Dollars don’t annihilate disease: why money cannot heal the world

This article was exclusively written for The European Sting by Ms. Jasmine Rutere, a second-year graduate medical student at the University of Manchester in the United Kingdom. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Money, money, money. If only we had an unlimited supply, then everything would be alright, right? WRONG! When considering global health, we encounter an enormous enigma with many problems but not enough solutions. From 1995-2016, global health expenditure increased by 4% per annum¹. It is a common misconception that the solution to the global health crisis is to increase funding, but this is comparable to using a band-aid to heal a gunshot wound. Money is not the be-all and end-all solution that it appears to be, and other co-solutions may be more beneficial in the long run.

The global health agenda has been broken down into three sub-agendas; the security agenda, the economic agenda, and the social justice agenda².  The security agenda concerns the rapid spread of disease wherein viruses can transverse the globe within a mere matter of hours. The economic agenda encompasses the effect of poor health on the global marketplace, and the economic impact of health decelerator industries such as the tobacco and fast-food industries. Finally, the social justice agenda champions the essence of health as a human right, as opposed to a service being provided. This includes the social determinants of health and the access to care and medications. The best one-health approach to achieving the global health agenda is one which collaboratively uses all three sub-agendas.

One would assume that the lower the proportion of a country’s GDP is spent on health, the higher the disease burden on its citizens.  This is far from the truth however, as we observe countries such as the United States which spends ~17% of its GDP (Gross Domestic Product) on health consumption³, yet many of its citizens still report that healthcare is inaccessible to them.  On the other hand, we have countries such as Qatar who only spend ~2.2% of their GDP yet still have a very well-supplied system⁴. This shows that the solution is not a financial one.

By contrast, countries such as the UK spend roughly the average percentage of their GDP on healthcare, yet they have combatted the social justice agenda better than some of their more extravagant counterparts. In countries where all persons have equal access to healthcare regardless of their social, economic or refugee status, there is far better health equity, and services are far better utilised. Countries such as these view healthcare as a right, rather than a privilege and they act accordingly.

In conclusion, throwing more money at this problem is not the answer. Attacking the global health agenda using a multi-faceted approach is key. Limited financial problems are faced by all countries, and everyone could do with a bit more money to provide better services. But it is not until there is further examination into whether citizens view healthcare as something available to them, provided within a system which is both designed to be financially and sociably accessible for them, and not at risk of causing harm to them that we will truly see change.

References

1. Global Burden of Disease Health Financing Collaborator Network. (2019). Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995–2050. The Lancet. 393 (10187), 2233–2260.
2. Ilona Kickbusch. (2018). Advancing the Global Health Agenda. Available: https://www.un.org/en/chronicle/article/advancing-global-health-agenda. Last accessed 24th Aug 2020.
3. Rabah Kamal . (2020). How does health spending in the U.S. compare to other countries?. Available: https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/#item-start. Last accessed 24th Aug 2021.
4. Jessica Dillinger. (2017). Countries Who Spend The Least On Healthcare The amount a country can spend on health is directly related to its wealth, but population size and infrastructure can also play key roles. Available: https://www.worldatlas.com/articles/the-countries-with-the-lowest-health-expenditures-in-the-world-relative-to-gdp.html. Last accessed 24th Aug 2021.

About the author

Jasmine Rutere is a second-year graduate medical student at the University of Manchester in the United Kingdom. She has a keen interest in Global Health, choosing to pursue it as her major in her third year of her undergraduate studies. Her passion mainly lies within women’s health, with a particular focus on addressing some of the health challenges faced in rural Eastern Africa, where she is from. Within medical school, Jasmine is devoted to widening participation, specifically for students of colour from low-income backgrounds, and serves as a mentor to various applicants.  She is excited to continue her journey