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Basic arithmetic with Jeffrey Sachs: 10 cents is what it takes

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In the September 8 issue of the respected medical journal The Lancet, Professor Jeffrey Sachs of the Columbia University Earth Institute, explained once again that it would costs the inhabitants of high-income countries not more than 10 cents out of every 100 euros (or dollars) to enable low-income countries to finance basic health care for all. This is how it works:

“… governments of low-income countries will often lack adequate domestic budget revenues to ensure universal access to a basic package of health services even if the government is disposed to guarantee universal access to health care. Some basic arithmetic is pertinent here. The minimum package for primary health services in 2012 is probably around US$50—60 per person.”

“Yet even this low sum (compared with the several thousand dollars per person per year of public health spending in the high-income countries) is out of the reach of governments of the poorest countries. Consider a country with a gross domestic product at roughly $300 per capita, such as Mali or Ethiopia. Public revenues through taxes, royalties, and other means, can amount to around 20% of national income, or $60 per person per year. That sum must cover all public services, including education, infrastructure, and public administration, not only the health sector. One international norm known as the Abuja Declaration is that low-income governments promoting universal access to health care should devote 15% of their total budgets to health. This amount is a stretch, but achievable. Yet it implies only $9 per person per year in the health sector (15% of $60) for these countries.”

“This cost suggests a total aid need of some $40 billion per year from the donor world, compared with roughly $27 billion in international health assistance in 2010. Another $13 billion per year would reach the $40 billion annual mark. Note that $40 billion is only 0.1% of high-income annual gross product, so the need for international development aid can be summarised as roughly 10 cents per each $100 of donor national income.”

Of course, these figures describe orders of magnitude, they are not precise. But they are realistic, and support our charter and our 10 cents demand.

Coincidence? Not really. Jeffrey Sachs was one of the keynote speakers at our 2009 conference; his work has always been a source of inspiration for us, and it is good to know that we’re still on the same wavelength.