May 17th, 2012

Primary Health Care in Low-Income CountriesBuilding on Recent Achievements

Global Health

Small investments in improved health of the poor have a remarkable return in reduced morbidity and mortality. While the developed economies grapple with health systems that cost several thousand dollars per person per year and often spend hundreds of thousands of dollars on a treatment to eke out an additional few months of life, outlays of just a few dozen dollars per person per year in impoverished countries can add several years to life expectancy. In the least developed countries, approximately 112 of every 1000 children die before their fifth birthday, as opposed to 8 per 1000 in the developed countries.1 With a concerted science-based effort, the under-5 mortality rate of the least developed countries could be reduced to less than 30 per 1000 by 2020. Such low under-5 mortality rates have already been achieved, for example, by the Dominican Republic (28 per 1000), Mexico (17 per 1000), and Thailand (13 per 1000).1

Rapid advances are already being achieved at remarkably low cost. During 1995-2000, the under-5 mortality rate of the least developed countries was estimated at 160 per 1000. After 2000, with the advent of the Millennium Development Goals and the financing recommendations of the Commission on Macroeconomics and Health, donor nations substantially increased their total development assistance for health, from around $10.5 billion in 2000 to around $26.9 billion in 2010.2 3 With approximately 1 billion low-income recipients for the preponderance of this aid, the current average is roughly $25 per recipient. The added funding came through a variety of channels, most notably bilateral aid programs (such as the US President’s Emergency Plan for AIDS Relief); the Global Fund to Fight AIDS, Tuberculosis and Malaria; the Global Alliance for Vaccines and Immunizations; the World Bank; the Gates Foundation; and several targeted initiatives against other specific diseases.

Read full article at the Journal of the American Medical Association


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