Page 27 - Nile Explorer Issue 007

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On average, countries need to increase flexibility of finance ministries to make In six countries, military spending as a
public spending on health by 2.5 times. allocative decisions across various percentage of GDP exceeds public
On current trends, and with numerous competing requirements. Health needs spending on health. Countries have
competing demands for public resourc- and the availability of funds for health- their own security requirements, but
es, governments are unlikely to be able care differ significantly across coun- given the importance of improved
to meet the health financing require- tries, and there is no consensus on how health outcomes for the future well-be-
ments. much countries should spend on the ing of their populations, governments
Moving forward and particularly draw- health sector. In 2001, member States of could consider prioritizing health in
their budgetary allocations.
ing from the lessons to be learnt follow- the African Union committed to
ing global isolation by countries, allocate at least 15 per cent of their Results-oriented innovative financing
through lockdowns, during the unfold- annual budgets to healthcare, common- mechanisms such as Development
ing COVID 19 pandemic, the private ly referred to as the Abuja target, but Impact Bonds and Social Impact Bonds
sector needs to leverage the African few countries have achieved this target. have been launched in some countries.
Continental Free Trade Area to invest in There is an estimated health financing For example, important lessons can be
many under-invested sectors at a conti- gap of $66 billion per annum for the learned by other countries from the
nental level. For instance, Africa manu- continent based on the threshold of 5 Cataract Bond in Cameroon.
factures less than 2 per cent of the medi- per cent of GDP for government expen- There is an urgent need to improve
cines it consumes. Imports cater for diture. Against the required $114 billion health outcomes in health-stressed
over 70 per cent of the pharmaceutical in current dollars, governments in countries. To target the countries with
market in Africa worth about $14.5 Africa spend approximately $46 billion. maximum health needs, the report uses
billion. This is a conservative estimate that is a combination of thresholds covering
likely to increase over the years. More
Africa has among the lowest densities of than half of this amount is required by seven indicators, such as domestic
skilled health professionals in the world. Egypt (19 per cent or $12 billion) and government health expenditure,
Against the global threshold of 23 health Nigeria (32 per cent or $21 billion). out-of-pocket expenditure, density of
professionals per 10,000 population, 13 Resource mobilization for health skilled health workers, average disease
of the 47 countries for which data are financing burden, government debt and the
available have less than five health annual GDP growth rate. Eight coun-
professionals per 10,000 population. In 22 countries, the average annual tries are severely health-stressed:
Scarce resources are misallocated as value of illicit financial flows far exceeds Angola, Chad, Mauritania, Nigeria,
many countries produce more physi- the health financing gap. This suggests Sierra Leone, South Sudan, Togo and
cians when more nurses are required to that by reducing these illicit flows, Zimbabwe. They are below the thresh-
deal with communicable diseases. There governments can fund healthcare and olds on six of the seven indicators.
is an ‘urban bias’ in the location of other social sectors in these countries. Another 12 countries are very
physicians: in 23 of the 25 countries
with comparable data, the percentage of
total physicians in urban areas far
exceeds the proportion of the urban
population.
On average, healthcare in Africa is
predominantly financed through
out-of-pocket expenses (36 per cent)
and domestic resources (35 per cent),
with external aid accounting for 22 per
cent of total health expenditure.
National health systems in most coun-
tries struggle with insufficient and
inequitably distributed resources and
the poorest countries bear a dispropor-
tionately high share of the burden of
disease and injury, yet have fewer
resources for financing healthcare. Map of public hospitals in Africa

Expenditure targets as a percentage of
government budgets compromise the

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