HEALTH and Wellness Minister Dr Christopher Tufton is adamant that Jamaica is not among the countries the World Health Organization (WHO) is reporting as deprioritising health spending.

“I don’t think we qualify as that country [which has deprioritised health spending] but there are other countries I believe, based on WHO’s assessment, where that may be the case,” Dr Tufton told the Jamaica Observer in response to the WHO report.

Free health care in public institutions is a policy of the current Jamaica Labour Party Administration.

According to the WHO’s 2024 Global Health Expenditure Report, the average per capita government spending on health in all country income groups fell in 2022 from 2021 after a surge in the early COVID-19 pandemic years.

Based on the Observer’s examination of the country’s health spending over the past five years, apart from a slight dip in capital expenditure in the 2021/22 fiscal year, the capital budget for the Ministry of Health and Wellness has steadily risen over the years.

In 2020/21 , funds allocated for capital health projects was $2.93 billion. This dropped to $2.71 billion in 2021/22, a year after the COVID-19 pandemic hit Jamaica. The health ministry’s capital budget then rose to $3.86 billion in 2022/23, $6.43 billion for fiscal year 2023/24, then to $11.53 billion in financial year 2024/25.

The WHO report said that after surging early in the pandemic, aggregate global health spending fell in 2022, to US$ 9.8 trillion, or 9.9 per cent of global gross domestic product (GDP), the first decline in global health spending in real terms since 2000.

Additionally, across all country income groups, except lower-middle income countries, average health spending per capita in 2022 fell in real terms from 2021; and domestic public spending on health per capita declined in all income groups in 2022.

The WHO also noted that in most income groups, this occurred against a backdrop of rising government spending, implying that health’s share of general government spending — a measure of health priority — fell. The exception, it said, was in high income countries where health priority remained close to 2021 levels, but general government spending declined.

Further reacting to the report, Dr Tufton pointed out to the Observer that COVID was a very unusual experience where resources, necessarily, were channelled into public health spending.

“I think, post-COVID, there is a tendency generally to re-look at it. But the truth is that we have not really experienced that here in Jamaica up to this point because I think that there is a general recognition by the government that health requires infrastructural upgrade,” he said.

He noted however that separate from COVID, there is a non-communicable disease (NCD) pandemic globally “but certainly in Jamaica”, that the Government is working to address.

“Lifestyle diseases are creating significant pressure in our system and so if you look at our health systems strengthening programme, it started before COVID, but has continued. If you look at some of the plans to expand in terms of primary health care, some other plans in terms of equipment leasing and so on… and more people through compensation reform, I think Jamaica is on a good trajectory to transform the upgrade of infrastructure. What we have to do now is to get the people to man it and to work with it,” he said.

The minister was referring to the Government’s US$50 million initiative aimed at boosting the country’s capacity to address NCDs and communicable illnesses. It involves upgrading and developing three hospitals and 10 health centres, benefiting around 800,000 Jamaicans.

The programme has as its objectives to ‘improve the health of Jamaica’s population by strengthening comprehensive policies for the prevention of NCD risk factors and for the implementation of a chronic care model with improved access to strengthened and integrated primary and hospital services networks that provide more efficient and higher quality care’.

Speaking at the launch of the programme some years ago, Dr Tufton described it as a big deal which came after three decades of a health system resourced below the WHO recommended six per cent of GDP (though it has been increased to 4.2 per cent over recent years); 30 years without the constructive of a single new hospital; and more than 70 per cent of current hospital equipment and infrastructure being assessed as at the end of life.

Financed through the Inter-American Development Bank and with supporting funds to the tune of Euro 10 million from the European Union, the programme, the minister noted, represented an important departure from business as usual in public health in Jamaica and at the right time.

“It also takes us further along the road to fulfilling the World Health Organisation criteria for a well-functioning health system, which includes not only improving the health status of individuals, families and communities; but also affording protection against the financial consequences of ill-health, as we see with the current free health-care policy; together with the provision of equitable access to people-centred care,” Dr Tufton noted then.