Sixty-four countries spend more on debt payments than health

  • New figures from Jubilee Debt Campaign show extent to which poor country health spending is overshadowed by debt payments
  • IMF and World Bank meetings this week will discuss possible debt relief in response to Covid-19

New analysis released by Jubilee Debt Campaign today shows that 64 lower income governments spend more on external debt payments than they spend on healthcare. Countries with the widest disparities between debt payments and health spending include Gambia, Ghana, Zambia, Laos, Lebanon and Pakistan.

The figures have been released as governments convene virtually for the IMF and World Bank Spring Meetings. Jubilee Debt Campaign has been joined by over 200 other organisations in calling for debt payments to be cancelled this year, so that poorer countries have more money to spend on healthcare and social protection in the face of the Covid-19 crisis.

Sarah-Jayne Clifton, Director of Jubilee Debt Campaign, said:

“In the face of a medical emergency the scale of Covid19, it is indefensible that poor countries are having to spend more money on debt payments than on healthcare. Before this crisis hit, 64 poorer countries were already spending more on external debt payments than on their public health systems.

“We need urgent action by the international community to cancel developing country 2020 debt payments. This is the fastest way to help provide the financing that is desperately needed to shore up public health systems in the face of this unprecedented global crisis.”

The 121 low- and middle-income governments for which there are figures spent an average of 10.7% of government revenue on public health systems, compared to 12.2% on external debt payments in 2019.[1] This was before the economic shock of Covid-19 which has led to falls in commodity prices, the main export income for many countries, huge capital flight, an increase in future borrowing costs, and loss of income in other ways such as remittances from diaspora workers.

The ten countries with the biggest difference between the proportion of government revenue spent on healthcare and external debt payments are Angola, Sri Lanka, Gambia, Republic of Congo, Ghana, Zambia, Laos, Lebanon, Pakistan and Cameroon. These ten all spent over 20% of government revenue on external debt payments in 2019.

Government spending on health as % of government revenue (2019) Government external debt service as % of government revenue (2019) Percentage points more spent on external debt service than health, as % of government revenue
Angola 6.4 42.6 36.2
Sri Lanka 13.0 47.6 34.6
Gambia 4.1 38.0 33.9
Congo, R 6.2 37.3 31.1
Ghana 10.8 39.1 28.3
Zambia 8.8 32.6 23.8
Laos 4.9 27.9 23.0
Lebanon 19.5 41.2 21.7
Pakistan 6.0 26.5 20.5
Cameroon 3.9 23.8 19.9

In 2020 the 76 IDA countries, a World Bank grouping of many of the world’s most impoverished countries, are due to spend at least $18.1 billion on debt payments to other governments, $12.4 billion to multilateral institutions and $10.1 billion to external private creditors.

For the full list of government spending on healthcare and external debt payments, see here.

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