WHO Unveils SDG Price Tag

Universal health coverage comes at a price but can countries afford it?

In 2015, the United Nations released an agenda that included 16 Sustainable Development Goals (SDG) that should be reached by 2030. SDG Health Price Tag, a recent release published by the Lancet Global Health, provides financial estimates of the amount of funding required to reach the health SDGs in 67 low-income countries. The analysis presents 2 scenarios—an “ambitious” scenario in which health SDGs are met, and a “progress” scenario in which two-thirds of targets are reached.

The different scenarios are consistent with the goal to use 75% of the investments to employ more health workers, build new facilities, and purchase medical equipment. The remaining 25% will be allocated to supplying medications to prevent and treat illnesses, provide training to employees and increase outreach to the communities.

The “ambitious” plan would require an annual growth in funding; the initiative would begin with the need for $134 billion and increase to $371 billion by 2030. Analysis shows that only 85% of annual costs can be allocated from domestic resources, leaving a gap of about $58 billion each year. The lack of funding would affect up to 32 low-income nations that do not have access to the proper financial resources. If investments cannot be secured, the “ambitious” plan will be unsuccessful.

Despite the big price tag, the “ambitious” plan has the potential to provide to prevent 97 million death—1 every 5 seconds–and increase life expectancy by 3.1 to 8.4 years in 67 countries. In addition to the health benefits, the plan has potential to secure jobs for 23 million workers and create 415,000 new health care facilities. As a result, health spending as a proportion of GDP will increase to an average of 7.5% in low-income countries. The investments would provide a significant increase in these countries, where the current average health spending as a proportion of GDP is 5.6% ­­—significantly lower than the global average of 9.9%.

In comparison, the “progress” plan would require $104 billion initially, and increase annually to $274 billion. The funding would increase the average health spending as a proportion of GDP to 6.5% in low-income nations, by creating 14 million new jobs and 378,000 health centers. The investments would prevent 71 million deaths and decrease the infant mortality rate.

A constant in both of the plans, is the need for external funding in low-income nations.

"Universal health coverage is ultimately a political choice. It is the responsibility of every country and national government to pursue it," said Dr Tedros Adhanom Ghebreyesus, WHO director-general, in a press release.

Investing in low-income health initiatives is very common. In June, the World Bank recently announced a new plan to issue nearly $425 million in pandemic bonds and derivatives to fund the Pandemic Emergency Finance Facility (PEF). This initiative is similar to catastrophe bonds which exceeds $90 billion in investments each year. PEF will provide funding to developing nations if a response is needed, in the event of a pandemic. While money is necessary to work towards reaching these goals, it is not the only driving factor. In order to complete the initiative there is a need for political commitment and respect for human rights.