Strong health systems for all with better public spending

The discourse on building strong public health systems tends to start with financing. Indeed, according to the World Bank, the per capita public spending on universal health coverage in low- and middle-income countries (LMICs) — including government expenditure and off-budget development assistance — is about half of the minimum benchmarks. As a share of gross domestic product (GDP), the health expenditure gap between LMICs and high-income countries narrowed from 2.05 percentage points in 2000 to 1.68 percentage points in 2023. While it may seem that LMICs are “catching up”, recent World Health Organization data show that in per capita terms the gap has in fact expanded more than three-fold during this period.