SEATTLE - G20 leaders meeting in Japan this week should focus on fulfilling their obligations to improve and expand their nations' health care systems.
In a commentary published today, 20 health data, financing, and policy experts contend that funding for low- and middle-income nations must be increased to address the growing impacts of climate change, wars and conflicts, and a global political trend toward nationalism. They also argue that increased domestic funding is needed to achieve the United Nations' Sustainable Development Goals (SDGs), including universal health coverage.
"Achieving universal health coverage should be at the top of the agenda for this meeting of world leaders," said Dr. Christopher Murray, Director of the Institute for Health Metrics and Evaluation at the University of Washington's School of Medicine. "The G20 leaders should assess how to encourage channeling resources to improve primary health care, as well as prevention and treatment of non-communicable diseases and to strengthen and support leadership, governance and accountability across all levels of health systems. We've witnessed a decade of plateaued funding and with the deadline to meet the SDGs just 11 years away, the world is watching."
Dr. Murray and other authors examined trends in spending for international development between 2012 and 2017, and are urging the G20 leaders to address three questions:
- How do you allocate funds to deliver equitable health improvement in people's lives?
- How do you deliver those funds to strengthen health systems?
- How do you support domestic spending in poor countries and create more effective partnerships to deliver universal health coverage?
"The landscape of development assistance for health is evolving, and therefore ripe for any desired realignment," the authors write in the commentary, which was published in the international medical journal The Lancet. "Reductions in child poverty and fertility throughout the world mean that many countries are undergoing demographic and epidemiological transitions, with their populations living longer and enduring a more diverse set of ailments."
The commentary notes that from 2000 to 2010, development assistance for health grew at a rate of 10% annually, though since 2010, funding has plateaued at 1.3% annually. In 2018, $38.9 billion (USD) was provided, with 65.2% coming from G20 members. This $38.9 billion represents 0.05% of the G20 nations' combined economies.
In addition, the commentary calls out the G20 nations for their levels of funding, the annual rate of change in funding provided between 2012 and 2017, and the health sectors for which those funds were earmarked. Among the highlights:
- India (43.4%), Brazil (37.2%), and Indonesia (30.9%) had the highest percentage increases in development assistance provided between 2012 and 2017.
- The greatest decreases in development assistance provided between 2012 and 2017 were in Saudi Arabia (-19.4%), Australia (-16.0%), and Russia (-10.1%).
- The US' increase over the same time period was 0.9%, while the UK's was 2.6%.
- South Africa was the lowest G20 contributor with $5.2 million spent in 2017, while the US was the highest at $14.4 billion.
"The global health challenges and expansive set of global health goals in the SDGs require a new approach to address pending questions about how development assistance for health can better prioritize equity, efficiency, and sustainability, particularly through domestic resource use and mobilization and strategic partnerships," the authors write.