Health spending continued to rise worldwide last year at 3.9 percent to reach a high of $31.3 billion, though the pace of growth had slowed after rising by five times during the past generation.

Poor countries spent about one percent of the total rich countries spent on their own health systems, researchers at the University of Washington say in a report published Tuesday in the journal Health Affairs.

The slower growth last year followed much more rapid annual increases in health funding worldwide since 1990, with non-governmental organizations compensating for funding drops from bilateral donors and international relief banks. The Global Fund to Fight AIDS, Tuberculosis and Malaria — among other health groups — spent more money last year, as the United Kingdom also gave more money to international health expenditures.

The findings come as Cuba announces a restructuring of its massive health care system to cut 100,000 redundant jobs while raising pay for doctors and other health care workers. These cuts come after the elimination two years ago of 50,000 other mostly low-skilled health jobs, including ambulance drivers and hospital support staff, as part of President Raul Castro’s economic reforms, The Associated Press reported.

Christopher Murray, who led the university’s study, says the new report also provides a detailed description of health spending by international donors, tracking spending on various health issues to 2011.

"Donors' continued support for increased spending on maternal, newborn, and child health reflects the global sense of urgency to meet the Millennium Development Goals by 2015," Murray said in a statement. Funding for those health areas rose by nearly 18 percent between 2010 and 2011 to reach $6.1 billion.

But perhaps most interesting, Murray and his colleagues measured for the first time worldwide health spending on tobacco control, which rose to $68 million in 2011 — a paltry sum compared to funding for HIV/AIDS, which is 113 times higher.

The researchers also found gaps between funding and disease burden in most regions of the world, particularly with regard to non-communicable diseases. Though such disease is increasingly prevalent in the developing world, infectious diseases tend to grab the most headlines — and the most funding, says researcher Joseph Dieleman.

"The Global Burden of Disease shows steady growth in the burden of non-communicable diseases in all regions except sub-Saharan Africa," Dieleman said. "There is relatively little development assistance for health in these countries for [other] programs."

As spending on non-communicable diseases in the developing world increased slowly during recent years, global disparities continued to emerge in funding versus disease burden. Though sub-Saharan African nations received a greater proportion of international malaria money, outcomes continued to lag countries in Latin America and the Caribbean. For every healthy year of life lost, sub-Saharan countries got $60, compared to $2,000 for other countries with a malaria burden.

In total, governments around the world spent $613.5 billion in 2011 on health at an annual growth rate of 7.2 percent — with international donations accounting for 10 percent of expenditures in most developing countries. Among the poorest, sub-Saharan countries operated health systems with more than half of funding from international donors.

 

Source: Murray CJL, Dieleman JL, Graves CM, et al. Global Health Development Assistance Remained Steady In 2013 But Did Not Align With Recipients’ Disease Burden. Health Affairs. 2014.