1. Health sector spending and spending on HIV/AIDS, tuberculosis, and malaria, and development assistance for health: progress towards Sustainable Development Goal 3
- Author
-
Priya Rathi, Ritesh G. Menezes, Edris Hasanpoor, Sanni Yaya, Mohsen Bayati, Maciej Banach, Raffaele Palladino, Mikhail Sergeevich Zastrozhin, Siamak Sabour, Theo Vos, Tuomo J. Meretoja, Dimas Ria Angga Pribadi, Shahin Soltani, Simona Cătălina Ștefan, Behzad Karami Matin, Cyrus Alinia, Tudorel Andrei, Mehdi Bohluli, Nikita Otstavnov, Yanfang Su, Mohammad Ali Mansournia, Simon I. Hay, Mansour Ghafourifard, Songhomitra Panda-Jonas, Pushpendra Singh, Salman Rawaf, Morteza Arab-Zozani, Robert Ancuceanu, Samer Hamidi, Maarten J. Postma, Vijay Kumar Chattu, Ted R. Miller, Stanislav S. Otstavnov, Gbenga A. Kayode, Chhabi Lal Ranabhat, João Vasco Santos, Savita Lasrado, Jonathan F. Mosser, Chaw Yin Myint, Mihajlo Jakovljevic, Masoud Moghadaszadeh, Tanvir M. Huda, Fakher Rahim, Seyedeh Zahra Masoumi, Yingxi Zhao, Aziz Sheikh, Subramanian Senthilkumaran, Sheikh Mohammed Shariful Islam, Fariborz Mansour-Ghanaei, Andrew T Olagunju, Atif Amin Baig, Ali H. Mokdad, Anders Larsson, Atte Meretoja, Bach Xuan Tran, Lal B. Rawal, Brandon Cunningham, Vahid Alipour, Sowmya J. Rao, Anamika Pandey, Vahid Yazdi-Feyzabadi, Salime Goharinezhad, Angela E Micah, Leticia Avila-Burgos, Hayley N Stutzman, Farshad Farzadfar, M. Mofizul Islam, Sharareh Eskandarieh, Saqib Ali, Srikanta Banerjee, Zhi-Jiang Zhang, Anirudh Kotlo, Ravensara S. Travillian, Aziz Rezapour, Huong Lan Thi Nguyen, Sergio I. Prada, Biagio Simonetti, Maitreyi Sahu, Sadaf G. Sepanlou, Carlos A Castañeda-Orjuela, Hoa Thi Do, Farahnaz Joukar, Aso Mohammad Darwesh, Syed Mohamed Aljunid, Modhurima Moitra, In-Hwan Oh, Ayman Grada, Kenji Shibuya, Sojib Bin Zaman, Steven D Bachmeier, Hilda L Harb, Edson Serván-Mori, Bahram Mohajer, Van C. Lansingh, Ali Almasi, German Martinez, Till Bärnighausen, Reza Malekzadeh, Adam E. Berman, Matthew T. Schneider, Michael K. Hole, Reza Rawassizadeh, Bing-Fang Hwang, Bianca S. Zlavog, Mohammad Rabiee, Moses K. Muriithi, Anton C Harle, Mokhtar Mahdavi, Yohannes Kinfu, Olatunde Aremu, Cristiana Abbafati, Nelson Alvis-Guzman, Joseph L Dieleman, Lucero Cahuana-Hurtado, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Zeleke Hailemariam Abebo, Muge Cevik, Hassan Abolhassani, Farnam Mohebi, Job F M van Boven, Nataliya Foigt, Neda Milevska Kostova, Abdallah M. Samy, Roman Topor-Madry, Golsum Tsakalos, Benjamin B. Massenburg, Spencer L. James, Erkin M. Mirrakhimov, Miloje Savic, Mehdi Hosseinzadeh, Sawyer W Crosby, Ayesha Humayun, Hamidreza Setayesh, G Anil Kumar, Juan Sanabria, Jalal Arabloo, Milena M Santric Milicevic, Ai Koyanagi, Shokofeh Maleki, Junjie Wu, Nathaniel J Henry, Efat Mohamadi, Francesco Saverio Violante, Samad Azari, Delia Hendrie, Ahad Bakhtiari, Olayinka Stephen Ilesanmi, Pankaj Bhardwaj, Ahamarshan Jayaraman Nagarajan, Adnan Kisa, Masood Ali Shaikh, Shafiu Mohammed, Justice Nonvignon, Firooz Esmaeilzadeh, Eduardo A. Undurraga, Khurshid Alam, Muktar Beshir Ahmed, Mohamed M. Gad, Mikk Jürisson, Usman Iqbal, Chuanhua Yu, Luis Camera, Mohammad Ali Jahani, Abigail Chapin, Pascual R. Valdez, Reinhard Busse, Tomislav Mestrovic, Paul S. F. Yip, Christopher J L Murray, Jacob Olusegun Olusanya, Salah Eddin Karimi, Mustafa Z. Younis, Michael R.M. Abrigo, Rahul R. Zende, Mina Anjomshoa, Shane D. Morrison, Marcel Ausloos, Bruno Piassi Sao Jose, Zohre Javaheri, Saravanan Muthupandian, Valentin Yurievich Skryabin, Endalkachew Worku Mengesha, Lalit Dandona, Jacek Jerzy Jozwiak, Omar Mukhtar Salman, Rakhi Dandona, Mojtaba Bagherzadeh, Mostafa Dianatinasab, Reza Mohammadpourhodki, Seyed Sina Naghibi Irvani, Nancy Fullman, Claudiu Herteliu, Andreea Mirica, Jasvinder A. Singh, Amin Soheili, Lee Ling Lim, Charles D.A. Wolfe, Catalina Liliana Andrei, Ali Kazemi Karyani, Bolajoko O. Olusanya, Carl Abelardo T. Antonio, Tommi Vasankari, Jean Jacques Noubiap, Mehdi Naderi, Jagadish Rao Padubidri, Bernhard T. Baune, Navid Rabiee, Mark G. Shrime, Mayowa O. Owolabi, Lorenzo G. Mantovani, Desta Debalkie Atnafu, Vasily Vlassov, Kyle E. Simpson, Sorin Hostiuc, Shaun Wen Huey Lee, Cuong Tat Nguyen, Ian E Cogswell, Tesleem Kayode Babalola, Sanjay Basu, Hassan Haghparast Bidgoli, Leila Doshmangir, Marcos Roberto Tovani-Palone, Maha El Tantawi, Obinna Onwujekwe, Mohammad Ali Sahraian, Ahmed Omar Bali, Joshua A. Salomon, Hamidreza Komaki, David Laith Rawaf, Zoubida Zaidi, Hassan Magdy Abd El Razek, Reshmi Bhageerathy, Emilie R Maddison, Naohiro Yonemoto, Ahmad Ghashghaee, Asadollah Gholamian, Ferrán Catalá-López, Stefan Kohler, Rafael Tabarés-Seisdedos, Anwar Faraj, Rafael Lozano, Rufus Akinyemi, Florian Fischer, Jost B. Jonas, Dian Kusuma, Martin Amogre Ayanore, Rohollah Kalhor, Falk Schwendicke, Seyyed Meysam Mousavi, Micah, A. E., Su, Y., Bachmeier, S. D., Chapin, A., Cogswell, I. E., Crosby, S. W., Cunningham, B., Harle, A. C., Maddison, E. R., Moitra, M., Sahu, M., Schneider, M. T., Simpson, K. E., Stutzman, H. N., Tsakalos, G., Zende, R. R., Zlavog, B. S., Abbafati, C., Abebo, Z. H., Abolhassani, H., Abrigo, M. R. M., Ahmed, M. B., Akinyemi, R. O., Alam, K., Ali, S., Alinia, C., Alipour, V., Aljunid, S. M., Almasi, A., Alvis-Guzman, N., Ancuceanu, R., Andrei, T., Andrei, C. L., Anjomshoa, M., Antonio, C. A. T., Arabloo, J., Arab-Zozani, M., Aremu, O., Atnafu, D. D., Ausloos, M., Avila-Burgos, L., Ayanore, M. A., Azari, S., Babalola, T. K., Bagherzadeh, M., Baig, A. A., Bakhtiari, A., Banach, M., Banerjee, S. K., Barnighausen, T. W., Basu, S., Baune, B. T., Bayati, M., Berman, A. E., Bhageerathy, R., Bhardwaj, P., Bohluli, M., Busse, R., Cahuana-Hurtado, L., Camera, L. L. A., Castaneda-Orjuela, C. A., Catala-Lopez, F., Cevik, M., Chattu, V. K., Dandona, L., Dandona, R., Dianatinasab, M., Do, H. T., Doshmangir, L., El Tantawi, M., Eskandarieh, S., Esmaeilzadeh, F., Faraj, A., Farzadfar, F., Fischer, F., Foigt, N. A., Fullman, N., Gad, M. M., Ghafourifard, M., Ghashghaee, A., Gholamian, A., Goharinezhad, S., Grada, A., Haghparast Bidgoli, H., Hamidi, S., Harb, H. L., Hasanpoor, E., Hay, S. I., Hendrie, D., Henry, N. J., Herteliu, C., Hole, M. K., Hosseinzadeh, M., Hostiuc, S., Huda, T. M., Humayun, A., Hwang, B. -F., Ilesanmi, O. S., Iqbal, U., Irvani, S. S. N., Islam, S. M. S., Islam, M. M., Jahani, M. A., Jakovljevic, M., James, S. L., Javaheri, Z., Jonas, J. B., Joukar, F., Jozwiak, J. J., Jurisson, M., Kalhor, R., Karami Matin, B., Karimi, S. E., Kayode, G. A., Kazemi Karyani, A., Kinfu, Y., Kisa, A., Kohler, S., Komaki, H., Kosen, S., Kotlo, A., Koyanagi, A., Kumar, G. A., Kusuma, D., Lansingh, V. C., Larsson, A. O., Lasrado, S., Lee, S. W. H., Lim, L. -L., Lozano, R., Magdy Abd El Razek, H., Mahdavi, M. M., Maleki, S., Malekzadeh, R., Mansour-Ghanaei, F., Mansournia, M. A., Mantovani, L. G., Martinez, G., Masoumi, S. Z., Massenburg, B. B., Menezes, R. G., Mengesha, E. W., Meretoja, T. J., Meretoja, A., Mestrovic, T., Milevska Kostova, N., Miller, T. R., Mirica, A., Mirrakhimov, E. M., Moghadaszadeh, M., Mohajer, B., Mohamadi, E., Mohammad Darwesh, A., Mohammadian-Hafshejani, A., Mohammadpourhodki, R., Mohammed, S., Mohebi, F., Mokdad, A. H., Morrison, S. D., Mosser, J. F., Mousavi, S. M., Muriithi, M. K., Muthupandian, S., Myint, C. -Y., Naderi, M., Nagarajan, A. J., Nguyen, C. T., Nguyen, H. L. T., Nonvignon, J., Noubiap, J. J., Oh, I. -H., Olagunju, A. T., Olusanya, J. O., Olusanya, B. O., Omar Bali, A., Onwujekwe, O. E., Otstavnov, S. S., Otstavnov, N., Owolabi, M. O., Padubidri, J. R., Palladino, R., Panda-Jonas, S., Pandey, A., Postma, M. J., Prada, S. I., Pribadi, D. R. A., Rabiee, M., Rabiee, N., Rahim, F., Ranabhat, C. L., Rao, S. J., Rathi, P., Rawaf, S., Rawaf, D. L., Rawal, L., Rawassizadeh, R., Rezapour, A., Sabour, S., Sahraian, M. A., Salman, O. M., Salomon, J. A., Samy, A. M., Sanabria, J., Santos, J. V., Santric Milicevic, M. M., Sao Jose, B. P., Savic, M., Schwendicke, F., Senthilkumaran, S., Sepanlou, S. G., Servan-Mori, E., Setayesh, H., Shaikh, M. A., Sheikh, A., Shibuya, K., Shrime, M. G., Simonetti, B., Singh, J. A., Singh, P., Skryabin, V. Y., Soheili, A., Soltani, S., Stefan, S. C., Tabares-Seisdedos, R., Topor-Madry, R., Tovani-Palone, M. R., Tran, B. X., Travillian, R., Undurraga, E. A., Valdez, P. R., van Boven, J. F. M., Vasankari, T. J., Violante, F. S., Vlassov, V., Vos, T., Wolfe, C. D. A., Wu, J., Yaya, S., Yazdi-Feyzabadi, V., Yip, P., Yonemoto, N., Younis, M. Z., Yu, C., Zaidi, Z., Zaman, S. B., Zastrozhin, M. S., Zhang, Z. -J., Zhao, Y., Murray, C. J. L., Dieleman, J. L., Global Burden of Disease Health Financing Collaborator Network, Violante FS, Micah, A, Su, Y, Bachmeier, S, Chapin, A, Cogswell, I, Crosby, S, Cunningham, B, Harle, A, Maddison, E, Moitra, M, Sahu, M, Schneider, M, Simpson, K, Stutzman, H, Tsakalos, G, Zende, R, Zlavog, B, Abbafati, C, Abebo, Z, Abolhassani, H, Abrigo, M, Ahmed, M, Akinyemi, R, Alam, K, Ali, S, Alinia, C, Alipour, V, Aljunid, S, Almasi, A, Alvis-Guzman, N, Ancuceanu, R, Andrei, T, Andrei, C, Anjomshoa, M, Antonio, C, Arabloo, J, Arab-Zozani, M, Aremu, O, Atnafu, D, Ausloos, M, Avila-Burgos, L, Ayanore, M, Azari, S, Babalola, T, Bagherzadeh, M, Baig, A, Bakhtiari, A, Banach, M, Banerjee, S, Barnighausen, T, Basu, S, Baune, B, Bayati, M, Berman, A, Bhageerathy, R, Bhardwaj, P, Bohluli, M, Busse, R, Cahuana-Hurtado, L, Camera, L, Castaneda-Orjuela, C, Catala-Lopez, F, Cevik, M, Chattu, V, Dandona, L, Dandona, R, Dianatinasab, M, Do, H, Doshmangir, L, El Tantawi, M, Eskandarieh, S, Esmaeilzadeh, F, Faraj, A, Farzadfar, F, Fischer, F, Foigt, N, Fullman, N, Gad, M, Ghafourifard, M, Ghashghaee, A, Gholamian, A, Goharinezhad, S, Grada, A, Haghparast Bidgoli, H, Hamidi, S, Harb, H, Hasanpoor, E, Hay, S, Hendrie, D, Henry, N, Herteliu, C, Hole, M, Hosseinzadeh, M, Hostiuc, S, Huda, T, Humayun, A, Hwang, B, Ilesanmi, O, Iqbal, U, Irvani, S, Islam, S, Islam, M, Jahani, M, Jakovljevic, M, James, S, Javaheri, Z, Jonas, J, Joukar, F, Jozwiak, J, Jurisson, M, Kalhor, R, Karami Matin, B, Karimi, S, Kayode, G, Kazemi Karyani, A, Kinfu, Y, Kisa, A, Kohler, S, Komaki, H, Kosen, S, Kotlo, A, Koyanagi, A, Kumar, G, Kusuma, D, Lansingh, V, Larsson, A, Lasrado, S, Lee, S, Lim, L, Lozano, R, Magdy Abd El Razek, H, Mahdavi, M, Maleki, S, Malekzadeh, R, Mansour-Ghanaei, F, Mansournia, M, Mantovani, L, Martinez, G, Masoumi, S, Massenburg, B, Menezes, R, Mengesha, E, Meretoja, T, Meretoja, A, Mestrovic, T, Milevska Kostova, N, Miller, T, Mirica, A, Mirrakhimov, E, Moghadaszadeh, M, Mohajer, B, Mohamadi, E, Mohammad Darwesh, A, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mohammed, S, Mohebi, F, Mokdad, A, Morrison, S, Mosser, J, Mousavi, S, Muriithi, M, Muthupandian, S, Myint, C, Naderi, M, Nagarajan, A, Nguyen, C, Nguyen, H, Nonvignon, J, Noubiap, J, Oh, I, Olagunju, A, Olusanya, J, Olusanya, B, Omar Bali, A, Onwujekwe, O, Otstavnov, S, Otstavnov, N, Owolabi, M, Padubidri, J, Palladino, R, Panda-Jonas, S, Pandey, A, Postma, M, Prada, S, Pribadi, D, Rabiee, M, Rabiee, N, Rahim, F, Ranabhat, C, Rao, S, Rathi, P, Rawaf, S, Rawaf, D, Rawal, L, Rawassizadeh, R, Rezapour, A, Sabour, S, Sahraian, M, Salman, O, Salomon, J, Samy, A, Sanabria, J, Santos, J, Santric Milicevic, M, Sao Jose, B, Savic, M, Schwendicke, F, Senthilkumaran, S, Sepanlou, S, Servan-Mori, E, Setayesh, H, Shaikh, M, Sheikh, A, Shibuya, K, Shrime, M, Simonetti, B, Singh, J, Singh, P, Skryabin, V, Soheili, A, Soltani, S, Stefan, S, Tabares-Seisdedos, R, Topor-Madry, R, Tovani-Palone, M, Tran, B, Travillian, R, Undurraga, E, Valdez, P, van Boven, J, Vasankari, T, Violante, F, Vlassov, V, Vos, T, Wolfe, C, Wu, J, Yaya, S, Yazdi-Feyzabadi, V, Yip, P, Yonemoto, N, Younis, M, Yu, C, Zaidi, Z, Zaman, S, Zastrozhin, M, Zhang, Z, Zhao, Y, Murray, C, Dieleman, J, University of Helsinki, Clinicum, HUS Comprehensive Cancer Center, HUS Neurocenter, Helsinki University Hospital Area, University of St Andrews. School of Medicine, University of St Andrews. Infection and Global Health Division, Groningen Research Institute for Asthma and COPD (GRIAC), Value, Affordability and Sustainability (VALUE), and Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET)
- Subjects
Economic growth ,Financing, Government ,Psychological intervention ,HIV Infections ,burden of disease ,030204 cardiovascular system & hematology ,DISEASE ,ALLOCATION ,0302 clinical medicine ,RA0421 ,RA0421 Public health. Hygiene. Preventive Medicine ,Sustainable development ,Global health ,health economics ,Healthcare Financing ,HIV Infection ,030212 general & internal medicine ,10. No inequality ,11 Medical and Health Sciences ,DALY ,Healthy lives ,1. No poverty ,Public Health, Global Health, Social Medicine and Epidemiology ,3rd-DAS ,General Medicine ,Sustainable Development ,3. Good health ,tuberculosis ,IMPOVERISHMENT ,TERRITORIES ,Financing ,Human ,Financing, Personal ,Resource (biology) ,Tuberculosi ,195 COUNTRIES ,Developing Countrie ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,Acquired immunodeficiency syndrome (AIDS) ,General & Internal Medicine ,SYSTEMATIC ANALYSIS ,medicine ,Humans ,Burden, HIV/AIDS, tubercolosis, malaria ,Human resources ,Developing Countries ,Government ,Acquired Immunodeficiency Syndrome ,Health economics ,business.industry ,DISABILITY ,CATASTROPHE ,Global Burden of Disease Health Financing Collaborator Network ,GLOBAL BURDEN ,medicine.disease ,Malaria ,SDG ,health sector spending ,development assistant for health ,Health Expenditure ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,3121 General medicine, internal medicine and other clinical medicine ,NA ,Health Expenditures ,business ,EXPENDITURE - Abstract
BACKGROUND: Sustainable Development Goal (SDG) 3 aims to "ensure healthy lives and promote well-being for all at all ages". While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to measure progress in financing the priority areas of SDG3, examine the association between outcomes and financing, and identify where resource gains are most needed to achieve the SDG3 indicators for which data are available. METHODS: We estimated domestic health spending, disaggregated by source (government, out-of-pocket, and prepaid private) from 1995 to 2017 for 195 countries and territories. For disease-specific health spending, we estimated spending for HIV/AIDS and tuberculosis for 135 low-income and middle-income countries, and malaria in 106 malaria-endemic countries, from 2000 to 2017. We also estimated development assistance for health (DAH) from 1990 to 2019, by source, disbursing development agency, recipient, and health focus area, including DAH for pandemic preparedness. Finally, we estimated future health spending for 195 countries and territories from 2018 until 2030. We report all spending estimates in inflation-adjusted 2019 US$, unless otherwise stated. FINDINGS: Since the development and implementation of the SDGs in 2015, global health spending has increased, reaching $7·9 trillion (95% uncertainty interval 7·8-8·0) in 2017 and is expected to increase to $11·0 trillion (10·7-11·2) by 2030. In 2017, in low-income and middle-income countries spending on HIV/AIDS was $20·2 billion (17·0-25·0) and on tuberculosis it was $10·9 billion (10·3-11·8), and in malaria-endemic countries spending on malaria was $5·1 billion (4·9-5·4). Development assistance for health was $40·6 billion in 2019 and HIV/AIDS has been the health focus area to receive the highest contribution since 2004. In 2019, $374 million of DAH was provided for pandemic preparedness, less than 1% of DAH. Although spending has increased across HIV/AIDS, tuberculosis, and malaria since 2015, spending has not increased in all countries, and outcomes in terms of prevalence, incidence, and per-capita spending have been mixed. The proportion of health spending from pooled sources is expected to increase from 81·6% (81·6-81·7) in 2015 to 83·1% (82·8-83·3) in 2030. INTERPRETATION: Health spending on SDG3 priority areas has increased, but not in all countries, and progress towards meeting the SDG3 targets has been mixed and has varied by country and by target. The evidence on the scale-up of spending and improvements in health outcomes suggest a nuanced relationship, such that increases in spending do not always results in improvements in outcomes. Although countries will probably need more resources to achieve SDG3, other constraints in the broader health system such as inefficient allocation of resources across interventions and populations, weak governance systems, human resource shortages, and drug shortages, will also need to be addressed. For complete list of authors see http://dx.doi.org/10.1016/S0140-6736(20)30608-5
- Published
- 2020
- Full Text
- View/download PDF