Distinguished participants and partners,
It is a privilege to join this sixteenth WHO-OECD Annual Meeting of Asia Pacific Health Accounts Experts, which comes at a critical moment in the ongoing COVID-19 response, and in our quest to strengthen primary health care (PHC), build health system resilience, and achieve universal health coverage in all countries of the South-East Asia Region.
You have all been involved in regular health expenditure tracking studies. I need not emphasize again the importance of collecting such evidence. The numbers speak for themselves.
In most countries of the Region, overall government spending on health continues to be low, comprising an inadequate share of current health expenditure.
Over the past decade, countries have achieved some improvements in prioritizing health sector allocations in overall government spending; however, in four countries, the health sector still accounts for less than 5% of overall government spending.
The Region has the world’s highest share of out-of-pocket spending on health – 40% of current health expenditure in 2018.
Notably, most Member States have now reached lower-middle-income status, and there are signs that they are undergoing a health financing transition, with donor financing declining in terms of its share of current health expenditure.
In all countries of the Region, WHO will continue to provide actionable support for the development of policies and mechanisms that financially protect the most vulnerable and reduce catastrophic out-of-pocket costs.
We will continue to advocate for sustained and scaled up investments in health, not only to strengthen the COVID-19 response, but also to build a health and economic recovery from COVID-19 that is more resilient, equitable and sustainable.
Participants and partners,
You are well aware of the challenges in data collection, estimation, and classifications, especially in terms of accommodating heterogeneous health system and financing arrangements into the pre-set framework.
As producers of such data, you know best the granularities and the need to improve and harmonize the reporting quality to better serve policy makers, researchers, and the general public.
Since 2018, we have extracted from the data estimates of PHC expenditures, and almost half of all countries in the Region have produced at least one estimate so far.
The estimates show that in 2018 the real per capita PHC spending in the Region varied between US$ 32 to US$ 60. The source of financing contrasted hugely, from relying primarily on government funds, to relying primarily on private sources.
Our methodology is not perfect: The concept of PHC is likely defined differently across countries, and the accounting framework may not be ideal to fully capture the entire scope.
However, it gives a good sense of where we are right now, as the consensus on strengthening PHC builds, reflected in calls for countries in the Region and beyond to allocate an additional 1% of GDP on PHC spending from the public sector.
Over the course of this meeting, I look forward to continuing our discussions on how to improve PHC expenditure estimates and thereby increase the value they provide.
Of specific focus must be pharmaceutical expenditure, which in many countries of the Region has been the driving force of out-of-pocket spending and financial hardship.
On that score, the most significant challenges we face relate to data availability and classification, and the share of pharmaceutical expenditure that should be counted as PHC expenditure.
I am certain that the sharing of country experiences will stimulate and inform your discussions, providing valuable inputs for the conclusions you reach.
I also look forward to deliberations on strengthening health expenditure tracking within the COVID-19 response, which will enable policy makers to enhance national response efforts, for example by increasing the efficiency and impact of resource allocations earmarked for frontline service delivery.
For this, you must effectively navigate the two-year lag in the normal National Health Accounts (NHA) reporting procedure and establish clear boundaries as to what should be considered “health-related” COVID-19 expenditures.
On these and other points of deliberation, I wish you all success, and reiterate WHO’s ongoing and unmitigated support to you in strengthening NHA systems and expenditure tracking, for a fairer, healthier Region for all.
Thank you.