Current Trends in Government Health Spending

Government health spending in low- and lower-middle-income countries (LICs and LMICs) peaked during the COVID-19 pandemic, but has since consistently fallen until 2023, returning to pre-pandemic levels. Per capita spending in LICs rose to $13 in 2020, but decreased to below $10 by 2023. In LMICs, spending increased to $64 in 2021 before falling to $55, near 2019 levels. This drop has reduced annual growth in health investments to only 1.2% between 2019 and 2023, compared to 4.2% in LICs and 2.4% in LMICs from 2015 to 2019. A declining share of government resources allocated to health has reversed previous advances in health prioritization, leaving many nations unable to meet the minimum spending levels required to accomplish the 2030 health-related Sustainable Development Goals (SDGs). In 35 nations with a population of more than 2.5 billion, both per capita health spending and the health share of government budgets have fallen.

Nepal's government health spending trends are consistent with the issues faced by other low-income countries (LICs), however per capita data are context-specific. Nepal's health-care spending increased dramatically during the COVID-19 pandemic, with the government dedicating significant resources to tackle the situation. However, like in many LICs, health spending per capita has since decreased, returning to pre-pandemic levels. Globally, LICs peaked at $13 per capita in 2020, but fell to $10 by 2023 (World Bank, 2023). Nepal's government health spending in 2020 was around $11 per capita, slightly lower than the LIC average (Ministry of Health and Population Nepal, 2021). This reflects a global trend of decreasing health prioritization in budgets following the epidemic, creating considerable obstacles to meeting the Sustainable Development Goals (SDGs) by 2030.

Addressing this dilemma demands immediate action to prioritize health spending, increase efficiency, and navigate fiscal constraints, or face setbacks in human growth, poverty reduction, and pandemic readiness. To avoid obstacles in human capital development and poverty reduction, Nepal must urgently prioritize health in its budget, while improving spending efficiency and resolving fiscal constraints.

References:
- World Bank. (2023). Health spending trends through 2023: Peaks, declines, and mounting risks. Washington, DC: World Bank Group.
- Ministry of Health and Population Nepal. (2021). *Annual health report*. Kathmandu: Government of Nepal.

Transcript

1. Current Trends in Government Health Spending Presented by Dr. Nawa Raj Subba.
2. Slide 1: Title Slide • Title: Current Trends in Government Health Spending • Subtitle: Challenges and Opportunities in Low-Income and Lower-Middle-Income Countries • Visuals: Global health spending map or graph
3. Slide 2: Introduction • Peak government health spending during COVID-19 pandemic. • Significant decline in health budgets post-2020. • Impact on Sustainable Development Goals (SDGs). Overview: • How can countries address the decline in health spending? Key Question:
4. Slide 3: Global Trends in Government Health Spending • LICs per capita spending: $13 (2020) → <$10 (2023). • LMICs per capita spending: $64 (2021) → $55 (2023). • Growth rates: 4.2% (2015–2019) → 1.2% (2019–2023). Key Statistics: Insights: Reversal of health prioritization in budgets.
6. Slide 4: Regional Impact • 35 nations with a combined population >2.5 billion. • Declines in both per capita spending and health budget shares. Focus Countries: • Many countries unable to meet SDG health spending targets. Outcome:
7. Slide 5: Nepal's Health Spending Trends • During COVID-19: Sharp increase in health spending. • $11 per capita in 2020 (slightly below LIC average). • Post-Pandemic Decline: Return to pre-pandemic spending levels. • Mirrors global LIC trends.
8. Slide 6: Challenges to Health Spending Decline in Prioritization: Reduced share of government resources for health. Fiscal Constraints: • Budget limitations post-pandemic. Implications: • Hinders progress toward SDGs. • Threatens human development and poverty reduction.
9. Slide 7: Sustainable Development Goals (SDGs) • Health-Related SDGs: • Universal health coverage. • Reduction of maternal and child mortality. • Pandemic preparedness. • Current Status: • Insufficient funding jeopardizes targets.
10. Slide 8: Recommendations for LICs and LMICs Prioritize Health Spending: • Increase budget allocations to health sectors. Efficiency Improvements: • Enhance transparency and effectiveness in spending. Innovative Financing: • Explore public- private partnerships and external aid.
11. Slide 9: Nepal: Specific Recommendations • Focus Areas: • Integrate health spending into national priorities. • Improve fiscal management and revenue generation. • Monitor and evaluate health performances and investments.
12. Slide 10: Broader Implications • Impact of Inaction: • Setbacks in human capital development. • Increased vulnerability to future pandemics. • Prolonged poverty cycles.
13. Slide 11: Conclusion Summary: • Declines in health spending post- pandemic pose a global challenge. • Urgent action required to meet SDG targets. Call to Action: • Governments must re-prioritize health investments to ensure long- term growth.
14. Slide 12: References • Sources Cited: • World Bank. (2023). Health spending trends through 2023: Peaks, declines, and mounting risks. Washington, DC: World Bank Group. • Ministry of Health and Population Nepal. (2021). Annual health report. Kathmandu: Government of Nepal.