The return of austerity imperils global health

Stubbs, Thomas; Kentikelenis, Alexandros; Gabor, Daniela; Ghosh, Jayati; McKee, Martin

Abstract

Recognising the world's lack of preparedness for the COVID-19 pandemic, international organisations like the World Health Organization, World Bank, and International Monetary Fund are calling for extensive additional funding to strengthen pandemic preparedness and response systems in low-income and middle-income countries, including through domestic resource mobilisation. This article examines the prospects of national health budgets increasing in such a context, drawing on new International Monetary Fund projections on public spending around the world. We show that by 2024 public spending will be lower than the 2010s average for almost half of all low-income and middle-income countries. A key driver of this new wave of austerity is the dramatic increase in public spending dedicated to repaying external debt - underpinned by growing debt stocks, US interest rates rises, and commodity price hikes. As in earlier crises, the stage is set for a situation where population health deteriorates - via compound effects of the pandemic and widespread economic hardship - while public health services required to tackle increased need are facing steep cuts. We conclude by considering what can be done to avoid repeating the mistakes of the past.

• Journal Article Type: Review
• Acceptance Date: Feb 5, 2023
• Online Publication Date: Feb 20, 2023
• Publication Date: Feb 20, 2023
• Deposit Date: Mar 14, 2023
• Publicly Available Date: Mar 14, 2023
• Journal: BMJ Global Health
• Electronic ISSN: 2059-7908
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 8
• Issue: 2
• Pages: e011620
• DOI: https://doi.org/10.1136/bmjgh-2022-011620
• Keywords: Global Health, Poverty, Health policy, Pandemics, Humans, COVID-19, Public Health, World Health Organization, United States, Health systems
• Public URL: https://uwe-repository.worktribe.com/output/10537572
• Publisher URL: https://gh.bmj.com/content/8/2/e011620