$25 Billion to $70 Billion in Additional Annual Aid Needed to Achieve HIV/AIDS Goals, Other Health-Related MDGs by 2015, World Bank Report Says

It will take about $25 billion to $70 billion annually in additional funding to achieve the U.N. Millennium Development Goals for health -- which include stopping and reversing the spread of HIV/AIDS and reducing incidence of malaria and other diseases by 2015 -- according to a report released on Thursday by the World Bank, AFP/Yahoo! News reports (Joshi, AFP/Yahoo! News, 5/25). "Although health aid increased to more than $10 billion in 2003 from $2.6 billion in 1990, estimates indicate that between three and seven times that much would be needed to reach the [MDGs] for health," the report says (Postelnicu, Medill News Service/MarketWatch, 5/25). According to Reuters, about half of global health aid goes directly into national budgets, with the rest going toward consultants and administration (Le Gras, Reuters, 5/25). Global spending on health in 2002 was $3.2 trillion, but only about $350 billion was spent in low- and middle-income countries. "High-income countries spend about 100 times more on health per [person] than low-income countries," the report says, adding, "Worse still, more than half of the meager spending in low-income countries is from out-of-pocket payments by consumers of care" (Aversa, AP/Washington Post, 5/25). According to a World Bank release, 90% of the world's disease burden is on people living in developing countries. Average life expectancy in Africa would be 62 years instead of 47 years were it not for HIV/AIDS, and thousands die daily from malaria and tuberculosis, even though both are "curable with low-cost drugs." Health care expenditures are expected to increase by 2% to 3% annually in most low- and middle-income countries for the next 20 years as the world's population is estimated to increase from six billion currently to 7.5 billion by 2020 and nine billion by 2050 (World Bank release, 5/25).

Recommendations
The report recommends that donors consider a country's specific health needs rather than directing funding to disease-specific programs, CQ HealthBeat reports (CQ HealthBeat, 5/25). Rwanda has more than 50 donors funding various health-related programs that hire health workers from the public sector and compete with one another, Reuters reports. "These are very good programs that are competing with each other rather than coordinating," Pablo Gottret, a report co-author, said (Reuters, 5/25). Report co-author George Schieber also noted that there are more Nigerian doctors in New York City than in Nigeria and more Malawian doctors in Manchester, England, than in Malawi (AFP/Yahoo! News, 5/25). The report concludes that, even though "there is no single road" for countries to provide good health services at low costs, an increase in donor funding must be accompanied by a political commitment to health and better management of health systems (Medill News Service/MarketWatch, 5/25).

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