Health Financing
How much do countries spend on health? Where does that money come from? And how is it spent?
We’re diving into all these questions to unpack the state of health financing. Spoiler alert: It varies dramatically across countries and income groups.
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- In 2021, countries spent US$9.8 trillion on health, up 2.1%from 2020.
- In 2021, high-income countries accounted for 79.6% of total health spending, upper middle-income countries for 16.6%, lower-middle income countries for 3.6%, and low-income countries for 0.2%.
- Health spending in Africa reached US$136.7 billion in 2021, an increase of 6.1% from 2020, accounting for an average of 5% of African countries’ gross domestic product (GDP). South Africa, Cabo Verde met the Abuja Declaration Target to spend 15% of domestic government spending on health in 2021.
How much do countries spend on health?
Over the past 20 years, total health spending has grown across all income levels, from US$4.4 trillion in 2000 to US$9.8 trillion in 2021. 79.6% of that spending has been in high-income countries. Low- and lower-middle income countries, home to 52% of the global population and 56% of the global burden of disease, account for only 3.8% of global health expenditure.
In 2021, low-income countries spent US$22.8 billion on health, a 3.9% increase from 2020. Lower-middle income countries spentUS$351.1 billion on health, a9.8% increase from 2020. Health’s share of GDP increased across all income levels between 2020 and 2021, likely caused by the COVID-19 pandemic. More data is needed to know if this upward trend will continue beyond 2021.
Over the last twenty years, total health spending has increased
This chart shows total health spending in different countries and income levels based on World Bank income classifications. Total health spending refers to health expenditure from all financing sources, including domestic government, external aid, domestic private, and out-of-pocket health spending.
The chart allows you to view data on total health spending (from all sources) in USD billions (in constant 2021 prices), per capita, and as a share of GDP.
How much should countries spend on health?
Some estimates suggest that countries should spend at least 5% of their GDP and US$86 per capita on health to ensure all citizens have access to primary healthcare services. No African countries met both targets in 2021.
Other regional targets for health spending exist, like the African Union’s Abuja Declaration Target to allocate 15% of government spending to health.
Few low- and lower-middle income countries in Africa are spending 5% of GDP or more on health
This chart shows domestic government spending on health as a share of GDP, based on World Bank income classifications.
Hover over each country point to see more details. Press the play button at the top of the graph to see changes over time.
Few low and lower-middle income countries in Africa are spending US$86 per capita or more on health
This chart shows domestic government spending on health per capita in USD based on 2021 constant prices, using World Bank income classifications. Only countries that spend at least US$1 per capita are included.
Hover over each country point to see more details. Press the play button at the top of the graph to see changes over time.
Very few African governments have met the Abuja Declaration Target since 2001
In 2001, African Union countries set a target of allocating at least 15% of their budget each year to the health sector, known as the Abuja Declaration. As recently as February 2023, African leaders recommitted to implementing the Abuja Declaration Target. In 2021, South Africa, Cabo Verde met the target.
This chart shows how domestic government spending on health by African governments compares to the Abuja Declaration Target. Hover over each country point to see more details. Press the play button at the top of the graph to see changes over time.
What are the main sources of health spending?
Total health spending in low- and lower-middle-income countries has increased steadily over the past 20 years. What is driving the increases?
In low-income countries, external aid’s share of total health spending increased by 20.0 percentage points between 2000 and 2021, while domestic government spending decreased by 9.3 percentage points. In lower-middle income countries, external aid’s share of total health spending increased by 0.6 percentage points between 2000 and 2021, while domestic spending increased by 8.6 percentage points.
Out-of-pocket spending is the primary source of health financing among low- and lower-middle income countries
This chart shows the four main sources of health financing as shares of total health spending: domestic government; out-of-pocket; external aid; and other domestic private (e.g. spending on health from households, corporations, or non-profit organisations that can be either prepaid to voluntary health insurance or directly to healthcare providers).
Use the drop down menu to select a specific country or income level to see health spending broken down by source. Hover over any point on a line to see more details.
See also
⁄How much do countries spend on health by disease or program area?
Health financing at the country-level supports a wide range of health programs, health services, and systems – such as HIV/AIDS, noncommunicable diseases, and maternal health.
Total health financing by disease or program area
This chart shows total health spending (from all sources) in constant USD for different disease types by country. Total health spending refers to health expenditure from all financing sources, including domestic government, external aid, domestic private, and out-of-pocket health spending.
Type a disease or program area in the search bar to select several at once. Hover over the graph to view additional details.
Sources of health financing by disease or program area
This chart shows the sources of health financing for each disease or program area, based on the latest available data for each country. The latest year of available data varies by country. Data for out-of-pocket spending by disease and program area is not reported individually and is grouped with domestic private spending, as a result the indicator “out-of-pocket & other domestic private” was created to represent this grouping. The three main sources of financing as reported by countries are: domestic government; external aid; and out-of-pocket & other domestic private.
Use the drop down menu to select a specific country to see health spending broken down by source. Hover over the chart for additional details. To see the latest available data for each country, please download the dataset.
How do Multilateral Development Banks invest in health?
Multilateral development banks (MDBs) provided US$12.2 billion in total health financing in 2021, up 10.5% from US$11.1 billion in 2020. The MDBs provide financing in the form of concessional or “soft” loans (ODA loans), non-concessional or “hard” loans (other official flows), and ODA grants. 65.0% of financing provided for health in 2021 was in the form of hard loans.