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Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026

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dc.contributor.author Micah, A.E.
dc.contributor.author Bhangdia, K.
dc.contributor.author Cogswell, I.E.
dc.contributor.author Lasher, D.
dc.contributor.author Lidral-Porter, B.
dc.contributor.author Maddison, E.R.
dc.contributor.author Nguyen, T.N.N.
dc.contributor.author Patel, N.
dc.contributor.author Pedroza, P.
dc.contributor.author Solorio, J.
dc.contributor.author Stutzman, H.
dc.contributor.author Tsakalos, G.
dc.contributor.author Wang, Y.
dc.contributor.author Warriner, W.
dc.contributor.author Zhao, Y.
dc.contributor.author Zlavog, B.S.
dc.contributor.author Abbafati, C.
dc.contributor.author Abbas, J.
dc.contributor.author Abbasi-Kangevari, M.
dc.contributor.author Abbasi-Kangevari, Z.
dc.contributor.author Abdelmasseh, M.
dc.contributor.author Abdulah, D.M.
dc.contributor.author Abedi, A.
dc.contributor.author Abegaz, K.H.
dc.contributor.author Abhilash, E.S.
dc.contributor.author Aboagye, R.G.
dc.contributor.author Abolhassani, H.
dc.contributor.author Abrigo, M.R.M.
dc.contributor.author Abubaker Ali, H.
dc.contributor.author Abu-Gharbieh, E.
dc.contributor.author Adem, M.H.
dc.contributor.author Afzal, M.S.
dc.contributor.author Ahmadi, A.
dc.contributor.author Ahmed, H.
dc.contributor.author Ahmed Rashid, T.
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dc.contributor.author Akbarialiabad, H.
dc.contributor.author Akelew, Y.
dc.contributor.author Al Hamad, H.
dc.contributor.author Alam, K.
dc.contributor.author Alanezi, F.M.
dc.contributor.author Alanzi, T.M.
dc.contributor.author Al-Hanawi, M.K.
dc.contributor.author Alhassan, R.K.
dc.contributor.author Aljunid, S.M.
dc.contributor.author Almustanyir, S.
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dc.contributor.author Kaambwa, B.
dc.contributor.author Kadashetti, V.
dc.contributor.author Kadel, R.
dc.contributor.author Kadir, D.H.
dc.contributor.author Kalankesh, L.R.
dc.contributor.author Kamath, R.
dc.contributor.author Kandel, H.
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dc.contributor.author Karanth, S.D.
dc.contributor.author Karaye, I.M.
dc.contributor.author Karimi, S.E.
dc.contributor.author Kassa, B.G.
dc.contributor.author Kayode, G.A.
dc.contributor.author Keikavoosi-Arani, L.
dc.contributor.author Keshri, V.R.
dc.contributor.author Keskin, C.
dc.contributor.author Khader, Y.S.
dc.contributor.author Khafaie, M.A.
dc.contributor.author Khajuria, H.
dc.contributor.author Khayat Kashani, H.R.
dc.contributor.author Kifle, Z.D.
dc.contributor.author Kim, H.
dc.contributor.author Kim, J.
dc.contributor.author Kim, M.S.
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dc.contributor.author Kisa, A.
dc.contributor.author Kohler, S.
dc.contributor.author Kompani, F.
dc.contributor.author Kosen, S.
dc.contributor.author Koulmane Laxminarayana, S.L.
dc.contributor.author Koyanagi, A.
dc.contributor.author Krishan, K.
dc.contributor.author Kusuma, D.
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dc.contributor.author Lee, S.W.H.
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dc.contributor.author Lozano, R.
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dc.contributor.author Martorell, M.
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dc.contributor.author Mendes, J.J.M.
dc.contributor.author Meretoja, A.
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dc.contributor.author Mesregah, M.K.
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dc.contributor.author Mirza, M.
dc.contributor.author Mirza-Aghazadeh-Attari, M.
dc.contributor.author Misganaw, A.
dc.contributor.author Moccia, M.
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dc.contributor.author Mohammadi, M.
dc.contributor.author Mohammadian-Hafshejani, A.
dc.contributor.author Mohammadshahi, M.
dc.contributor.author Mohammed, S.
dc.contributor.author Mohseni, M.
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dc.contributor.author Tufa, D.G.
dc.contributor.author Vasankari, T.J.
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dc.contributor.author Vlassov, V.
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dc.contributor.author Wamai, R.G.
dc.contributor.author Wang, C.
dc.contributor.author Wassie, G.T.
dc.contributor.author Wickramasinghe, N.D.
dc.contributor.author Yaya, S.
dc.contributor.author Yigit, A.
dc.contributor.author Yiğit, V.
dc.contributor.author Yonemoto, N.
dc.contributor.author Younis, M.Z.
dc.contributor.author Yu, C.
dc.contributor.author Yunusa, I.
dc.contributor.author Zaki, L.
dc.contributor.author Zaman, B.A.
dc.contributor.author Zangeneh, A.
dc.contributor.author Zare Dehnavi, A.
dc.contributor.author Zastrozhin, M.S.
dc.contributor.author Zeng, W.
dc.contributor.author Zhang, Z.-J.
dc.contributor.author Zuhlke, L.J.
dc.contributor.author Zuniga, Y.M.H.
dc.contributor.author Hay, S.I.
dc.contributor.author Murray, C.J.L.
dc.contributor.author Dieleman, J.L.
dc.contributor.author Global Burden of Disease 2021 Health Financing Collaborator Network
dc.date.accessioned 2023-09-06T20:45:08Z
dc.date.available 2023-09-06T20:45:08Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/14061
dc.description.abstract Background: The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic; characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic; and examine expectations for future health spending and put into context the expected need for investment in pandemic preparedness. Methods: In this analysis of global health spending between 1990 and 2021, and prediction from 2021 to 2026, we estimated four sources of health spending: development assistance for health (DAH), government spending, out-of-pocket spending, and prepaid private spending across 204 countries and territories. We used the Organisation for Economic Co-operation and Development (OECD)'s Creditor Reporting System (CRS) and the WHO Global Health Expenditure Database (GHED) to estimate spending. We estimated development assistance for general health, COVID-19 response, and pandemic preparedness and response using a keyword search. Health spending estimates were combined with estimates of resources needed for pandemic prevention and preparedness to analyse future health spending patterns, relative to need. Findings: In 2019, at the onset of the COVID-19 pandemic, US$9·2 trillion (95% uncertainty interval [UI] 9·1–9·3) was spent on health worldwide. We found great disparities in the amount of resources devoted to health, with high-income countries spending $7·3 trillion (95% UI 7·2–7·4) in 2019; 293·7 times the $24·8 billion (95% UI 24·3–25·3) spent by low-income countries in 2019. That same year, $43·1 billion in development assistance was provided to maintain or improve health. The pandemic led to an unprecedented increase in development assistance targeted towards health; in 2020 and 2021, $1·8 billion in DAH contributions was provided towards pandemic preparedness in LMICs, and $37·8 billion was provided for the health-related COVID-19 response. Although the support for pandemic preparedness is 12·2% of the recommended target by the High-Level Independent Panel (HLIP), the support provided for the health-related COVID-19 response is 252·2% of the recommended target. Additionally, projected spending estimates suggest that between 2022 and 2026, governments in 17 (95% UI 11–21) of the 137 LMICs will observe an increase in national government health spending equivalent to an addition of 1% of GDP, as recommended by the HLIP. Interpretation: There was an unprecedented scale-up in DAH in 2020 and 2021. We have a unique opportunity at this time to sustain funding for crucial global health functions, including pandemic preparedness. However, historical patterns of underfunding of pandemic preparedness suggest that deliberate effort must be made to ensure funding is maintained. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartofseries Lancet Global Health
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Pandemic preparedness en_US
dc.subject COVID-19 en_US
dc.subject Domestic spending en_US
dc.subject.mesh Pandemias
dc.subject.mesh COVID-19
dc.subject.mesh Gastos en Salud
dc.title Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026 en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/S2214-109X(23)00007-4
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.01
dc.relation.issn 2214-109X


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