Oxfam reaction: WHO Health Report 2010 - A wake-up call for all governments

The WHO report is available at http://www.who.int/en/

According to the WHO report (page 32): “…about half of the countries reporting their development assistance disbursements to OECD are on track to meet the targets they have committed to internationally (for overall development, including health).The other countries are failing to meet their pledges, some by a long way. Slow progress towards fulfilling these commitments comes at a huge human cost; three million additional lives could be saved before 2015 if all donors met their promises”. Only eight low-income countries have any chance of generating from domestic sources alone the funds required to achieve the MDGs by 2015, according to the WHO. WHR (page xiii): “Global solidarity is required. The funding shortfall faced by these low-income countries highlights the need for high-income countries to honor their commitments on official development assistance (ODA), and to back it up with greater effort to improve aid effectiveness … if countries were to immediately keep their current international pledges, external funding for health in low-income countries would more than double overnight and the estimated shortfall in funds to reach the health MDGs would be virtually eliminated.” 

The report states that recent studies show that out-of-pocket health payments pushed 100,000 households in both Kenya and Senegal  below the poverty line in a single year; and that 290 000 people experienced the same fate in South Africa. Medical debt has been the principle cause of personal bankruptcy in the USA.

In 2001 the heads of state of the African Union promised to increase government spending on healthcare to 15%, but only three countries – Liberia, Rwanda and Tanzania – achieved this by 2007.

The World Bank plays a significant role in influencing the health agendas of low-income countries. The WHR report notes: 'A World Bank report in 1987 suggested that charging fees was not only a good way to generate additional revenue, but would reduce overuse'. Twenty years later the 2007 World Bank's Strategy for Health Nutrition and Population Strategy states: 'Upon client-country demand, the Bank stands ready to support countries that want to remove user fees from public facilities'. However, the strategy also states that 'user fees have a role to play as co-payment when there is evidence of excess demand'.