Increased spending of $66 billion per year to improve the health status of developing nations will provide a sixfold return on the investment, a group of leading economists and public health experts says.
In a report prepared for the World Health Organization (WHO), the Commission on Macroeconomics and Health concludes that the increased investment — half to come from developed countries like Canada and the rest from “reprioritizing” the budgets of underdeveloped nations — would provide the large returns because healthier people would live longer and be more productive (see p. 293). Under the plan, “official development assistance” from countries like Canada would increase from its current level of $6 billion per year to $27 billion by 2007. The rest of the money would come from the developing countries themselves. The commission concludes that the additional spending would save about 8 million lives a year.
“The commissioners use clear scientific evidence to challenge the traditional argument that health will automatically improve as a result of economic growth,” says WHO. “Their report shows that the opposite is true: improved health is a critical requirement for economic development in poor countries.”
Under the plan, countries like Canada would make annual contributions to the health of developing nations that would amount to 0.1% of their gross national product — in Canada's case, about $1 billion annually. Developing countries would also aim to raise budgetary spending on health by an additional 1% by 2007 and 2% by 2015. “With bold decisions in 2002, the world could initiate a partnership between rich and poor of unrivalled significance offering the gift of life itself to millions of the world's dispossessed,” the report states.
But how well will this message go over in wealthy countries like Canada, where international concerns usually take a back seat to national issues? “The problem of winning public support is indeed a large one,” commission Chair Jeffrey Sachs told CMAJ. “Europe and Canada are much further along on the aid-health-development linkages than the US, which has become the stingiest of the 22 donor countries when aid is measured as a percentage of GNP. Since Canada is host of the G-7 summit this year and Africa is high on the agenda, I believe Canada is likely to accept the challenge of advocating for and contributing to greater aid.”
Sachs says the United Kingdom and European Union have both made promising comments about the need for increased aid, “but so far I haven't seen much progress with the US administration.”
The commission was created in 1999, with Sachs, director of Harvard's Center for International Development, as chair. Its report, Macroeconomics and health: investing in health for economic development, is available at www.cid.harvard.edu.
Signature
Patrick Sullivan
CMAJ
Figure. Time to invest in the future? Photo by: Canapress