Africa falls short on health spending
How much should governments spend on health care? A lot more than many governments are spending today, according to international benchmarks. Experts recommend that governments allocate at least 5% of GDP on health to build resilient health systems and move towards universal coverage. For low-income countries, an additional benchmark of at least US$86 per person ensures access to essential primary health care. Yet many countries—especially in Africa—fall short on both measures, leaving billions of people at risk.
Government health spending is vital: it ensures equitable access to care, protects households from financial hardship, and strengthens resilience against future pandemics. But despite its importance, health is increasingly being squeezed out of national budgets. In 2022, health spending declined as a share of government budgets across all income groups, even as overall public spending rose in every group except high-income. The message is clear: governments are deprioritising health.
The pattern of underprioritising health is especially stark in Africa. Government health spending has stagnated at around 6% of total budgets—far below the 15% commitment made under the Abuja Declaration in 2001. Few countries have ever reached that pledge and fewer still have sustained it.
Methodology Note
The government health spending target of US$86 per capita serves as a complementary benchmark for low-income countries. In many cases, achieving the broader government health spending target of 5% of GDP does not translate into sufficient resources to guarantee access to core primary healthcare services. For this reason, the US$86 per capita absolute target is used alongside the 5% of GDP target to better evaluate government health spending levels.
The US$86 figure is expressed in 2015 dollar terms. It is derived from earlier estimates made by the High-Level Taskforce on Innovative International Financing for Health Systems (HLTF) which in 2009 set the threshold at US$54 in 2005 dollar terms. To ensure comparability, all absolute values used to compare the US$86 target are expressed in 2015 dollar terms, including those presented in the first chart.