Millions of people in developing countries are at risk of going without even the most basic health services as a result of low domestic health spending and slow growth in international aid for health, experts have said.

Nearly half of 80 developing nations are unlikely to meet by 2040 the international target for healthcare to be deemed universally available – spending of $86 per person per year – two studies published in The Lancet medical journal said.

“Despite tremendous need, our results show that tepid growth in health spending is likely in many of the poorest countries with the largest disease burdens over the next 25 years,” Joseph Dieleman of the Seattle-based Institute for Health Metrics and Evaluation (IHME) said in a statement.

“These changes in the growth and focus of international aid could have a serious impact on over 15 million people taking antiretroviral therapy in developing countries and on health services in some low-income countries, particularly in sub-Saharan Africa, where HIV/AIDS, tuberculosis and malaria remain among the top threats to health.”

Global health spending is expected to reach $18.28-trillion in 2040, but low-income countries are predicted to spend just $0.03 for every dollar spent in high-income countries, the researchers said. 

High-income nations are expected to spend an average of $9 019 per person on health in 2040, they added.   

Health spending will remain lowest in countries which need the largest health advances, including Democratic Republic of Congo and Central African Republic, which in 2013 spent just $24 and $26 per person respectively, researchers said.

“For low- and middle-income countries to reach international spending targets and close the gap, domestic and international health funding will need to increase beyond historical growth
rates,” Dieleman said. 

Annual growth in development assistance for health (DAH) fell to just 1.2% per year between 2010 and 2015, from around 11% annually between 2000 and 2009, the researchers said. 

DAH is expected to grow to $64.1-billion in 2040 from $36.4-billion in 2015, but great uncertainty remains about how much domestic funding will rise, with predicted annual growth rates ranging from minus 0.72% to plus 5.96%, it said.

Of the low-income countries, only Rwanda is expected to meet the target of government health spending of 5% of gross domestic product (GDP) by 2040, along with one-third of 98 middle-income countries, the researchers said.

The research, funded by the Bill and Melinda Gates Foundation, analysed health spending for 184 countries from 2013 to 2040 based on World Health Organisation and IHME data and trends in development assistance between 1900 and 2015. –  Reuters

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health financingThe Lancetdeveloping countriesantiretrovirals