Modeling the effects of health on economic growth

Social and Economic Determinants of Life Expectancy at Birth in Eastern Europe

Life expectancy at birth is considered a parameter of the social development, health system, or economic development of a country. We aimed to investigate the effects of GDP per capita (as the economic factor), health care expenditure, the number of medical doctors (as social factors), and CO2 emissions (as the environmental factor) on life expectancy. We used panel data analysis for 13 Eastern European countries over the 2000-2020 period. After performing the analysis, we used a cross-country fixed-effects panel (GLS with SUR weights). According to our model, a one percent increase in health expenditure (as % of GDP) increases life expectancy at birth by 0.376 years, whereas each additional medical doctor per 10,000 inhabitants increases life expectancy at birth by 0.088 years on average. At the same time, each additional 10,000 USD per capita each year would increase life expectancy at birth by 1.8 years on average. If CO2 emissions increase by 1 metric ton per capita, life expectancy at birth would decrease by 0.24 years, suggesting that higher carbon emissions are capable of reducing longevity. Every European country has to make special efforts to increase the life expectancy of its inhabitants by applying economic and health policies focused on the well-being of the population.

The impact of health on economic growth: A narrative literature review

The nexus between health and economic growth is a dynamic and complex relationship. This article reviews the empirical evidence that has sought to assess the causal impact of health on growth, understood as growth in GDP per capita, and focusing on cross-country and selected single country studies. The review largely provides evidence in favour of a positive effect of population health on economic growth. However, the multitude of the factors at play and the possible bidirectional relationship between health and growth pose a challenge for the quantification of the effect and for the relative importance of the underlying mechanisms. There is notable heterogeneity between studies in the magnitude and, in some cases, even in the sign of the effect. The evidence suggests that the health-growth relationship may depend on three main factors: the sample composition (i.e. a country's demographic stage or GDP per capita); the health dimension considered (e.g. health improvements at different life stages may affect productivity differently); and the model specification (e.g. whether or not initial life expectancy is controlled for in the analysis or the quality of the instrument). These findings advocate for a policy approach that integrates health considerations into economic strategies and emphasizes intersectoral collaboration to maximize the economic returns from improved health outcomes.

Coupling coordination of the provision of medical services and high-quality economic development in the Yangtze River Economic Belt

Background

Promoting high-level coupling coordination between the provision of medical services (PMS) and high-quality economic development (HED) has emerged as a critical issue in China's pursuit of high-quality development and is now a significant subject of concern in the area of welfare economics.

Materials and methods

Based on panel data from 11 provinces and municipalities in the Yangtze River Economic Belt, covering the period from 2010 to 2020, this study conducted an empirical analysis of the coupling coordination between PMS and HED and its influencing factors. Methods combined a comprehensive evaluation model, a coupling coordination model, and a panel Tobit model.

Results

The study found that: (1) Regarding the overall situation in the Yangtze River Economic Belt, the overall PMS demonstrates a fluctuating upward trend, while HED fluctuates within the lower range of 0.3 to 0.4. The coupling coordination degree between PMS and HED fluctuates within the moderate range of 0.5 to 0.6. (2) In terms of the spatiotemporal evolution trends, there still exists substantial spatial disparity among provinces and municipalities within the Yangtze River Economic Belt regarding PMS; nonetheless, this gap is gradually narrowing. Significant regional disparities are also observed in HED, with Shanghai, Jiangsu, and Zhejiang leading among the provinces and municipalities in the Yangtze River Economic Belt. The coupling coordination degree between PMS and HED displays notable spatial discrepancies, where downstream areas of the Yangtze River Economic Belt such as Shanghai, Jiangsu, and Zhejiang exhibit a higher coupling coordination degree compared to other provinces and municipalities. However, most provinces and municipalities outside this group remain at a moderately coordinated stage concerning the degree of coupling coordination between PMS and HED. (3) Economic development level and local government competition had a significant negative impact on coupling coordination between PMS and HED, whereas there was a significantly positive impact on the degree of fiscal autonomy and urbanization.

Discussion

This study contributes to comprehensively understanding the coupling and coordination relationship between the PMS and HED across provinces and municipalities in the Yangtze River Economic Belt. It provides empirical evidence for the collaborative evolution of PMS and HED.

Determinants of life expectancy at birth: a longitudinal study on OECD countries

This paper analyses the influence of several determinants on life expectancy at birth in 36 OECD countries over the 1999-2018 period. We utilized a cross-country fixed-effects multiple regression analysis with year and country dummies and used dynamic models, backward stepwise selection, and Arellano-Bond estimators to treat potential endogeneity issues. The results show the influence of per capita health-care expenditure, incidence of out-of-pocket expenditure, physician density, hospital bed density, social spending, GDP level, participation ratio to labour, prevalence of chronic respiratory diseases, temperature, and total size of the population on life expectancy at birth. In line with previous studies, this analysis confirms the relevance of both health care expenditure and health care system (physicians and hospital beds in our analysis) in influencing a country's population life expectancy. It also outlines the importance of other factors related to population behaviour and social spending jointly considered on this outcome. Policy makers should carefully consider these mutual influences when allocating public funds, particularly after the COVID-19 pandemic period.

The nexus between economic growth, health expenditure, environmental quality: a comparative study for E7 countries

The motivation of this study is to analyze the relationship between economic growth, health expenditures, environmental pollution, gross fixed capital formation and labor force by using annual data of E7 countries for the period 2000 to 2018. The co-integration coefficient of the variables was analyzed using the PMG technique, and the causality relationship between the variables was analyzed using the Emirmahmutoglu F, Kose N. Testing for granger causality in heterogeneous mixed panels. Econ Modell 2011;28:870-6 technique. In the empirical findings, the elasticity coefficient of health expenditures, environmental pollution, gross fixed capital formation and labor force variables is positive and significant. On the other hand, in the results of the causality relationship, it was concluded that economic growth and health expenditures are causal. It is concluded that economic growth is causal to CO₂ emissions. In addition, CO₂ emissions are the cause of health expenditures. As a result of the empirical findings obtained, the implementation of policies that will reduce environmental pollution in the perspective of sustainable growth will also affect health expenditures.

The Impact Mechanism of Household Financial Debt on Physical Health in China

In recent years, Chinese household financial debt has been growing rapidly due to the expansion of mortgage lending. This study aims to examine the impact mechanism of Chinese household financial debt on physical health. Using the 2010-2018 China Household Tracking Survey (CFPS) panel data, we developed fixed effects models to explore the effect of household financial debt on individuals' psychical health, and we also used an instrumental variable to address endogeneity. The findings suggest that there is a negative effect of household financial debt on physical health and these findings still hold after a series of robustness tests. In addition, household financial debt can affect individuals' physical health through mediating variables, such as healthcare behaviors and mental health, and the effects are more significant for those who are middle-aged, married, and with low-income levels. The findings of this paper are important for developing countries to clarify the relationship between household financial debt and population health, and to develop appropriate health intervention policies for highly indebted households.

The influence of gender and wealth inequality on Alzheimer's disease among the elderly: A global study

This study was designed to explore the relationship between Alzheimer's disease (AD) rates and socioeconomic conditions in 120 countries. We used mixed effect models to investigate the relationship between the rates of AD and socioeconomic data. This study is among the first studies to put forward statistical evidence of a significant association between AD and other dementias among the elderly and socioeconomic inequality. These findings could help to inform the policies to be designed to improve the quality of interventions for AD.

Loss-of-learning and the post-Covid recovery in low-income countries

We analyze the medium-term macroeconomic impact of the Covid-19 pandemic and associated lock-down measures on low-income countries. We focus on the impact of the degradation of health and human capital caused by the pandemic and its aftermath, exploring the trade-offs between rebuilding human capital and the recovery of livelihoods and macroeconomic sustainability. A dynamic general equilibrium model is calibrated to reflect the structural characteristics of vulnerable low-income countries and to replicate key dimensions of the Covid-19 shock. We show that absent significant and sustained external financing, the persistence of loss-of-learning effects on labor productivity is likely to make the post-Covid recovery more attenuated and more expensive than many contemporary analysis suggests.

Should we adjust health expenditure for age structure on health systems efficiency? A worldwide analysis

INTRODUCTION

Healthcare expenditure, a common input used in health systems efficiency analyses is affected by population age structure. However, while age structure is usually considered to adjust health system outputs, health expenditure and other inputs are seldom adjusted. We propose methods for adjusting Health Expenditure per Capita (HEpC) for population age structure on health system efficiency analyses and assess the goodness-of-fit, correlation, reliability and disagreement of different approaches.

METHODS

We performed a worldwide (188 countries) cross-sectional study of efficiency in 2015, using a stochastic frontier analysis. As single outputs, healthy life expectancy (HALE) at birth and at 65 years-old were considered in different models. We developed five models using as inputs: (1) HEpC (unadjusted); (2) age-adjusted HEpC; (3) HEpC and the proportion of 0-14, 15-64 and 65 + years-old; (4) HEpC and 5-year age-groups; and (5) HEpC ageing index. Akaike and Bayesian information criteria, Spearman's rank correlation, intraclass correlation coefficient and information-based measure of disagreement were computed.

RESULTS

Models 1 and 2 showed the highest correlation (0.981 and 0.986 for HALE at birth and HALE at 65 years-old, respectively) and reliability (0.986 and 0.988) and the lowest disagreement (0.011 and 0.014). Model 2, with age-adjusted HEpC, presented the lowest information criteria values.

CONCLUSIONS

Despite different models showing good correlation and reliability and low disagreement, there was important variability when age structure is considered that cannot be disregarded. The age-adjusted HE model provided the best goodness-of-fit and was the closest option to the current standard.

The impact of medical infrastructure on regional innovation: An empirical analysis of China's prefecture-level cities

Because of public health emergencies, such as the COVID-19 pandemic, having an optimal medical infrastructure is an important way to maintain the normal operation of society and stimulate vitality in regional innovation. Based on the data on 260 cities at the prefecture level and above in China from 2001 to 2018, this paper investigates the characteristics and mechanisms of medical infrastructure on regional innovation. After a series of regressions, we robustly find that medical infrastructure has a significantly positive impact on regional innovation. In addition, based on the mediating effect model, the mechanism test shows that medical infrastructure can promote regional innovation through the channels of the natural population growth rate, educational level, and the environmental greening level. Finally, considering the urban heterogeneity, we find that the positive impact of medical infrastructure on regional innovation is reflected mainly in eastern and central cities, non-sub-provincial cities, and non-resource-based cities. These conclusions not only enrich the theoretical research on regional innovation from the perspective of medical infrastructure but also shed light on how to better promote regional innovation for China or even other countries.

Advancing global equity in cardiac care as cardiac implantable electronic device reuse comes of age

A nation's health and economic development are inextricably and synergistically connected. Stark differences exist between wealthy and developing nations in the use of cardiac implantable electronic devices (CIEDs). Cardiovascular disease is now the leading cause of death in low- and middle-income countries (LMIC), with a significant burden from rhythm-related diseases. As science, technology, education, and regulatory frameworks have improved, CIED recycling for exportation and reuse in LMIC has become possible and primed for widespread adoption. In our manuscript, we outline the science and regulatory pathways regarding CIED reuse. We propose a pathway to advance this technology that includes creating a task force to establish standards for CIED reuse, leveraging professional organizations in areas of need to foster the professional skills for CIED reuse, collaborating with regulatory agencies to create more efficient regulatory expectations and bring the concept to scale, and establishing a global CIED reuse registry for quality assurance and future science.

Agronomic biofortification of food crops: An emerging opportunity for global food and nutritional security

Fortification of food with mineral micronutrients and micronutrient supplementation occupied the center stage during the two-year-long Corona Pandemic, highlighting the urgent need to focus on micronutrition. Focus has also been intensified on the biofortification (natural assimilation) of mineral micronutrients into food crops using various techniques like agronomic, genetic, or transgenic. Agronomic biofortification is a time-tested method and has been found useful in the fortification of several nutrients in several crops, yet the nutrient use and uptake efficiency of crops has been noted to vary due to different growing conditions like soil type, crop management, fertilizer type, etc. Agronomic biofortification can be an important tool in achieving nutritional security and its importance has recently increased because of climate change related issues, and pandemics such as COVID-19. The introduction of high specialty fertilizers like nano-fertilizers, chelated fertilizers, and water-soluble fertilizers that have high nutrient uptake efficiency and better nutrient translocation to the consumable parts of a crop plant has further improved the effectiveness of agronomic biofortification. Several new agronomic biofortification techniques like nutripriming, foliar application, soilless activation, and mechanized application techniques have further increased the relevance of agronomic biofortification. These new technological advances, along with an increased realization of mineral micronutrient nutrition have reinforced the relevance of agronomic biofortification for global food and nutritional security. The review highlights the advances made in the field of agronomic biofortification via the improved new fertilizer forms, and the emerging techniques that achieve better micronutrient use efficiency of crop plants.

Economic Evaluations of Mindfulness-Based Interventions: a Systematic Review

Objectives

This study includes a systematic review of cost-effectiveness analyses (CEAs) and cost–benefit analyses (CBAs) of mindfulness-based interventions (MBIs).

Methods

A literature search was conducted using PubMed, Web of Science, JSTOR, and CINAHL for studies published between January 1985 and September 2021, including an original cost-related evaluation of an MBI. A qualitative assessment of bias was performed using the Drummond checklist.

Results

Twenty-eight mindfulness-based intervention studies (18 CEAs and 10 CBAs) were included in this review. Mindfulness-based stress reduction (MBSR) was less costly and more effective when compared with the usual care of cognitive behavioral therapy among patients with chronic lower back pain, fibromyalgia, and breast cancer. MBSR among patients with various physical/mental conditions was associated with reductions in healthcare costs. Mindfulness-based cognitive therapy (MBCT) was also less costly and more effective than the comparison group among patients with depression, medically unexplained symptoms, and multiple sclerosis. MBCT’s cost-effectiveness advantage was also identified among breast cancer patients with persistent pain, non-depressed adults with a history of major depressive disorder episodes, adults diagnosed with ADHD, and all cancer patients. From a societal perspective, the cost-saving property of mindfulness training was evident when used as the treatment of aggressive behaviors among persons with intellectual/developmental disabilities in mental health facilities.

Conclusions

Based on this review, more standardized MBI protocols such as MBSR and MBCT compare favorably with usual care in terms of health outcomes and cost-effectiveness. Other MBIs may result in cost savings from both healthcare and societal perspectives among high-risk patient populations.

The Impact of COVID-19 on Economic Growth of Countries: What Role Has Income Inequality in It?

This paper argues that income inequality explains the variation in the economic performance of different countries over the first year of the COVID-19 pandemic. Unlike the conclusions reported by some studies, this study shows that health casualties caused by COVID-19 has had a higher adverse economic impact on countries with lower income inequality. Notwithstanding, the decline in the economic growth as well as the number of casualties caused by COVID-19 were, overall, proportionate to the level of income inequality of the country. Furthermore, the results showed that countries with more dependence on the service sector and countries that implemented more restrictive measures (lockdowns) experienced a higher decline in GDP growth over the first year of the pandemic period. The paper concludes with some important policy implications that support the role of strong institutions in making economies resilient over a period of pandemic.

Constructing a Region DSGE Model with Institutional Features of Territorial Development

The growing importance of regional units in national economies gives rise to the objective need to improve the tools of spatial management. The construction of realistic development scenarios and forecasts is possible on the basis of the DSGE models’ tools. At the same time, models of a similar class that describe socio-economic processes at the level of the regional economy are practically not represented in modern studies. The purpose of the paper is to build a model of the regional economy based on DSGE tools. A feature of the proposed model is the consideration of spatial features through budget expenditures on the digitalization of such areas as healthcare and education. The high importance of these costs became evident during the COVID-19 crisis, when the consequences of underfunding IT costs in education and healthcare led to slowing economic growth. We have allocated health and education expenses in the standard budget limit of the regional government. On the basis of the developed model, response functions for shocks of exogenous variables for 20 periods were built. The result of the simulation is the response functions of endogenous variables in response to the fading growth in the share of spending on human capital in the region, as well as the obtained values of elasticities for a single change in shocks.

Prevalence, causes, and impact of self-reported vision impairment among older people in China: Findings from the China health and retirement longitudinal study

This article investigated the prevalence, causes, and impact of self-reported vision impairment among older people in China. A total of 12,910 participants aged ⩾50 years were included in this study from China Health and Retirement Longitudinal Study (CHARLS) over the periods of 2011, 2013, and 2015. All data were reported by participants via a self-reported questionnaire. Distance vision was assessed by asking if they could see the face of a person on the other side of the street. Near vision was assessed by asking if they could read ordinary newspaper. Depressive symptoms were evaluated by 10-item Center for Epidemiological Studies Depression Scale. The analysis method included the χ2 – square distribution test and multiple regression analysis. This article first found that prevalence of self-reported vision impairment was much higher in rural than in urban areas; in urban areas, females had a greater chance of being affected than males, and for both sexes, it increases with increasing age. Second, some factors found are significantly associated with increased vision impairment rates, include increasing age, female gender, rural residents, elementary-level education, unmarried individuals, and non-agricultural occupations. Third, the leading cause of vision impairment was a refractive error and the most common causes of vision impairment include cataracts and glaucoma. Fourth, vision impairment was significantly associated with falls and depressive symptoms and has a negative effect on the quality of life of older Chinese. The article concluded that older people with self-reported vision impairment were relatively low and it is majorly caused by refractive error. Older people with distance vision impairment and near vision impairment were more likely to report falls and depressive symptoms in the future. In line with these findings, a couple of policy recommendations for further research were made.

Modelling COVID-19 effect on the performance of MENA Health-care sector

Purpose

This study models the effects of the COVID-19 pandemic on the performance of the private health-care sector in the Middle East and North Africa (MENA) countries. This paper aims to address the economic, societal and sustainability of the health-care sector.

Design/methodology/approach

Data were collected from Bloomberg and the sample consists of 534 firm-year observations from 55 firms listed over 2010–2020. The authors apply panel data and control for the country and governance effects.

Findings

The authors found heterogeneous results regarding the three sub-sectors. The pandemic has a negative effect on the accounting and market performances of the “Pharmaceutical companies” and an insignificant impact on “Healthcare Management and Facilities Services.” Moreover, the impact of COVID-19 on health-care firms’ performance depends on the country’s economic classification and the degree of regulatory and governance frameworks.

Research limitations/implications

Further studies may consider a larger sample and other regions. It is recommended to address the health-care sector's challenges to invest in new technologies such as “digital twin” and predictive and personalized medicine. It is worth testing model development theory and its effects on speeding up and designing models to ensure the proper functioning and developing mathematics to determine uncertainties in patient data and model predictions.

Originality/value

To the best of the authors’ knowledge, this paper is novel as it is unique in modeling the impact of COVID-19 on the health-care public companies in the MENA region. The findings pinpoint firms’ and countries’ heterogeneous impacts on financial and market performances.

The effect of health on economic growth: a meta-regression analysis

The main objective of this study is to examine the effect of health on economic growth based on 719 estimates obtained from 64 studies from all over the world. We find evidence of a publication bias towards a positive estimated effect of health on economic growth. After accounting for heterogeneity of the estimates, we show that health has a genuine positive effect on economic growth. Less developed countries seem to enjoy a higher effect of health on growth driven by the ongoing economic-demographic transition in those countries. The variation of the health effect on economic growth is also influenced by the available data, estimation procedure, model specification, publication channel, and country characteristics in each study. Studies that do not account for endogeneity seem to create an upward bias. Studies with more comprehensive variables seem to increase the estimated effect of health on growth. A higher number of years of compulsory education, longer working experience, and more favourable environmental conditions also increase the effect size. Overall, our results confirm the key role of the health factor in explaining economic growth across countries.

Does Public Health Influence Economic Performance? Investigating the Role of Governance and Greener Energies for the Case of China

In the last few decades, the world has faced some natural issues, due to which economic growth faces a severe threat. Natural disasters like pandemic outbreaks and man-made disasters like pollution emissions are very frequent in the current times, which also influenced the economic growth, where the institutes could play a primary role in economic growth stimulation. This study aims to analyze the association of public health expenditures, institutional quality, renewable energy, and economic performance in China. This study uses quarterly data covering the period from 1996Q1 to 2020Q4 and employs various time-series estimating approaches. The Augmented Dickey-Fuller estimates asserted that all the variables are stationary at first difference. Also, the Bayer-Hanck combined cointegration validates that all the variables are cointegrated. Employing the three long-run estimators, i.e., Fully Modified Ordinary Least Square, Dynamic Ordinary Least Square, and canonical cointegrating regression, the results asserted public health expenditures and institutional quality (including government efficiency and political stability) significantly enhances economic performance in China. Whereas two indicators of corruption control and regulatory quality do not play any significant role in promoting the economic performance of China. On the contrary, renewable energy is found negatively associated with economic performance. Also, the Pair-wise Granger causality validates mixed causal associations between the study variables. As a developing and fossil energy-dependent economy, this study provides relevant policy implications for maintaining economic growth and rebalancing economic performance in China.

What threatens stock markets more - The coronavirus or the hype around it?

We use a linear regularized model with structural changes and found that the coronavirus pandemic had a direct and an indirect effect (via media hype) on stock markets. We reveal a correlation between internet search queries, discussions of the pandemic in the press and social media, and changes in stock market indices. We demonstrated that the effect of the pandemic coverage in digital and printed media and the effect of Google queries was comparable to, and sometimes even exceeded, the effect of the pandemic itself. We showed the effect of hype on the volume of Google queries and social media publications.

Are Healthcare Expenditures Related to Economic Growth in China? Bootstrap ARDL Approach

This study attempts to investigate whether healthcare expenditures (HCE) are related to economic growth in China using a newly developed Bootstrap autoregressive distributed lag (ARDL) test for China over the period of 1990–2019. To avoid omitted variable bias, we use the ratio of the population of 65 years old over the total population (aging ratio) as a control variable. Empirical result indicates that no cointegration among these three variables. Granger causality test based on Bootstrap ARDL model demonstrates that one-way Granger causality running from HCE to aging ratio and from economic growth to both HCE and aging ratio. Empirical results have important policy implications for China understudy

The Horrors of COVID-19 and the Recent Macroeconomy in Ethiopia

This review paper is emphasized on COVID-19 and macro-economy like GDP, unemployment, inflation and macro-economic policy in Ethiopia. The COVID-19 pandemic represents an unprecedented global crisis. Even if the spread of COVID-19 is suppressed in Africa, its economic damage will be unavoidable. In spite of the fact that COVID-19 was less expanded during the last 3 months, the Ethiopia economy showed a significant shock and drastically reduced in major macroeconomic variables. A 25-30% drop in exports of goods and services during 2020 is possible.COVID-19 will have a two-fold fiscal impact, pulling in opposite directions. Hence, there is a need to re-bounce back the economy while keeping our peoples safe from the pandemic, COVID-19.

Do Non-Communicable Diseases Influence Sustainable Development in Sub-Saharan Africa? A Panel Autoregressive Distributive Lag (ARDL) Model

The burden of non-communicable diseases (NCDs) in Sub-Saharan Africa has been on the surge during the last two decades. This study examines the relationship between NCDs, measured by disability adjusted life years (DALYs), and sustainable development in Sub-Saharan African (SSA) countries. We adopt a panel Autoregressive Distributed Lag model to evaluate the association between NCDs and sustainability of development, alternately measured by adjusted net savings and gross domestic savings, in 24 SSA countries, from 1990 to 2017. The results show that NCDs adversely affect sustainable development in the long run. The findings demonstrate an urgent need to mitigate the rapidly rising burden of NCDs. We argue that reducing the current trend of NCDs in the sub-region is necessary for countries to be on a sustainable development trajectory.

Impact of pandemic COVID-19 on global economies (a seven-scenario analysis)

Coronavirus (COVID-19) has affected life expectancy and disturbed economic growth. In pursuance of a better understanding of the probable economic consequences, the present research evaluates seven diverse scenarios/situations to anticipate the possible progression of COVID-19 using a global hybrid dynamic stochastic general equilibrium (DSGE)-computable general equilibrium (CGE) general equilibrium model and also investigates the macroeconomic outcomes.

Innovation in Company Labor Productivity Management: Data Science Methods Application

The article considers the challenge of labor productivity growth in a company using objective data about economic, demographic and social factors and subjective information about an employees’ health quality. We propose the technology for labor productivity management based on the phased data processing and modeling of quantitative and qualitative data relations, which intended to provide decision making when planning trajectories for labor productivity growth. The technology is supposed to use statistical analysis and machine learning, to support management decision on planning health-saving strategies directed to increase labor productivity. It is proved that to solve the problem of employees’ clustering and design their homogeneous groups, it is properly to use the k-means method, which is more relevant and reliable compared to the clustering method based on Kohonen neural networks. We also test different methods for employees’ classification and predicting of a new employee labor productivity profile and demonstrate that over problem with a lot of qualitative variables, such as gender, education, health self-estimation the support vector machines method has higher accuracy.

Health system efficiency and democracy: A public choice perspective

Due to increasing demand and scarce financial resources for healthcare, health system efficiency has become a major topic in political and scientific debates. While previous studies investigating determinants of health system efficiency focused primarily on economic and social influence factors, the role of the political regime has been neglected. In addition, there is a lack of formal theoretical work on this specific topic, which ensures transparency and logical consistency of arguments and implications. Using a public choice approach, this paper provides a rigorous theoretical and empirical investigation of the relationships between health system efficiency and political institutions. We develop a simple principal-agent model describing the behavior of a government with respect to investments in population health under different political regimes. The main implication of the theoretical model is that governments under more democratic regimes put more effort in reducing embezzlement of health expenditure than non-democratic regimes. Accordingly, democratic countries are predicted to have more efficient health systems than non-democratic countries. We test this hypothesis based on a broad dataset including 158 countries over the period 1995-2015. The empirical results clearly support the implications of the theoretical model and withstand several robustness checks, including the use of alternative indicators for population health and democracy and estimations accounting for endogeneity. The empirical results also indicate that the effect of democracy on health system efficiency is more pronounced in countries with higher income levels. From a policy perspective, we discuss the implications of our findings in the context of health development assistance.

The Impact of COVID-19 and Its Policy Responses on Local Economy and Health Conditions

US states have implemented lockdown measures to contain the COVID-19 pandemic. We assess the impact of state policy responses on local economic and health conditions, with the goal to shed light on marginal health benefits and economic costs associated with social distancing. We find that lockdown measures are effective in alleviating disease severity, but yield significant contraction of the economy. Deteriorating health conditions are disruptive to the labor supply, financial health, and economic output. The adverse economic impact of lockdowns exceeds the economic damage brought by the disease itself, but health conditions better forecast economic contraction outcomes.

Regional Development in Romania: Empirical Evidence Regarding the Factors for Measuring a Prosperous and Sustainable Economy

The present study aims to present, evaluate and identify the factors required to measure the prosperity and sustainability of Romania’s economy over the specific period 2000–2020 in light of sustainable regional development assessments, and examines how the main factors—as considered by the authors—may be integrated into regional development policies. The focus throughout the study is on the need to permanently support the development of Romanian regions in direct relation to the sustainable indicators presented within the model—through the use of data from empirical analysis—which are measures of Romania’s economic prosperity and long-term economic growth. Therefore, the study intends to assess the progress of each region of the country, showing the evolution and selection of factors that are related to sustainability, namely, child survival, poverty and education, with implications for regional development strategies and local initiatives that must promote wider sustainable regional development. Furthermore, the aim of the study is to analyse the influence of sustainable inflows on economic prosperity, reflected in the Gross Domestic Product (GDP) per capita for each region in Romania, considering factors related to sustainability and the major differences between the regions, depending on the effectiveness of these public policy applications. With this approach, our goal—considering all the macroregions of the country—is to emphasize the significance of two main aims in sustainable regional development: a better allocation of the means which actively aim to decrease the unemployment rate and a better infrastructure for public services. National, regional and local administrations play important roles in promoting coherent sustainability in economic, social and environmental activities. Regardless of the level at which development policies are devised—local, county or regional—they must take into consideration and monitor the determinants of sustainable development in cases where development is the ultimate goal.

Has the COVID-19 Pandemic Affected Maritime Connectivity? An Estimation for China and the Polar Silk Road Countries

In light of about 80% of international freight traffic carried by sea, maritime supply chains’ stability is pivotal to global connectivity. For over a year now, the transboundary mobility of vessels and cargoes has been restricted by diverse forms of the COVID-19 containment measures applied by national governments, while the lockdowns of people, businesses, and economic activities have significantly affected the growth prospects of various maritime connectivity initiatives. This study investigates how the pandemic-related public health, trade, and market factors have shifted the connectivity patterns in the Polar Silk Road (PSR) transport corridor between China, South Korea, Japan, Russia, and four economies of Northern Europe. The causality links between the Shipping Connectivity Index (SCI) and the number of COVID-19 cases and deaths, trade volumes with China and the rest of the world, and price indexes of minerals, fuels, food, and agricultural products are revealed separately for eight countries and thirty-five ports. The study algorithm is built on the consecutive application of the Augmented Dickey-Fuller (ADF) and the Phillips-Perron (PP) stationarity tests, the Autoregressive Distributed Lag (ARDL) method, the Fully-Modified Ordinary Least Squares (FMOLS) and the Dynamic Ordinary Least Squares (DOLS) robustness checks, and the Toda-Yamamoto causality test. Tight trade-connectivity links are recorded in all locations along the China-PSR transport corridor in 2015–2019, but in 2020, the relationships weakened. Bidirectional influences between the number of COVID-19 cases and connectivity parameters demonstrate the maritime sector’s sensitivity to safety regulations and bring into focus the role of cargo shipping in the transboundary spread of the virus. The authors’ four-stage approach contributes to the establishment of a methodology framework that may equip stakeholders with insights about potential risks to maritime connectivity in the China-PSR maritime trade in the course of the pandemic.

Generalized Trust and Economic Growth: The Nexus in MENA Countries

This study mainly examines the relationship between generalized/horizontal/social trust and economic growth in countries in the Middle East and North Africa (MENA) region, considering the substantial decline in their trust values since 2005. The study utilizes a multiple linear regression model based on panel data comprising 104 countries over the period from 1999 to 2020. Trust data were obtained from the last four waves of the World Values Survey (WVS). A Pooled Ordinary Least Squares (POLS) estimation technique was used, and interaction terms between trust and several dummy variables were employed. The results show an overall positive and significant relationship between trust and economic growth in the general model and for all country classifications, except for MENA, where the overall relationship is negative but almost negligible. Trust has the highest impact on growth in transition economies, followed in order by developing Asia, developed, developing/Sub-Saharan Africa, developing America, and then MENA countries. Further investigations reveal that the overall negative/reversed effect of trust on economic growth in MENA is only during waves 6 and 7, where the coefficients are sizable.

Cost analysis of dengue from a State in south India

Background & objectives:

Improved dengue cost estimates offer the potential to provide a baseline measure to determine the cost-effectiveness of interventions. The objective of this study was to estimate the cost of dengue prevention, treatment and fatalities in Kerala, India, over a period of one year.

Methods:

The study was done in Kerala, a southern State in India. Costing of treatment was done from a family perspective. It was found by primary data collection in a sample of 83 dengue patients from Thiruvananthapuram district and estimated for Kerala using the reported number of cases in 2016. Costing of prevention was done from the government perspective for the entire State. In-depth interviews with State programme officers and experts in the field were conducted. The present value of lifetime earnings was used to value lives.

Results:

The cost of treatment of dengue in the State was ₹137 milion (2.16 million US$). The cost of prevention in the State was ₹535 million (8.3 million US$). The cost of fatalities was the highest among costs at ₹1760 million (27.7 million US$). US$ 38 million was the least possible estimate of total cost of dengue. The total out-of-pocket spending (OOPS) of >60 yr was significantly (P<0.05) higher than other age groups. The total OOPS was significantly (P<0.001) higher in private sector compared to public.

Interpretation & conclusions:

Although deaths due to dengue were few, the cost of fatalities was 12 times more than the cost of treatment and three times the cost of prevention. Focusing on mortality reduction and disease prevention in elderly would be beneficial.

Perspectives Measuring more than just economic growth to improve well-being

It's official: The UK is in a recession. The economy has suffered its biggest slump on record with a drop in gross domestic product (GDP) of 20.4%. 1 This is going to have a significant impact on our health and well-being. It risks creating a spiralling decay as we know good health is not only a consequence, but also a condition for sustained and sustainable economic development. 2 In this way, the health of a nation creates a virtuous circle of improved health and improved economic prosperity. How we measure prosperity is therefore important and needs to be considered.

The macroeconomic effects of COVID-19 in Montenegro: a Bayesian VARX approach

This study examines, diagnoses, and assesses appropriate macroeconomic policy responses of the Montenegrin Government to the outbreak of COVID-19. The model econometrically measures the macroeconomic costs using a Bayesian VARX Litterman/Minessota prior to the pandemic disease in terms of demand and supply loss due to illness and closed activities and their effects on GDP growth in various pandemic scenarios. We explore five economic scenarios-shocks-using the available data from January 2006 to December 2019, following real out-of-sample forecasts generated from January 2020 to December 2020. Sensitivity scenarios spanning January 2020 to June 2020 from ± 10 to ± 60% were analyzed. We observed what happens to the supply and demand sides, namely, GDP, tourism, capital stock, human capital, health expenditures, economic freedom, and unemployment. The results show a toll on the GDP, tourism, unemployment, capital stock, and especially human capital for 2020. The recommended policy measures are public finance spending initiatives focused on securing employment and keeping highly qualified staff in Montenegrin companies. Considering all uncertainties, the rebound of the Montenegrin economy could take a few years to reach pre-COVID 19 output levels.

The implications of Neoliberalism on African economies, health outcomes and wellbeing: a conceptual argument

Not only did the 2015 Ebola Outbreak in West African countries leave the whole of the sub-Saharan region with a sense of uncertainty and panic, it was also a stress test to Africa's and the wider world's capacity to respond to and mitigate humanitarian crises in the twenty-first century. One plausible conclusion drawn from the spread and impact of the pandemic is that the pace of health infrastructure development in sub-Saharan Africa has lagged behind its population and economic growth posted in the last decade (2003-2013). An exhaustive audit of health infrastructure and remedial measures is, therefore, critical in navigating Africa to sustainable growth and development in the next decade. For the next charge of growth and development to not only be robust but also more sustainable and resilient to major emergencies (such as Ebola), there is a need to edify the state of healthcare across the continent to ensure the optimisation of the human resource and to redress the gap aggravated by loss of human-hours due to poor health.

Healthcare Expenditure and Economic Performance: Insights From the United States Data

This research explores the association of public health expenditure with economic performance across the United States. Healthcare expenditure can result in better provision of health opportunities, which can strengthen human capital and improve the productivity, thereby contributing to economic performance. It is therefore important to assess the phenomenon of healthcare spending in a country. Using visual analytics, we collected economic and health data from the Bureau of Economic Analysis and the Bureau of Labor Statistics for the years 2003-2014. The overall results strongly suggest a positive correlation between healthcare expenditure and the economic indicators of income, GDP, and labor productivity. While healthcare expenditure is negatively associated with multi-factor productivity, it is positively associated with the indicators of labor productivity, personal spending, and GDP. The study shows that an increase in healthcare expenditure has a positive relationship with economic performance. There are also variations across states that justify further research. Building on this and prior research, policy implications include that the good health of citizens indeed results in overall better economy. Therefore, investing carefully in various healthcare aspects would boost income, GDP, and productivity, and alleviate poverty. In light of these potential benefits, universal access to healthcare is something that warrants further research. Also, research can be done in countries with single-payer systems to see if a link to productivity exists there. The results support arguments against our current healthcare system's structure in a limited way.

The Economic Burden of Malaria: Revisiting the Evidence

A portion of the economics literature has long debated about the relative importance of historical, institutional, geographical, and health determinants of economic growth. In 2001, Gallup and Sachs quantified the association between malaria and the level and growth of per capita income over the period 1965–1995 in a cross-country regression framework. We took a contemporary look at Gallup and Sachs’ seminal work in the context of significant progress in malaria control achieved globally since 2000. Focusing on the period 2000–2017, we used the latest data available on malaria case incidence and other determinants of economic growth, as well as macro-econometric methods that are now the professional norm. In our preferred specification using a fixed-effects model, a 10% decrease in malaria incidence was associated with an increase in income per capita of nearly 0.3% on average and a 0.11 percentage point faster per capita growth per annum. Greater average income gains were expected among higher burden countries and those with lower income. Growth of industries with the same level of labor intensity was found to be significantly slower in countries with higher malaria incidence. To analyze the causal impact of malaria on economic outcomes, we used malaria treatment failure and pyrethroid-only insecticide resistance as exogeneous instruments in two-stage least squares estimations. Despite several methodological challenges, as expected in these types of analyses, our findings confirm the intrinsic link between malaria and economic growth and underscore the importance of malaria control in the agenda for sustainable development.

Will the Economic Recession Inhibit the Out-of-Pocket Payment Willingness for Health Care?

We used an individual regression and panel data regression method to analyze the samples of 60 countries from 2000 to 2016 to study the impact of the economic recession on residents’ out-of-pocket payment willingness for health care. Although we found an increase in the willingness during the economic recession in most countries, we couldn’t find significant evidence of a positive relationship between the economic recession and such willingness. We discovered that the relationship differentiates in different countries, which mainly depends on the differences in the medical systems and degree of economic development. By controlling individual differences in countries, we found that the economic recession inhibited the out-of-pocket payment willingness for health care. Especially after the impact of the financial crisis in 2008, the cumulative effect of the economic recession and the aftershock of financial crisis was discovered, which significantly inhibited residents’ willingness. In addition, we verified that the economic recession inhibited the out-of-pocket payment willingness by reducing employee compensation in specific types of countries.

Pattern and correlates of out-of-pocket payment (OOP) on female sterilization in India, 1990-2014

Background

Large scale public investment in family welfare programme has made female sterilization a free service in public health centers in India. Besides, it also provides financial compensation to acceptors. Despite these interventions, the use of contraception from private health centers has increased over time, across states and socio-economic groups in India. Though many studies have examined trends, patterns, and determinants of female sterilization services, studies on out-of-pocket payment (OOP) and compensations on sterilisation are limited in India. This paper examines the trends and variations in out-of-pocket payment (OOP) and compensations associated with female sterilization in India.

Methods

Data from the National Family Health Survey - 4, 2015–16 was used for the analyses. A composite variable based on compensation received and amount paid by users was computed and categorized into four distinct groups. Multivariate analyses were used to understand the significant predictors of OOP of female sterilization.

Results

Public health centers continued to be the major providers of female sterilization services; nearly 77.8% had availed themselves of free sterilization and 61.6% had received compensation for female sterilization. About two-fifths of the women in the economically well-off state like Kerala and one-third of the women in a poor state like Bihar had paid but did not receive any compensation for female sterilization. The OOP on female sterilization varies from 70 to 79% across India. The OOP on female sterilization was significantly higher among the educated and women belonging to the higher wealth quintile linking OOP to ability to pay for better quality of care.

Conclusion

Public sector investment in family planning is required to provide free or subsidized provision of family welfare services, especially to women from a poor household. Improving the quality of female sterilization services in public health centers and rationalizing the compensation may extend the reach of family planning services in India.

Measuring and correcting bias in indirect estimates of under-5 mortality in populations affected by HIV/AIDS: a simulation study

BACKGROUND

In populations that lack vital registration systems, under-5 mortality (U5M) is commonly estimated using survey-based approaches, including indirect methods. One assumption of indirect methods is that a mother's survival and her children's survival are not correlated, but in populations affected by HIV/AIDS this assumption is violated, and thus indirect estimates are biased. Our goal was to estimate the magnitude of the bias, and to create a predictive model to correct it.

METHODS

We used an individual-level, discrete time-step simulation model to measure how the bias in indirect estimates of U5M changes under various fertility rates, mortality rates, HIV/AIDS rates, and levels of antiretroviral therapy. We simulated 4480 populations in total and measured the amount of bias in U5M due to HIV/AIDS. We also developed a generalized linear model via penalized maximum likelihood to correct this bias.

RESULTS

We found that indirect methods can underestimate U5M by 0-41% in populations with HIV prevalence of 0-40%. Applying our model to 2010 survey data from Malawi and Tanzania, we show that indirect methods would underestimate U5M by up to 7.7% in those countries at that time. Our best fitting model to correct bias in U5M had a root median square error of 0.0012.

CONCLUSIONS

Indirect estimates of U5M can be significantly biased in populations affected by HIV/AIDS. Our predictive model allows scholars and practitioners to correct that bias using commonly measured population characteristics. Policies and programs based on indirect estimates of U5M in populations with generalized HIV epidemics may need to be reevaluated after accounting for estimation bias.

How does body mass index affect economic growth? A comparative analysis of countries by levels of economic development

The WHO views obesity as a significant risk to population health. Evidence suggests that obesity reduces labor-market attachment, worker productivity, and earnings. This link at the micro level may translate into adverse effects on economic growth at the macro level. Few studies have evaluated how body mass index impacts economic growth across and within countries. This sparse evidence base reflects the lack of consistent data across a broad spectrum of countries and timespan, as well as the empirical difficulties in bypassing endogeneity bias relating to unobserved selection and potential reverse causality between bodyweight and GDP. We address both of these challenges by first assembling a comprehensive panel of data spanning 116 countries over 25 years (1984-2008), and then presenting, to the best of our knowledge, the first empirical study of economic growth and obesiy correcting for endogeneity. Our GMM estimates indicate that, in developed countries, a higher level of BMI has direct negative effects on economic growth in a fully saturated model that controls for levels of human capital. In particular, we predict that the increase in BMI over the time period of analysis may have reduced potential economic growth over this period by between 3.5-5.8 percentage points.

Economic development and health outcomes: Evidence from cardiovascular disease mortality in Europe

The impact of economic growth on health outcomes has generated various conflicting results in recent years, particularly with the emergence of cardiovascular disease as one of the most salient global health issues. This paper looks at the relationship between economic development and health outcomes. We first estimate an empirical model using data on annual cardiovascular disease mortality in a panel of 27 European countries, over the period 2003 to 2014, together with per capita GDP levels in each country. We also include a number of additional determinants of health outcomes as prescribed by the literature, including various socio-economic, lifestyle and contextual variables. The results show that there is a statistically-significant inverted U-shaped relationship, whereby as income increases mortality rates first rise, before declining at subsequent levels of development. This trajectory persists even after the inclusion of the other determinants of health, as well as other robustness checks. We then seek to explain the persistence of the inverted U-shaped income-mortality relationship using a microeconomic model of consumer choice, with our findings suggesting that this relationship is consistent with a scenario of increasing returns to scale from healthcare investment. The results emphasise the importance of investment in the latest healthcare technologies and continued improvements to public healthcare systems, particularly within developing countries, in conjunction with efforts to boost economic growth.

Pharmaceutical expenditure and gross domestic product: Evidence of simultaneous effects using a two-step instrumental variables strategy

This paper estimates the income elasticity of government pharmaceutical spending and assesses the simultaneous effect of such spending on gross domestic product (GDP). Using a panel dataset for 136 countries from 1995 to 2006, we employ a two-step instrumental variable procedure where we first estimate the effect of GDP on public pharmaceutical expenditure using tourist receipts as an instrument for GDP. In the second step, we construct an adjusted pharmaceutical expenditure series where the response of public pharmaceutical expenditure to GDP is partialled out and use this endogeneity adjusted series as an instrument for pharmaceutical expenditure. Our estimations show that GDP has a strong positive impact on pharmaceutical spending with elasticity in excess of unity in countries with low spending on pharmaceuticals and countries with large economic freedom. In the second step, we find that when the quantitatively large reverse effect of GDP is accounted for, public pharmaceutical spending has a negative effect on GDP per capita particularly in countries with limited economic freedom.

Wealth and health revisited: Economic growth and wellbeing in developing countries, 1970 to 2015

Is wealthier always healthier, or are the health effects of economic growth trivial, irregular, or perhaps even detrimental? Using data for up to 134 developing countries between 1970 and 2015, this article revisits the effect of economic growth on health, focusing on infant mortality, life expectancy, and caloric consumption. The analysis enlarges the geographical and temporal scope of previous samples and attempts to isolate the causal effects of growth using two-stage models with instrumental variables. Results show that five-year economic growth rates improve all three health outcomes, even after controlling for other important determinants and accounting for the possibility of reverse causality. Growth effects are largest for infant mortality rates. Nevertheless, there are diminishing returns to economic growth as a function of economic development: as countries become more affluent, the benefits of growth for health diminish.

Health and economic growth: Evidence from dynamic panel data of 143 years

This paper re-examines health-growth relationship using an unbalanced panel of 17 advanced economies for the period 1870-2013 and employs panel generalised method of moments estimator that takes care of endogeneity issues, which arise due to reverse causality. We utilise macroeconomic data corresponding to inflation, government expenditure, trade and schooling in sample countries that takes care of omitted variable bias in growth regression. With alternate model specifications, we show that population health proxied by life expectancy exert a positive and significant effect on both real income per capita as well as growth. Our results are in conformity with the existing empirical evidence on the relationship between health and economic growth, they, however, are more robust due to the presence of long-term data, appropriate econometric procedure and alternate model specifications. We also show a strong role of endogeneity in driving standard results in growth empirics. In addition to life expectancy, other constituent of human capital, education proxied by schooling is also positively associated with real per capita income. Policy implication that follows from this paper is that per capita income can be boosted through focussed policy attention on population health. The results, however, posit differing policy implications for advanced and developing economies.

Modeling and Forecasting Mortality With Economic Growth: A Multipopulation Approach

Research on mortality modeling of multiple populations focuses mainly on extrapolating past mortality trends and summarizing these trends by one or more common latent factors. This article proposes a multipopulation stochastic mortality model that uses the explanatory power of economic growth. In particular, we extend the Li and Lee model (Li and Lee 2005) by including economic growth, represented by the real gross domestic product (GDP) per capita, to capture the common mortality trend for a group of populations with similar socioeconomic conditions. We find that our proposed model provides a better in-sample fit and an out-of-sample forecast performance. Moreover, it generates lower (higher) forecasted period life expectancy for countries with high (low) GDP per capita than the Li and Lee model.

Uncovering the hidden impacts of inequality on mental health: a global study

Women are nearly twice as likely as men to suffer from mental illness. This gender disparity in depressive disorders may relate to social inequalities and living standards across nations. Currently, these disparities were not reflected at the level of health policies. This study utilized global data for depressive disorders and socioeconomic data from the United Nations' World Bank databases and Global Burden of Disease database to demonstrate the correlation between social inequality and gender disparities in mental health. This study investigated the association among the ratio of female to male depressive disorder rates, gross domestic product, the GINI Index, and the gender inequality index for 122 countries. The research yielded some major findings. First, there exists a significant correlation between gender inequality and gender disparities in mental health. Second, the GINI index is significantly associated with male-but not female-depressive disorder rates. Third, gender disparities in depressive disorders are associated with a country's wealth. These findings can help to inform society, policy-makers, and clinicians to improve the overall health level globally.

The economic consequences of neurosurgical disease in low- and middle-income countries

OBJECTIVEThe objective of this study was to estimate the economic consequences of neurosurgical disease in low- and middle-income countries (LMICs).METHODSThe authors estimated gross domestic product (GDP) losses and the broader welfare losses attributable to 5 neurosurgical disease categories in LMICs using two distinct economic models. The value of lost output (VLO) model projects annual GDP losses due to neurosurgical disease during 2015-2030, and is based on the WHO's "Projecting the Economic Cost of Ill-health" tool. The value of lost economic welfare (VLW) model estimates total welfare losses, which is based on the value of a statistical life and includes nonmarket losses such as the inherent value placed on good health, resulting from neurosurgical disease in 2015 alone.RESULTSThe VLO model estimates the selected neurosurgical diseases will result in $4.4 trillion (2013 US dollars, purchasing power parity) in GDP losses during 2015-2030 in the 90 included LMICs. Economic losses are projected to disproportionately affect low- and lower-middle-income countries, risking up to a 0.6% and 0.54% loss of GDP, respectively, in 2030. The VLW model evaluated 127 LMICs, and estimates that these countries experienced $3 trillion (2013 US dollars, purchasing power parity) in economic welfare losses in 2015. Regardless of the model used, the majority of the losses can be attributed to stroke and traumatic brain injury.CONCLUSIONSThe economic impact of neurosurgical diseases in LMICs is significant. The magnitude of economic losses due to neurosurgical diseases in LMICs provides further motivation beyond already compelling humanitarian reasons for action.

Public Health Care Financing and the Costs of Cancer Care: A Cross-National Analysis

Expenditure and financing aspects in the healthcare system in general, and in cancer care in particular, are subjects of increasing concern to the medical community. Nowadays, it is imperative for the healthcare system to respond to the challenge of universal access to quality healthcare, by measuring the financial resources within the healthcare sector. The purpose of this review is to highlight the major gaps in the healthcare expenditures for all types of care, as well as on cancer and anti-cancer drugs across 28 European Union member states. The indicators taken into account are divided into two major groups: (1) healthcare expenditures for all types of care, and (2) healthcare expenditures on cancer and anti-cancer drugs. The programs used for our analysis are SPSS Statistics V20.0 (IBM Corporation, Armonk, NY, USA) and Stat World Explorer. The overall picture confirms that there are considerable disparities between the 28 countries in relation to their expenditures on health. The trend in public expenditures for all types of care, compared to the share of healthcare expenditures as a percentage of the GDP, shows the increase of health expenses between 2010 and 2014, but a lower rise compared to the total GDP increase. Healthcare expenditure on cancer (%THE) is rather low, despite the high cost associated with anti-cancer drugs. New treatments and drugs development will be increasingly difficult to achieve if the share devoted to cancer does not increase, and the lack of funds may act as a barrier in receiving high-quality care.