What are health systems?
More than a third of the world’s population – around 2.4 billion people – currently has no access to a basic health facility.
Many more live in countries where the system for providing health services is under-funded and overstretched.
A problem of money
Lack of money is the most obvious cause. Countries with weak economies are unable to invest enough in buildings, staff, equipment and medicines (their health systems).
International aid could help, but not as much has been given as was promised by wealthy countries.
What to spend aid on?
Much of the aid that has been forthcoming has been put towards specific diseases such as HIV, tuberculosis and malaria. This aid has helped save many lives, but a lack of money to strengthen health systems themselves has brought about new challenges and threatened to undermine progress.
Furthermore, what funds there are for health services are often badly allocated, with too little going to provide services for the poorest and most marginalised who need them the most. And the introduction of user fees for heath services in many countries has further undermined access. Again this has affected the health of the poorest people the most.
A lack of money to train, pay and retain health staff has also worsened staff shortages in many developing countries. In many countries in sub-Saharan Africa HIV and tuberculosis have already killed many health workers. Poaching by wealthy countries has made the situation worse. The new phenomenon of health tourism also threatens to bring additional strains to health systems in some countries as high paying health tourists fragment already weak systems.
Health Poverty Action says:
- Developing countries need health systems that can address the full spectrum of basic health problems that their citizens face, not just specific high profile diseases. Many common illnesses and neglected tropical diseases, can be easily and cheaply prevented or treated.
- Health systems should be accessible and affordable for all. They also need to be community-based, taking into account the needs and context of local people.
- Wealthy countries need to act on their promises and make sure there is long-term, predictable and sustainable financing for health systems. This sits at the heart of efforts to improve global health and well-being.
- National governments must also increase their proportion of spending on health and make sure services reach the poor, marginalised and isolated.