Proportion of expenditure used on health has increased in most of the Asian and Pacific countries since 2000.
Disparities in health conditions between rich and poor countries are strongly related to spending levels. In some countries, however, vaccination services and health facilities are underutilized because parts of the population do not recognize the benefits of medical services. It is therefore necessary not only to increase spending, but also to advocate the use of medical services and take steps to inform the population.
Expenditure on health relative to GDP varies widely in Asia and the Pacific. Pacific islands have some of the highest expenditures on health; such countries as Kiribati, the Marshall Islands, Niue and Tuvalu spend more than 10 per cent of their GDP on health. In contrast, some ASEAN members, such as Myanmar, Indonesia and Brunei Darussalam, have the lowest expenditures in terms of GDP in the region. In Myanmar, total health expenditure accounted for just 2.2 per cent of GDP in 2004.
In the Pacific subregion, health expenditure as a percentage of total government spending increased considerably between 2000 and 2004. Nauru recorded the largest increase in the value of this indicator, which reached almost a third in 2004. Tuvalu also recorded a considerable increase, by close to 10 percentage points, while the Solomon Islands and Niue increased the proportion of the government budget spent on health by 7 and 6 percentage points, respectively.
Least developed countries have some of the highest rates of private spending on health as a percentage of total health expenditure. In Myanmar, 87 per cent of total health expenditures is private, similar to the 83 per cent in Afghanistan. In South and South-West Asia, private expenditure as a percentage of all expenditure on health is over 70 per cent in Bangladesh (also a least developed country) and India and 80 per cent in Pakistan.
In most of the Pacific subregion, on the other hand, private spending as a share of total expenditure on health is below 30 per cent, the 38 per cent of Fiji being the only exception. These levels are similar to those attained by the developed economies of Asia and the Pacific, since in Australia private spending on health is 33 per cent, and in both Japan and New Zealand it is less than 30 per cent.
Generally, private expenditure on health is out-of-pocket spending. For more than two thirds of all countries in the Asian and Pacific region, out-of-pocket expenditure exceeds 80 per cent, which carries significant implications for low-income households, particularly in emergencies or in case of chronic diseases.
Out-of-pocket expenditure is below 50 per cent in only four Asian and Pacific countries, namely Papua New Guinea, the Federated States of Micronesia, Timor-Leste and Tuvalu. In the latter country, out-of-pocket expenditure accounts for 17 per cent of total private health expenditure.
Figure 9.1 Proportion of health expenditure in total government expenditure in Asia and the Pacific, 2000 and 2004
Figure 9.2 Proportion of private health expenditure in total health expenditure in Asia and the Pacific, 2000 and 2004 | 
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