Asia-pacific officials urge states to prioritize spending on health

The government of the Philippines, as well as those in Asia and the Pacific, must prioritize spending on health in the budget amid the Covid-19 pandemic, finance and health ministers said.

During the 53rd Annual Meeting of the Asian Development Bank (ADB) Board of Governors on Thursday, more than 40 officials emphasized the importance of universal health coverage (UHC) and the need for stronger collaboration to mobilize healthcare financing.

Citing a World Bank Group analysis, World Bank Global Director for Health, Nutrition and Population Muhammad Ali Pate said estimates show that growth in public spending for health will decline across most low-income and middle-income countries in the region amid the pandemic, adding that this may put at risk the gains that have been made in expanding UHC in recent years.

“As countries emerged slowly from the lockdowns, they must determine the best way forward for their health systems and economies in the face of huge uncertainty,” Pate said during the symposium on “UHC in Asia and the Pacific: COVID-19 and Beyond.” “We need to make sure our countries mobilize the necessary funding to respond to the Covid-19, and also its secondary impact while building sustainable and resilient health systems that will prepare countries for future outbreaks because Covid-19 is one, but it’s not going to be the last, public health threat that we will face.”

Moreover, Pate pointed out that finance and health ministers “must work hand in hand in ensuring adequate funding and proper spending of the budget for health.”

“Finance ministers must sufficiently prioritize health in the budget and health ministers must demonstrate that funds are spent efficiently and effectively,” he added.

ADB President Masatsugu Asakawa also said collaboration between finance and health ministers is crucial for member-economies to provide “cost-effective, inclusive, and highquality health interventions, underpinned by sustainable finance.”

“We have to build health systems where people from all walks of life, including the elderly, the poor and the vulnerable, can access health services at an affordable cost while maintaining these health systems’ financial sustainability—even in aging societies that many countries in Asia and the Pacific are heading toward,” Asakawa said. “Our collective experience of the fight against the pandemic speaks volumes about why we must also ensure that UHC is financially sustainable and inclusive to all.”

Finance Secretary Carlos G. Dominguez III said increased excise taxes on “sin products” in the country softened the blow of the pandemic to the country’s revenues.

“We were able to leverage excise tax collections from so-called ‘sin products’ to fund our UHC program. We are the only administration in the Philippine history to have increased sin taxes three times in the last four years,” Dominguez said. “Tax increases on cigarettes, alcohol, and electronic nicotine devices shielded us from the worst of the pandemic’s impacts on our revenue collection.”

World Health Organization Regional Director for Southeast Asia Poonam Khetrapal Singh lauded this move by the Philippine government to mobilize domestic revenues for health through pro-health taxes.

“Such levies would not only generate additional revenues for health but also produce happier, healthier populations,” Singh said.

But on top of prioritizing health in the budget and imposing pro-health taxes, Singh also recommended that countries improving value for money in health by investing in primary healthcare and pro-poor initiatives that protect and promote the health of vulnerable groups.

Last week, senators questioned the “anemic” budget for health, including the funding for vaccines and test kits under the proposed 2021 national budget amid the pandemic.

Senator Risa Hontiveros was “baffled” as to why the Department of Health (DOH) ranked only fifth in budget prioritization behind the Education sector (P754.4 billion) Department of Public Works and Highways (P667.3 billion), Department of the Interior and Local Government (P246.1 billion) and the Department of National Defense (P209.1 billion).

This is despite the 26.06-percent increase in the proposed 2021 budget for DOH alone amounting to P131.72 billion from P104.49 billion in 2020.

However, Minority Leader Franklin Drilon said the proposed budget for DOH this year is even lower than its adjusted budget this year of P153 billion, which included the increased funding from Republic Act (RA) 11469 and RA 11494.

Under the proposed 2021 national budget, the Executive branch has also allotted an “initial” P2.5 billion for the acquisition of the Covid-19 vaccine. Development Budget Coordination Committee Chairman and Budget Secretary Wendel E. Avisado said this would hopefully cater to about 3.8 million poor Filipinos.

The Executive branch is proposing P2.67 billion and P1 billion for personal protective equipment sets and test kits, respectively.