Funding flows for health: what might the future hold?

Mark Pearson, April 2007

How are aggregate funding flows for health going to evolve over the coming years? It is, of course, impossible to answer this question with any certainty, but we can make informed guesses. This paper models a possible trajectory for overall health financing over the coming years. It maps progress against a set of key indicators, and estimates the size of the funding gaps against a range of assumptions.

It concludes that significantly reducing the financing gap would not only require a combination of extraordinary outturns, but would be likely to result in increased aid dependency in much of Africa. And, realistically, there is very little likelihood of countries achieving financing targets by 2015, and even by 2030 (in the case of the Abuja targets for many African countries). Reaching these targets would also make little difference to projected funding shortfalls.

The paper endorses the view that countries should focus on spending the additional US$2 or US$3 per capita they might receive year on year, and on seeking ways to improve value for money from both public and private spending rather than focusing on unattainable financing goals which provide little incentive to prioritise between competing objectives.