A new report by the World Bank warns that the sharply rising cost of health care is creating a burden on third world countries struggling to cope with epidemics such as AIDS and, possibly, bird flu. It says while donor nations should substantially increase aid for health programs to developing countries, third world governments must make health care spending a higher priority.
The World Bank report says thousands of people are dying each day from curable diseases such as tuberculosis, despite major increases in health care aid for the developing world. The study says three million people worldwide died from AIDS last year, many in sub-Saharan Africa.
Public health expert Ramanan Laxminarayan is with the private research group Resources for the Future in Washington. He says it is not necessarily the amount of money spent on health care that is important, but how it is used.
"It's possible to do something about malaria, for instance, in sub-Saharan Africa, if the world would spend money on effective anti-malarial drugs. It's possible to spend a lot of good money on proven programs for preventing AIDS. So there are interventions that exist on which not enough money is being spent which can make a big impact."
The report says an enormous health gap continues between rich and poor countries, partly because high income nations spend about 100 times more money on health care per person than low income countries. It says since most people in developing countries have to pay for health care themselves, donor nations should work with third world governments to develop national health programs that provide adequate health care. Laxminarayan says often donor nations are determining health care priorities, instead of governments, and that should change.
"And having a single, unified picture on what the country wants for its health, would actually be a good way on focusing resources on its priorities. Have countries create their own plans and then for donors spend on entire programs or an entire sector, so the priorities of governments are not distorted because of what the donor wants to do."
The study says populations in 50 of the world's poorest countries will double by 2050. And this means much greater increases in health care funding will be needed - 52 percent in sub-Saharan Africa, 47 percent in Latin America and the Caribbean, 45 percent in South Asia, and 37 percent in East Asia and the Pacific. Laxminarayan says third world nations need to make health care a top priority now.
"A lot of money can come from countries actually spending money on health rather than other things they may be spending money on, just by recognizing that spending money on health is one of the best routes to economic development and that countries don't necessarily don't have to wait to get rich before they get healthy, they can get healthy as a way of getting rich."
The report says most increases in health care aid have been in Africa for specific diseases such as AIDS. While that may be helpful in the short term, it says, what is needed for the long haul are viable health systems.