Intended for healthcare professionals

Reviews Personal views

Reconciling 21st century temptations with 20th century resources and problems

BMJ 2006; 332 doi: (Published 06 April 2006) Cite this as: BMJ 2006;332:861
  1. Marcos Bosi Ferraz, professor and director (
  1. São Paulo Center for Health Economics, Federal University of São Paulo

    Healthcare systems in many developing countries face a major challenge: how to meet the demand for 21st century standards of health care and technology with funds that, as a percentage of gross domestic product (GDP), remain lower than what developed nations were investing in health in the 1980s. And, furthermore, how can developing countries meet such expectations when they are still dealing with health problems that rich countries had overcome 40 or 50 years ago?

    Take my country, for example. In recent years Brazil has been spending some 7-8% of its GDP (both public and private sector investment) on the health sector. Over the past few decades developed nations have been progressively increasing their spending on health. In the 1960s countries such as Canada, France, Switzerland, Australia, Italy, and the United States spent some 4-5% of their GDP on health. By the end of the 1980s this figure had …

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