Your Excellency Ambassador Endresen,
Dear colleagues and friends,
Good afternoon, and thank you all for joining us today.
I'm delighted to launch the annual update to the Global Health Expenditure Database and the accompanying report.
This is not just any update: it marks 25 years since the Health Expenditure Tracking Programme was launched in 1999.
This programme has transformed how health spending data is compiled and reported nationally and globally, supporting an unprecedented level of informed policymaking and transparency.
The two products we are launching today are important global public goods for guiding investment in health, and for promoting transparency and accountability.
This is the world’s largest and most comprehensive database of health spending across more than 190 countries from, 2000 to 2022.
It covers 454 indicators, including expenditure by governments, donors and households, with a focus on universal health coverage and health security.
The report analyzes the latest trends and patterns in global health spending, and provides insights into top policy issues and priorities.
These products are not just numbers: they are used widely by governments, development partners, international organizations, academia, and civil society to monitor financial trends;
To assess equity and efficiency in health spending;
And to guide evidence-based health financing decisions nationally and globally.
This analysis helps us understand the impact of investment, where the gaps are, and to prioritize accordingly.
This is especially important in a time of increasingly tight budgets, with many competing demands.
This year’s database and report offer fresh data for 2022, which provide insights into how countries responded to the health and economic shocks of the COVID-19 pandemic.
They show that between 2000 and 2022, global health spending per capita grew by more than 60%, outpacing GDP growth.
That increase is clearly correlated with significant improvements in life expectancy over the same period, and other health outcomes including maternal and child mortality.
However, in low-income countries, these increases in health spending were driven mostly by out-of-pocket spending and by external aid.
Out of pocket spending now accounts for more than 40% of all health spending in low-income countries, and in 30 low- and lower-middle income countries, out-of-pocket payments are still the dominant source of financing for health.
Over the same period, governments in low-income countries consistently deprioritized health in national budgets.
So, while the increase in health spending is welcome, the trends in the sources of that spending are concerning, especially the out-of-pocket payments.
Out-of-pocket health spending is the most inequitable type of spending, while aid is volatile and aid dependency is a major issue for low-income countries.
Increasing domestic health spending must therefore be a policy priority for all countries, to reduce financial hardship caused by out-of-pocket spending, and aid reliance.
However, in 2022, domestic public health spending per capita actually decreased for the first time since 2010, although it did increase significantly during the COVID-19 pandemic.
It is too soon to tell which direction spending on health will take: it could return to pre-pandemic levels, or it could continue on a declining trend, putting us even further off track.
We are therefore at a time of uncertainty. As countries emerge from the pandemic, enormous challenges remain.
About half the world’s population still lack access to one or more essential health services, and 2 billion people face financial hardship due to out-of-pocket health spending.
Governments now stand at a crossroads, tasked with building resilient health systems for future crises while meeting current health needs in a challenging economic environment.
I thank Member States and partners for working with WHO through this programme, which continues to expand in scale and scope.
It could not be sustained without the support of the OECD, the World Bank, the Gates Foundation, Gavi, and many bilateral partners.
This occasion provides a valuable opportunity to look back at the past 25 years, and to consider what shifts we must put in place to ensure sustainable health financing and financial protection to accelerate UHC and health security for all.
And again, I thank His Excellency Ambassador Endresen for joining us and for all the support of Norway for the last 25 years.
I thank you.