Ramesh Govindaraj

Health expenditures in Latin America and the Caribbean

This paper presents the results of a study commissioned by the Latin American and Caribbean Technical Department of the World Bank to document and analyze health expenditures in Latin America and the Caribbean. In 1990, the countries of this region spent US

The Indian pharmaceutical sector : issues and options for health sector reform

69 billion on health, with an average per capita health expenditure of US

Strengthening Post-Ebola Health Systems

162. On average, the countries spent 6.2% of their GDP on health, with the expenditures divided about equally between the public and private sectors. In both the public and private sectors, per capita health expenditures were positively and significantly correlated with per capita income. However, this relationship holds only for the public sector, when health expenditures are measured as a proportion of GDP. While several poorer countries were dependent on external assistance, with increasing income, the countries relied more on public expenditures to finance health care. Based on the limited time series data, it is evident that there was a considerable variation among countries regarding the proportion spent on capital investments, primary health care, and drugs, but not on salaries. Looking ahead, with increasing economic development, the proportion of GDP spent on health, along with public health expenditure as a proportion of total health expenditure, is likely to increase rapidly, while aid dependency is likely to decline.

National health expenditures: a global analysis.

This report assesses the pharmaceutical sector in India, particularly focusing on four key issues related to the production, procurement, and distribution of drugs in India: a) availability, b) affordability; c) quality, and d) the rational use of drugs. The results of a survey of three states indicate considerable variation across states in the above four areas in both public and private sectors. The report concludes that problems with the availability, affordability, and rational use of good quality, cost-effective, essential drugs have persisted in most parts of India, and that these health-related issues need be addressed as a priority. An overarching recommendation is the need to focus on strengthening the implementation and regulation of the pharmaceutical sector at the state level, rather than on simply introducing new regulations. Adequate pharmaceutical quality assurance needs to be particularly emphasized as, in its absence, other reform measures could be rendered moot. Similarly, the rational use of drugs needs to be emphasized as it is likely to yield significant cost savings to the government and to consumers, in addition to its positive impact on health.

Applying market mechanisms to central medical stores : experiences from Burkina Faso, Cameroon, and Senegal

Moving Beyond Zero addresses the challenge of enabling the development of viable, resilient, and fiscally sustainable health system in Guinea, Liberia, and Sierra Leone. Initiated while Ebola was still raging in all of the three most-affected countries in West Africa, it identifies the requirements for strengthening the health systems in these countries to go beyond just getting the number of Ebola cases to zero. The overall goal of this study is thus twofold: To assess the capacity of the health systems of the three most-affected countries in terms of their ability to deliver quality health services to their populations, perform core public health functions on a routine basis, and to respond to public health emergencies; and To identify the highest impact strategies to help these countries to strengthen their health systems to be more effective and resilient, drilling down into three key aspects of the health system--that is, fiscal space for universal health coverage (UHC), development and deployment of an effective health workforce, and continuous disease surveillance.