Health Financing and Sustainability

Sustainable Development Goal 3 (SDG 3) 2030 calls for healthy lives and promoting well-being for all ages. Healthcare refers to the entire range of curative, preventive, promotive, and rehabilitative care delivered at all care levels, from the primary (often in the community) to the tertiary level (hospitals). Health financing refers to the sourcing of funds from all sources that can be used to pay for the entire range of healthcare services. It is one of the six World Health Organization (WHO) health system building blocks. The overall goal of health financing is to protect healthcare users from social and financial risks and also to build a sustainable health system for healthcare providers to continue providing care. In 2000, the WHO defined health finance as a function of “a health system concerned with the mobilization, accumulation, and allocation of money to cover the health needs of the people, individually and collectively” [1]. In 2007, the definition of good health financing was expanded to include “raising adequate funds for health, so that people can use the needed services protected from financial catastrophe or impoverishment associated with having to pay for them” [2]. Health financing today must be prepared for additional expenditures to accommodate increasing healthcare costs related to increased longevity and improved quality of life in the elderly. It is estimated that an increment of USD274–371 billion in funding is required per year till 2030 to make satisfactory progress towards the SDGs. Three-quarters of this financial resource would be required for health system strengthening (health workforce, infrastructure, and medical equipment). With an additional annual funding of USD20–54 billion, one could save 97 million lives globally and increase life expectancy by 3.1–8.4 years [3]. Low- and middle-income countries (most South-East Asia Region countries belong to this category) receive health financing of approximately USD141–183 billion per year. This chapter will deal with three broad subjects: (1) health financing, (2) health system sustainability, and (3) health financing sustainability with reference to the SEAR countries.