Resource allocation and health financing

Member states of the African Union pledged at the 2001 Abuja summit to commit at least 15% of national budgets to healthcare but 6 years later have largely failed to do so. This failure amongst others has resulted in the annual loss of an estimated 8 million African lives to preventable, treatable and manageable diseases and health conditions. In other words Africa has lost a staggering estimated 40 million lives since 2001 due to a failure to develop, implement and fund comprehensive Public Health policies alone. African governments are not yet all working collectively or quickly enough to analyse and resolve the long term big picture and real scale of Africa’s health catastrophe. Many appear to be relying mainly on international efforts from wealthy philanthropists, donor countries and facilities such as the Global Fund to resolve Africa’s accumulated Public Health problems. Some are also still focusing on only some specific diseases without long-term perspectives to ensure that Public Health is comprehensively promoted to resolve what are essentially interlinked symptoms of one problem – the lack of a comprehensive long term Public Health policy and planning across Africa.

The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria today approved 73 new grants worth more than US$ 1.1 billion over two years. The Board has also approved US$ 130 million for renewal of five grants that have reached the end of their five year life. More than 80 percent of the approved Round 7 grants are for low-income countries, with the majority of resources (66 percent) for Africa. Asia and the Western Pacific will receive 13 percent of the newly approved funding, Latin America and the Caribbean five percent, Eastern Europe three percent, and the Middle East 13 percent.

A comparative approach was adopted to study four groups of informal economy operators (cobblers, welders, carpenters, small scale market retailers) focusing on a method of prepayment which could help them access health care services. Two groups with a total of 714 operators were organized to prepay for health care services through a group premium, while the other two groups with a total of 702 operators prepaid through individual premium, each operator paying from his or her sources. Data collected showed that the four groups were similar in many respects. These similarities included levels of education, housing, and social services such as water supplies, health problems, family size and health seeking behaviour. At the end of a period of three years 76% of the members from the two groups who chose group premium payment were still members of the prepayment health scheme and were receiving health care. For the two groups which opted for individual premium payment only 15% of their members were still receiving health care services at the end of three years.

A number of different methodologies will be tested as part of the Risk Equalisation Fund (REF) shadow process in South Africa, according to the Registrar of Medical Schemes Patrick Masobe, under whose control the shadow process falls. The REF is being set up to make sure that all medical scheme members, regardless of their age or state of health, pay the same to access certain basic healthcare benefits. Medical schemes that have a large number of younger and healthier members will have to pay into the REF, while schemes with many older and sicker members will receive payments from the fund.