Globally, the report found, only 26 of the 158 countries surveyed were spending the recommended 15% of their budgets on health. “Nigeria, Bahrain and India, (the last of) which is currently experiencing the world’s fastest-growing outbreak of Covid-19, were among the world’s worst performing countries in tackling inequality going into the pandemic,” the Oxfam statement said. The survey data show India spent less than 4% of its budget on health and ranked 155th on the health spending index. “Its health budget is the fourth lowest in the world. Just half of its population have access to even the most essential health services,” the report said.
According to the World Bank database, India was the 13th lowest (among 206 for which data was available) in terms of the percentage of total government expenditure that went to health in 2017. It puts the figure for India at 3.4%. Burundi spent 8.5% of its total government budget on health in the same year. For perspective, the average for high income countries was 18.6%, for lower middle income (the group to which India belongs) 5.1%. Japan spent 23.6% of the government budget on health.
The trend is consistent across South Asia — Pakistan spent just above 4% of its budget on health, Nepal and Bangladesh spent 5%, according to the Oxfam report. “This is particularly damaging when just half of India’s population (55%) has access to even the most essential services, and more than 70% of health spending is being met from household budgets (one of the highest levels in the world). This has left the country woefully ill-prepared to deal with the coronavirus pandemic,” the report said.
For the economic fallout of the pandemic, India was even worse prepared. “India, which has weak labour rights and a high incidence of vulnerable employment (about 75%), is eighth from the bottom,” the report said. India and Haiti are the only countries outside Africa in the bottom 10. In both Bangladesh and Pakistan, 57% of the workers are vulnerable — which takes into account wages, rights, conditions of work. In Nepal, it’s a little higher than India, at 79%.
“Most workers earn less than half of the minimum wage; 71% do not have any written job contract and 54% do not get paid leave. Only about 10% of the workforce in India is formal, with safe working conditions and social security,” the report said.