Publication: Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990–2050
4
Issued Date
2021-10-09
Resource Type
ISSN
1474547X
01406736
01406736
Other identifier(s)
2-s2.0-85116527441
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
The Lancet. Vol.398, No.10308 (2021), 1317-1343
Suggested Citation
Angela E. Micah, Ian E. Cogswell, Brandon Cunningham, Satoshi Ezoe, Anton C. Harle, Emilie R. Maddison, Darrah McCracken, Shuhei Nomura, Kyle E. Simpson, Hayley N. Stutzman, Golsum Tsakalos, Lindsey E. Wallace, Yingxi Zhao, Rahul R. Zende, Cristiana Abbafati, Michael Abdelmasseh, Aidin Abedi, Kedir Hussein Abegaz, E. S. Abhilash, Hassan Abolhassani, Michael R.M. Abrigo, Tara Ballav Adhikari, Saira Afzal, Bright Opoku Ahinkorah, Sepideh Ahmadi, Haroon Ahmed, Muktar Beshir Ahmed, Tarik Ahmed Rashid, Marjan Ajami, Budi Aji, Yonas Akalu, Chisom Joyqueenet Akunna, Hanadi Al Hamad, Khurshid Alam, Fahad Mashhour Alanezi, Turki M. Alanzi, Yosef Alemayehu, Robert Kaba Alhassan, Cyrus Alinia, Syed Mohamed Aljunid, Sami Almustanyir Almustanyir, Nelson Alvis-Guzman, Nelson J. Alvis-Zakzuk, Saeed Amini, Mostafa Amini-Rarani, Hubert Amu, Robert Ancuceanu, Catalina Liliana Andrei, Tudorel Andrei, Blake Angell, Mina Anjomshoa, Carl Abelardo T. Antonio, Catherine M. Antony, Muhammad Aqeel, Jalal Arabloo, Morteza Arab-Zozani, Timur Aripov, Alessandro Arrigo, Tahira Ashraf, Desta Debalkie Atnafu, Marcel Ausloos, Leticia Avila-Burgos, Asma Tahir Awan, Getinet Ayano, Martin Amogre Ayanore, Samad Azari, Gulrez Shah Azhar, Tesleem Kayode Babalola, Mohammad Amin Bahrami, Atif Amin Baig, Maciej Banach, Nastaran Barati, Till Winfried Bärnighausen, Amadou Barrow, Sanjay Basu, Bernhard T. Baune, Mohsen Bayati, Habib Benzian, Adam E. Berman, Akshaya Srikanth Bhagavathula, Nikha Bhardwaj, Pankaj Bhardwaj, Sonu Bhaskar, Sadia Bibi, Ali Bijani, Virginia Bodolica, Nicola Luigi Bragazzi, Dejana Braithwaite, Nicholas J.K. Breitborde, Alexey V. Breusov, Nikolay Ivanovich Briko, Reinhard Busse, Lucero Cahuana-Hurtado, Emily Joy Callander, Luis Alberto Cámera, Carlos A. Castañeda-Orjuela, Ferrán Catalá-López, Jaykaran Charan, Souranshu Chatterjee, Soosanna Kumary Chattu Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990–2050. The Lancet. Vol.398, No.10308 (2021), 1317-1343. doi:10.1016/S0140-6736(21)01258-7 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/77765
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Authors
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Thesis
Title
Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990–2050
Author(s)
Angela E. Micah
Ian E. Cogswell
Brandon Cunningham
Satoshi Ezoe
Anton C. Harle
Emilie R. Maddison
Darrah McCracken
Shuhei Nomura
Kyle E. Simpson
Hayley N. Stutzman
Golsum Tsakalos
Lindsey E. Wallace
Yingxi Zhao
Rahul R. Zende
Cristiana Abbafati
Michael Abdelmasseh
Aidin Abedi
Kedir Hussein Abegaz
E. S. Abhilash
Hassan Abolhassani
Michael R.M. Abrigo
Tara Ballav Adhikari
Saira Afzal
Bright Opoku Ahinkorah
Sepideh Ahmadi
Haroon Ahmed
Muktar Beshir Ahmed
Tarik Ahmed Rashid
Marjan Ajami
Budi Aji
Yonas Akalu
Chisom Joyqueenet Akunna
Hanadi Al Hamad
Khurshid Alam
Fahad Mashhour Alanezi
Turki M. Alanzi
Yosef Alemayehu
Robert Kaba Alhassan
Cyrus Alinia
Syed Mohamed Aljunid
Sami Almustanyir Almustanyir
Nelson Alvis-Guzman
Nelson J. Alvis-Zakzuk
Saeed Amini
Mostafa Amini-Rarani
Hubert Amu
Robert Ancuceanu
Catalina Liliana Andrei
Tudorel Andrei
Blake Angell
Mina Anjomshoa
Carl Abelardo T. Antonio
Catherine M. Antony
Muhammad Aqeel
Jalal Arabloo
Morteza Arab-Zozani
Timur Aripov
Alessandro Arrigo
Tahira Ashraf
Desta Debalkie Atnafu
Marcel Ausloos
Leticia Avila-Burgos
Asma Tahir Awan
Getinet Ayano
Martin Amogre Ayanore
Samad Azari
Gulrez Shah Azhar
Tesleem Kayode Babalola
Mohammad Amin Bahrami
Atif Amin Baig
Maciej Banach
Nastaran Barati
Till Winfried Bärnighausen
Amadou Barrow
Sanjay Basu
Bernhard T. Baune
Mohsen Bayati
Habib Benzian
Adam E. Berman
Akshaya Srikanth Bhagavathula
Nikha Bhardwaj
Pankaj Bhardwaj
Sonu Bhaskar
Sadia Bibi
Ali Bijani
Virginia Bodolica
Nicola Luigi Bragazzi
Dejana Braithwaite
Nicholas J.K. Breitborde
Alexey V. Breusov
Nikolay Ivanovich Briko
Reinhard Busse
Lucero Cahuana-Hurtado
Emily Joy Callander
Luis Alberto Cámera
Carlos A. Castañeda-Orjuela
Ferrán Catalá-López
Jaykaran Charan
Souranshu Chatterjee
Soosanna Kumary Chattu
Ian E. Cogswell
Brandon Cunningham
Satoshi Ezoe
Anton C. Harle
Emilie R. Maddison
Darrah McCracken
Shuhei Nomura
Kyle E. Simpson
Hayley N. Stutzman
Golsum Tsakalos
Lindsey E. Wallace
Yingxi Zhao
Rahul R. Zende
Cristiana Abbafati
Michael Abdelmasseh
Aidin Abedi
Kedir Hussein Abegaz
E. S. Abhilash
Hassan Abolhassani
Michael R.M. Abrigo
Tara Ballav Adhikari
Saira Afzal
Bright Opoku Ahinkorah
Sepideh Ahmadi
Haroon Ahmed
Muktar Beshir Ahmed
Tarik Ahmed Rashid
Marjan Ajami
Budi Aji
Yonas Akalu
Chisom Joyqueenet Akunna
Hanadi Al Hamad
Khurshid Alam
Fahad Mashhour Alanezi
Turki M. Alanzi
Yosef Alemayehu
Robert Kaba Alhassan
Cyrus Alinia
Syed Mohamed Aljunid
Sami Almustanyir Almustanyir
Nelson Alvis-Guzman
Nelson J. Alvis-Zakzuk
Saeed Amini
Mostafa Amini-Rarani
Hubert Amu
Robert Ancuceanu
Catalina Liliana Andrei
Tudorel Andrei
Blake Angell
Mina Anjomshoa
Carl Abelardo T. Antonio
Catherine M. Antony
Muhammad Aqeel
Jalal Arabloo
Morteza Arab-Zozani
Timur Aripov
Alessandro Arrigo
Tahira Ashraf
Desta Debalkie Atnafu
Marcel Ausloos
Leticia Avila-Burgos
Asma Tahir Awan
Getinet Ayano
Martin Amogre Ayanore
Samad Azari
Gulrez Shah Azhar
Tesleem Kayode Babalola
Mohammad Amin Bahrami
Atif Amin Baig
Maciej Banach
Nastaran Barati
Till Winfried Bärnighausen
Amadou Barrow
Sanjay Basu
Bernhard T. Baune
Mohsen Bayati
Habib Benzian
Adam E. Berman
Akshaya Srikanth Bhagavathula
Nikha Bhardwaj
Pankaj Bhardwaj
Sonu Bhaskar
Sadia Bibi
Ali Bijani
Virginia Bodolica
Nicola Luigi Bragazzi
Dejana Braithwaite
Nicholas J.K. Breitborde
Alexey V. Breusov
Nikolay Ivanovich Briko
Reinhard Busse
Lucero Cahuana-Hurtado
Emily Joy Callander
Luis Alberto Cámera
Carlos A. Castañeda-Orjuela
Ferrán Catalá-López
Jaykaran Charan
Souranshu Chatterjee
Soosanna Kumary Chattu
Other Contributor(s)
University of Kurdistan Hewlêr
College of Medicine Alfaisal University
School of Business Administration
University of Leicester School of Business
Murdoch Business School
Health Human Resources Research Center (SUMS)
Research Center for Immunodeficiencies
University of Florida Health
Social Determinants of Health Research Center, Birjand University of Medical Sciences
University of The Gambia
Melbourne Medical School
University of Health and Allied Sciences, Ghana
Madda Walabu University
Arba Minch University
All India Institute of Medical Sciences, Jodhpur
Bucharest University of Economic Studies
Universidad de la Costa
George Institute for Global Health
Imam Abdulrahman Bin Faisal university
Capella University
Universiti Sultan Zainal Abidin
Foundation University, Islamabad
Institute for Health Metrics and Evaluation
The Faculty of Health Sciences
COMSATS University Islamabad
University of Gondar
Sree Narayana Guru College, Chelannur
University of Agriculture, Faisalabad
Rumailah Hospital
Hamad Medical Corporation
Instytut Centrum Zdrowia Matki Polki
University of the Philippines Manila
Universidad Peruana Cayetano Heredia
Jimma University
Bahar Dar University
University of Lahore
Health Sciences Center Kuwait
Universitas Jenderal Soedirman
Universidad Nacional de Colombia
Universidad de Cartagena
Universitatea de Medicina si Farmacie Carol Davila din Bucuresti
Ministry of Health Saudi Arabia
Harvard T.H. Chan School of Public Health
Sapienza Università di Roma
University of Nevada, Las Vegas
University of South Australia
Arak University of Medical Sciences
Children's Hospital Boston
Aarhus Universitet
University of Southern California
Tehran University of Medical Sciences
Babol University of Medical Sciences
Keio University
The University of Tokyo
Università degli Studi di Genova
Medical College of Georgia
University of Technology Sydney
IRCCS Ospedale San Raffaele
Birjand University of Medical Sciences
Instituto Nacional de Salud Pública. México
University College London
Shiraz University of Medical Sciences
New York University
Urmia University of Medical Sciences
Isfahan University of Medical Sciences
Karolinska Universitetssjukhuset
Shahid Beheshti University of Medical Sciences
Universität Heidelberg
Charles University
National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences
Imperial College London
RUDN University
University of Florida
Faculty of Medicine, Nursing and Health Sciences
Technische Universität Berlin
University of KwaZulu-Natal
Sechenov First Moscow State Medical University
Harvard University
Nuffield Department of Medicine
Hong Kong Polytechnic University
United Arab Emirates University
Instituto Universitario del Hospital Italiano de Buenos Aires
Hamadan University of Medical Sciences
Medical University of Lodz
Yakin Doğu Üniversitesi
University of Lagos
Marshall University
RAND Corporation
The Ohio State University
Ottawa Hospital Research Institute
Universiti Kebangsaan Malaysia
Instituto de Salud Carlos III
Westfälische Wilhelms-Universität Münster
South West Sydney Local Heath District and Liverpool Hospital
NSW Brain Clot Bank
Medanta Medicity
Federal Ministry of Health
Government Medical College Pali
Nepal Health Frontiers
Texila American University
Tashkent Institute of Postgraduate Medical Education
Philippine Institute for Development Studies
King Edward University
National Institute of Health
Argentine Society of Medicine
The Intercountry Centre for Oral Health (ICOH) for Africa
Institute of Public Health
Ministry of Health
College of Medicine Alfaisal University
School of Business Administration
University of Leicester School of Business
Murdoch Business School
Health Human Resources Research Center (SUMS)
Research Center for Immunodeficiencies
University of Florida Health
Social Determinants of Health Research Center, Birjand University of Medical Sciences
University of The Gambia
Melbourne Medical School
University of Health and Allied Sciences, Ghana
Madda Walabu University
Arba Minch University
All India Institute of Medical Sciences, Jodhpur
Bucharest University of Economic Studies
Universidad de la Costa
George Institute for Global Health
Imam Abdulrahman Bin Faisal university
Capella University
Universiti Sultan Zainal Abidin
Foundation University, Islamabad
Institute for Health Metrics and Evaluation
The Faculty of Health Sciences
COMSATS University Islamabad
University of Gondar
Sree Narayana Guru College, Chelannur
University of Agriculture, Faisalabad
Rumailah Hospital
Hamad Medical Corporation
Instytut Centrum Zdrowia Matki Polki
University of the Philippines Manila
Universidad Peruana Cayetano Heredia
Jimma University
Bahar Dar University
University of Lahore
Health Sciences Center Kuwait
Universitas Jenderal Soedirman
Universidad Nacional de Colombia
Universidad de Cartagena
Universitatea de Medicina si Farmacie Carol Davila din Bucuresti
Ministry of Health Saudi Arabia
Harvard T.H. Chan School of Public Health
Sapienza Università di Roma
University of Nevada, Las Vegas
University of South Australia
Arak University of Medical Sciences
Children's Hospital Boston
Aarhus Universitet
University of Southern California
Tehran University of Medical Sciences
Babol University of Medical Sciences
Keio University
The University of Tokyo
Università degli Studi di Genova
Medical College of Georgia
University of Technology Sydney
IRCCS Ospedale San Raffaele
Birjand University of Medical Sciences
Instituto Nacional de Salud Pública. México
University College London
Shiraz University of Medical Sciences
New York University
Urmia University of Medical Sciences
Isfahan University of Medical Sciences
Karolinska Universitetssjukhuset
Shahid Beheshti University of Medical Sciences
Universität Heidelberg
Charles University
National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences
Imperial College London
RUDN University
University of Florida
Faculty of Medicine, Nursing and Health Sciences
Technische Universität Berlin
University of KwaZulu-Natal
Sechenov First Moscow State Medical University
Harvard University
Nuffield Department of Medicine
Hong Kong Polytechnic University
United Arab Emirates University
Instituto Universitario del Hospital Italiano de Buenos Aires
Hamadan University of Medical Sciences
Medical University of Lodz
Yakin Doğu Üniversitesi
University of Lagos
Marshall University
RAND Corporation
The Ohio State University
Ottawa Hospital Research Institute
Universiti Kebangsaan Malaysia
Instituto de Salud Carlos III
Westfälische Wilhelms-Universität Münster
South West Sydney Local Heath District and Liverpool Hospital
NSW Brain Clot Bank
Medanta Medicity
Federal Ministry of Health
Government Medical College Pali
Nepal Health Frontiers
Texila American University
Tashkent Institute of Postgraduate Medical Education
Philippine Institute for Development Studies
King Edward University
National Institute of Health
Argentine Society of Medicine
The Intercountry Centre for Oral Health (ICOH) for Africa
Institute of Public Health
Ministry of Health
Abstract
Background: The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods: We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings: In 2019, health spending globally reached $8·8 trillion (95% uncertainty interval [UI] 8·7–8·8) or $1132 (1119–1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40·4 billion (0·5%, 95% UI 0·5–0·5) was development assistance for health provided to low-income and middle-income countries, which made up 24·6% (UI 24·0–25·1) of total spending in low-income countries. We estimate that $54·8 billion in development assistance for health was disbursed in 2020. Of this, $13·7 billion was targeted toward the COVID-19 health response. $12·3 billion was newly committed and $1·4 billion was repurposed from existing health projects. $3·1 billion (22·4%) of the funds focused on country-level coordination and $2·4 billion (17·9%) was for supply chain and logistics. Only $714·4 million (7·7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34·3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448–1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation: Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Funding: Bill & Melinda Gates Foundation.