| Original language | English |
|---|---|
| Pages (from-to) | 693-724 |
| Number of pages | 32 |
| Journal | The Lancet |
| Volume | 396 |
| Issue number | 10252 |
| DOIs | |
| Publication status | Published (VoR) - 5 Sept 2020 |
Funding
R O Akinyemi acknowledges supports from the US National Institutes of Health (NIH; Grant U01HG010273) as part of the H3Africa Consortium and a Global Challenges Research Fund (GCRF) fellowship grant (FLR/R1/191813) from the UK Royal Society and the African Academy of Sciences. S M Aljunid acknowledges International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia and Department of Health Policy and Management, and Faculty of Public Health, Kuwait University for the approval and support to participate in this research project. M Ausloos acknowledges partial support from a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI (project number PN-III-P4-ID-PCCF-2016-0084). T W Bärnighausen acknowledges support from the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the Federal Ministry of Education and Research. S I Hay acknowledges primary support from the Bill & Melinda Gates Foundation (grant OPP1132415). Claudiu Herteliu acknowledges partial support from a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI (project number PN-III-P4-ID-PCCF-2016-0084) and from a grant co-funded by European Fund for Regional Development through Operational Program for Competitiveness (project ID P_40_382). B-F Hwang acknowledges support from China Medical University (CMU 107-Z-04), Taichung, Taiwan. S M S Islam acknowledges funding from the National Heart Foundation of Australia and Deakin University. M Jakovljevic acknowledges the Ministry of Education Science and Technological Development of the Republic of Serbia for co-funding for the Serbian part of this Global Burden of Disease (GBD) contribution (grant OI 175 014). A M Samy acknowledges support from a fellowship from the Egyptian Fulbright Mission Program. M M Santric Milicevic acknowledges support from The Ministry of Education, Science and Technological Development, Serbia (contract number 175087). A Sheikh acknowledges support from Health Data Research UK. R Tabarés-Seisdedos acknowledges support in part from Generalitat Valenciana (grant number PROMETEOII/2015/021) and from Instituto de Salud Carlos III-La Federación Española de Enfermedades Raras (national grant PI17/00719). J F M van Boven acknowledges support from the Department of Clinical Pharmacy and Pharmacology of the University Medical Center Groningen, University of Groningen, Groningen Netherlands. S B Zaman acknowledges the Australian Government research training programme for providing a scholarship in support of his academic career. Editorial note: the Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations. C A T Antonio reports personal fees from Johnson & Johnson (Philippines) outside of the submitted work. A E Berman reports personal fees from Biosense Webster outside of the submitted work. S L James reports grants from Sanofi Pasteur and future employment with Genentech/Roche outside of the submitted work. J J Jóźwiak reports personal fees from VALEANT, ALAB Laboratoria, and AMGEN outside of the submitted work. M J Postma reports grants and personal fees from MSD, GlaxoSmithKline (GSK), Pfizer, Boehringer Ingelheim, Novavax, Bristol-Myers Squibb, AstraZeneca, Sanofi, Seqirus, and IQVIA; grants from Bayer, BioMerieux, WHO, the European Union? FIND, Antilope, DIKTI, LPDP, and BUDI; personal fees from Novartis, Pharmerit, and Quintiles; holds stocks in Ingress Health and Pharmacoeconomics Advice Groningen; and is advisor to Asc Academics outside of the submitted work. M Savic reports employment with the GSK group of companies and hold restricted shares in the GSK group of companies. M G Shrime reports grants from Mercy Ships and Damon Runyon Cancer Research Foundation outside of the submitted work. J A Singh reports personal fees from Crealta/Horizon, Medisys, Fidia, UBM LLC, Trio health, Medscape, WebMD, Clinical Care Options, Clearview Healthcare Partners, Putnam Associates, Spherix, Practice Point communications, the National Institutes of Health and the American College of Rheumatology, and Simply Speaking; participating in the Speaker's Bureau at Simply Speaking; owning stock options in Amarin Pharmaceuticals and Viking Pharmaceuticals; membership in the FDA Arthritis Advisory Committee, Veterans Affairs Rheumatology Field Advisory Committee, and in the Steering Committee of Outcome Measures in Rheumatology (OMERACT), and acting as Editor and the Director of the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis outside of the submitted work. All other authors declare no competing interests. Although economic development is associated with reducing the domestic health financing burden that is funded by out-of-pocket spending, considerable variation exists in this association ( figure 5A ). For any one level of GDP per capita, a sizeable range of the fraction of domestic health spending is financed by out-of-pocket spending, suggesting that economic development does not solely determine the transition away from household financing. Additionally, large variation exists across countries in the association between rate of change in the fraction of domestic health spending that is out-of-pocket and the rate of change in the proportion of households with catastrophic health expenditure ( figure 5B ). A reliance on domestic government, prepaid, and pooled health financing is a means towards achieving universal health coverage and financial risk protection. Globally, this fraction contributing to universal health coverage ranges from 6·7% (95% UI 4·5–9·1) in Afghanistan to 100% (100–100) in Greenland (for more details see the WHO Global Health Data Exchange).