One Billion People Worldwide Cannot Afford Healthcare

A new World Health Organization (WHO; Geneva, Switzerland) study claims that close to one billion people worldwide cannot afford any health services, and that about 100 million people per annum are plunged into poverty due to healthcare costs.

The World Health Report 2010 calls on all countries, both rich and poor, to do more toward achieving universal healthcare coverage, and urges them to consider new ways to increase efficiency, using new taxes and innovative fund-raising measures to boost access to healthcare. The report outlines steps countries could take to raise more funds and reduce financial barriers to obtaining healthcare, and to make health services even more efficient. According to the report, government payments should make up less than 15% to 20% of a country's total health spending. Despite this, healthcare still account for more than 50% of total health spending. On average, 20% to 40% of this spending is wasted, often through purchase of expensive but unnecessary drugs, hospital-related inefficiency, and poor use of skilled professionals' time.

According to the study, more than half all medicines globally are prescribed, dispensed, or sold inappropriately, and half of all patients fail to take their medication as prescribed. Better use of medicines could save nations up to 5% of health spending. The WHO also suggests 10 areas where changes could be made, including reducing unnecessary spending on drugs, targeting medicines properly, and adopting a generics policy, whereby any branded medicine for which there is an equally effective generic version is substituted.

The report found some countries pay far more for medicines than others, with some pricing drugs at up to 67 times the international average. The report therefore suggests that governments should attempt to diversify sources of revenue from levies such as taxes on tobacco and alcohol, currency transaction taxes, and national "solidarity” taxes on certain sectors. For example, Gabon raised US$30 million for health in 2009 by imposing a 1.5% tax on companies handling remittances, and a 10% tax on mobile phone operators. France, conversely, used a generic substitution policy that led to savings equivalent to $1.94 billion in 2008 alone. The report claims that if India were to implement a levy of just 0.005% on foreign exchange transactions, it could raise $370 million per year.

"As the world grapples with economic slowdown, globalization of diseases ... and growing demands for chronic care ... the need for universal health coverage, and a strategy for financing it, has never been greater,” concluded report editor in chief Carissa Etienne, assistant director-general, health systems and services. "There is no magic bullet to achieving universal access. Nevertheless, a wide range of experiences from around the world suggests that countries can move forward faster.”

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