Donors spend more for health, governments less

In Africa government spending on health care, as a percentage of national expenses, rose just 0.3 percent from 2001 to 2007, while donor funding of the sector during the same period increased from 15.3 to 20.1 percent, according to a review of 52 African countries’ health spending by The Global Fund to Fight AIDS, Tuberculosis and Malaria.

In the 1990s donors spent US$7.5 billion on health care worldwide, $21.8 billion in 2007.

Below are some highlights from the report:

• Donors covered 43 percent of health care expenses in Ethiopia in 2006, up four times from 2002. Over the same period donor backing for health care in Benin dropped 10 percent to 13.4 percent
• Donors spent $43.74 per person in development assistance to health (DAH) in Namibia in 2007 versus 65 US cents in Mauritius
• DAH increased the most in East Africa from 2002 to 2006 (19.6 to 28.4 percent), versus 22 percent in West and Central Africa, 20.3 percent in Southern Africa and 11.5 percent in North Africa
• In 2007 half of African countries set aside at least 5 percent of their national income for health care
•  In 2007 seven African countries spent less than 5 percent of total budgets on health care, compared to eight in 2001
• Patients in Africa’s lowest income countries paid out-of-pocket for more than half their health care, with governments pitching in 46 percent
• By 2007 four countries had met or all but met the Abuja Declaration goal of spending 15 percent of annual budgets on health: Burkina Faso (14.8 percent), Botswana (17.3 percent), Djibouti (15.1 percent) and Rwanda (18.8 percent). Liberia and Malawi had exceeded the target in 2006 at 16.4 and 18 percent, respectively, but then dropped to 6.4 and 12.1 percent in 2007 
•  Botswana and Rwanda had the biggest jumps in health care spending as a percentage of overall expenses from 1999 to 2007 – 8.9 and 9.7 percent, respectively, while Ghana and Benin had the largest drops – 6.1 and 3.6 percent
• Nigeria spent 3.5 percent of its 2007 budget on health care, a nearly 2-percent drop since 1999. The oil sector has accounted for more than 80 percent of government revenue, according to Extractive Industries Transparency Initiative 

Report authors note that a failure to report by some donors and governments (latest data available for Somalia from 2001) precludes accurate and complete analysis.

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