HEALTH care costs drive 100 million people worldwide into poverty each year, according to a new report released by the World Health Organisation yesterday.

The 2010 World Health Report, which seeks to chart a path for financing universal health-care coverage, “identifies continued reliance on direct payments, including user fees, as by far the greatest obstacle to progress”.

“The obligation to pay directly for services at the moment of need – whether that payment is made on a formal or informal basis – prevents millions of people receiving health care when they need it; for those who do seek treatment, it can result in financial hardship, even impoverishment,” the report said.

A specialist at the WHO said out-of-pocket payment is the most important problem for Cambodia as well.

Dr Henk Bekedam, director of Health Sector Development for the Western Pacific at the WHO, said the single greatest factor that drove Cambodians into poverty when he worked here for the WHO from 1996-2002 was health-care expenses. “It is still one of the main causes”, he said.

“The main challenge we still see is that most of the expenditures are still coming from people’s own pockets and that’s a problem”, said Bekedam. “But the government has recognised this and has come up with a couple initiatives.”

The Cambodian government and local NGOs have been jointly operating a health-financing programme through Health Equity Funds that offer financial support to Cambodians unable to pay for hospital care. Bekedam said this is a “laudable” project, but urged the government to devote a larger percentage of its GDP to health spending.

According to Cambodia’s draft budget, approved by the Council of Ministers on October 15, US$165 million has been allocated to the Ministry of Health, an increase of 16 percent from last year.

“I would hope that a big part of that money would go to improving hospital health equity funds and making a good part of maternal and child health care for free,” Bekedam said.

Te Kuy Seang, secretary of state at the Ministry of Health, said the priorities within the ministry have yet to be finalised. “The budget division within the ministry will be made after the approval from the parliament and the Ministry of Economic and Finance’s announcement,” he said.

ADDITIONAL REPORTING BY CHEANG SOKHA