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
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
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
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."