Increased spending on health in the developing world would prevent millions of deaths

and boost the global economy, a major World Health Organization report issued December

20 stated.

The study was published by a group of prominent economists and health experts working

for WHO's Commission on Macroeconomics and Health.

Macroeconomics and Health: Investing in Health for Economic Development showed that

a high proportion of deaths in developing countries are caused by only a few conditions.

AIDS, malaria, tuberculosis and childhood diseases - significant killers in Cambodia

- were responsible for many health problems in poor countries. The report stated

that well-targeted measures using existing technologies could save eight million

lives around the world annually.

Dr Henk Bekedam, WHO's medical officer in Cambodia, said that there was a need for

more investment in health.

"It is certainly true that people can better contribute to economic development

if they're more healthy," he said, adding that the study had drawn together

leaders in the fields of economics and health to assess the problem.

The report calculated that basic health services could be provided at an annual cost

of $34 a person. Cambodia spends an average $36 per person each year, although by

far the highest proportion of that is borne by individuals. The government spends

$2, and $5 comes from donors. The balance is paid by households. At $29 a year, that

is one of the highest rates in the world. That contributed to the country's poor

health figures.

The report stated that an annual spending increase of $66 billion worldwide by 2015-2020

would generate a yearly return of at least $360 billion in economic benefits. Half

would come from the world's poorest people living longer and having more days of

good health, thus increasing their earnings. The other half would stem from increased

individual productivity.

Cambodian Health Minister Huong Sun Huot told the Post that "the health sector

is the main investment, the center of development".

"In our country, if you are not healthy you cannot go to school, you cannot

go to work, you cannot go to the market," he said.

The commission's report stated: "With bold decisions in 2002, the world could

initiate a partnership of rich and poor of unrivaled significance, offering the gift

of life itself to millions of the world's dispossessed and proving to all doubters

that globalization can indeed work to the benefit of all humankind."

Some wondered about the practical difficulties of implementing the findings. The

plan requires strong political leadership from donor countries, as well as matching

efforts from developing nations. Among the necessary changes are improved health

sector management, better balance between different health-sector programs, and increased

government spending on health.

"Donors have their own interests and objectives, which can often be difficult

to reconcile with those of the government," stated a recent strategy report

for Cambodia by Sweden, a major donor. "While the support of international donors

puts very substantial resources at the disposal of the NGO sector, the NGOs need

to improve their strategic thinking, methodology, follow-up, evaluation and leadership."

Bekedam said discussions over the health budget were due in August, by which time

he hoped senior ministers would have reviewed the report. He warned the document

was "not a specific template" for Cambodia, and stressed the need for transparency,

accountability and better management of health resources. Higher wages for health

staff was also important.

"Quality of service is a major challenge, and money won't directly resolve it,"

he said. "It's helpful to get more funds, but the continuous challenge is to

properly manage resources."