Subject: RE: Reminder: Financing Global Health Capstone Paper for review– comments due January 16
From: Ketevan Goginashvili
To: GBD Secretariat <[email-masked]>
Date: Wed, 16 Jan 2019 13:47:00 +0000

Dear colleagues,

Thank you for sharing of the preliminary version of the paper, "Past, present, and future of global health financing: country spending, and development assistance for health for 195 countries, 1995–2050".

A prognosis of health-related financing by countries in 1995-2050 is interesting and important for planning the health policy.

Since 2005, Georgia has been implementing National Health Accounts (NHA) and, since 2018, the system of health accounts (SHA11) has been launched. In this field the country actively closely cooperates with the World Health Organization, the Global Fund, and the World Bank.

The WB World Development Indicators (https://databank.worldbank.org/data/reports.aspx?source=world-development-indicators) and the WHO Global Health Expenditure Database (http://apps.who.int/nha/database/ViewData/Indicators/en) have used the results of national health reports.

There are several opinions about prognosis for Georgia, based on the analysis of the shared document, we have.

1.       For analyzing of the prognosis is important inflation-adjusted 2018 US dollars and 2018 purchasing-power-parity-adjusted dollars exchange rates for all countries.

2.       In the 185 line of the „Estimating development assistance for health: 1990–2018“„Past, present, and future of global health financing: country spending, and development assistance for health for 195 countries, 1995–2050“ (File 2018 past and future of global health financing.pdf): the method of the DAH estimation it is better to implement only for those countries that do not produce SHA, and the WHO has produce an assessment of their development assistance for health.

3.       As regards to the estimates given in file “Appendix final with page numbers.pdf “ pages 367-370, the only way to verify them was a comparison of Government spending, out-of-pocket spendings, pre-payment schemes and DAH's shares in the total expenditures on health care, including the WHO, and the WB data.

Data for 2015

NHA

WB

WHO

GBD estimations

Government Expenditure on health as % of Total health expenditure

36.3%

39%

36%

32%

OOP as % of Total health expenditure

57.3%

59% (private health expenditure

57%

61%

Prepaid private health expenditure as % of Total health expenditure

4.6%

5%

5%

Development assistance for health as % of Total health expenditure

1.8%

3%

2%

2%

The results of prognosis differ from the WHO and WB data. For such countries, where the share of the government spending large, the 2% -4% differences is not so important, but for our country such difference is essential and it took a lot of effort to achieve such result.

4.       Comparison of shares in 2016 and 2050: file FGH compiled figures and tables.pdf

Georgia

Health spending per

capita (2018 US$)

Government

health

spending per

capita (2018 US$)$)

Health spending per

GDP (%

Government health

spending per total

Health spending (%)

Prepaid private

spending per total

health spending (%

Out-of-pocket spending

per total health

Spending (%)

Development assistance

for health per total

Health spending (%)

Annualized rate of

change in health

spending per capita,

1995–2016 (%)

Annualized

rate of change

in health

spending per

capita, 2017-2050

(%)

Annualized rate of

change in health

Spending, 1995-2016 (%)

Annualized

rate of change

in health

spending,

2017-2050 (%)

GBD 2016

424

147

8.1

34.5

5.7

58.8

1.0

8.8

2.5%

7.7

2.0%

GBD 2050

988

375

9.9

38.0

6.0

55.2

1.0

NHA

8.4%

37.2

5.6

55.6

1.6

According to the prognosis, the Governmental expenditures will increase only 3-fold in 30 years, the same time, the share of which will only be changed by 4%. Also the DAH remains 1%, when the country is in the middle income countries group with the trend for the economic growth (for calculations we used the document as a source for the population number - https://www.un.org/development/desa/publications/world-population-prospects-the-2017-revision.html).

Also in 1995 – 2016, the Annualized rate of change in health spending per capita was 8.8%, and in 2017 – 2050, it will be only 2.5%?!!!

5.       The results of such prognosis are less convincing for us. Be so kind to provide additional information on calculations and to communicate with us to verify details, better using a teleconference.

With best regards,

Ketevan Goginashvili, MPH

Head of Health Policy Division

Health Care Department

Ministry of Internally displaced Persons

from  Occupied Territories,

Labor, Health and Social Affairs

144 Tsereteli Ave

Tbilisi 0119, Georgia

Tel: +995 32 251 00 38 ext 1108

Mob: 995 577717984

From: GBD Secretariat [mailto:[email-masked]]
Sent: 07 January, 2019 23:12
To: Ketevan Goginashvili
Subject: Reminder: Financing Global Health Capstone Paper for review – comments due January 16

Dear Colleagues,

This is a reminder that we have shared with you a preliminary version of the paper, "Past, present, and future of global health financing: country spending, and development assistance for health for 195 countries, 1995–2050".

For this capstone send us your feedback on this manuscript by Wednesday, January 16, 2019.

Your feedback should be submitted to the online comment platform here:
https://ihmeuw.wufoo.com/forms/q1tw9ayx035y0rh/

Please draft your comments in Microsoft Word or another word processing program and divide them into the eight categories listed.

To submit, copy each section of comments into the appropriate text box; send any attachments to [email-masked].

Access the paper here: https://cloud.ihme.washington.edu/index.php/s/byGcy3aRFsy9qCT
Password: Financing2018

Please hold this draft in strictest confidence as any citation or circulation could jeopardize the submission review process.

Kind regards,
GBD Secretariat