The Financial Burden of Healthcare in Southeast Asia


SEATTLE — In 2012, the World Health Organization (WHO) developed a strategy for implementing universal healthcare in its Southeast Asia region. Since 2014, WHO has made this a regional priority due in part to the financial burden of healthcare in Southeast Asia, which is among the highest in the world.

Healthcare in Southeast Asia

WHO discovered in 2014 that 60 percent of total health expenditure in Southeast Asia was out-of-pocket spending higher than in any of the organization’s regions. According to the same report, healthcare costs played a part in a third of all new cases of poverty among South-East Asians each year.

Data from 2017 and 2018 indicates that, of the 100 million people worldwide who live in extreme poverty due to healthcare costs, at least 65 million are in Southeast Asia. These 65 million are forced to live on less than $2 a day.

Out-Of-Pocket Costs

Although the past decade has seen a slight reduction in out-of-pocket spending in Southeast Asia, it still comprises over 30 percent of total health expenditure in seven of the 11 countries that make up the region. This is well above the 20 percent cutoff, at which point evidence suggests out-of-pocket spending begins to pose a threat to the financial security of a country’s citizens. Data from 2015 showed an average of less than 5 percent of Southeast Asian countries’ GDPs goes toward healthcare.

The cost of medication contributes greatly to the financial burden of healthcare in Southeast Asia. The majority of out-of-pocket payments in this region go toward medication, making the affordability of medicine a primary factor in healthcare-related poverty. For many Southeast Asians, medicine is currently unaffordable and many choose to forego treatment. As a result, it is more difficult for countries in this region to manage disease among their populations.

According to WHO’s 2018 report, communicable diseases such as HIV and tuberculosis remain an issue in Southeast Asia. In addition, the report cites a 2015 estimation that 23.2 percent of 30-year-olds in the region would die of a noncommunicable disease before they reach 70, in comparison to the estimated 18.8 percent of the global population.

Improving Access to Healthcare

Populations across Southeast Asia are aging, meaning that a growing proportion of people in these countries are especially susceptible to disease. Older members of a population are likewise more likely to suffer from multiple health conditions at one time. In 2011, the U.N. declared noncommunicable diseases one of the major impediments to overall social and economic development for the burden that it places on nations and their populations. Medications for this type of disease are the least accessible to many Southeast Asians.

The U.N. and WHO, specifically, continue to work toward improvements in healthcare around the world as a part the Sustainable Development Goals (SDGs) launched in 2015, an initiative to reach worldwide, sustainable development by 2030. This includes protection against financial risk due to healthcare costs. To this end, the accessibility to, and affordability of, medications have been established as an indicator of progress.

In 2014, countries in WHO’s Southeast Asia region committed themselves to improving health workforces from 2015 to 2024. These countries are also currently participating in a WHO initiative to reduce mortality rates due to noncommunicable diseases by 25 percent between 2013 and 2020, relative to the mortality rates of each country when the initiative began in 2013. Increasing the affordability of medications plays a large role in this goal.

Southeast Asia Regulatory Network

In 2016, WHO launched the Southeast Asia Regulatory Network in order to address the five areas most in need of revision and most crucial to progress in healthcare in this region. These five areas include:

  • The quality of medical products
  • Regulatory practices
  • Ensuring the safety of medical products
  • Access to healthcare-related information
  • Medical technology and diagnostics

Thailand serves as an example to other countries in this region, having achieved a sustainable universal healthcare system — despite having a low GDP — when it took its initial steps in 1975. Since 2000, five countries including Thailand have increased their health budget, the other four being Bhutan, Indonesia, Maldives and Myanmar.

Steady Improvement

Healthcare in Southeast Asia has already begun to become more accessible to the region’s most vulnerable populations, who are the most likely to be driven into poverty due to healthcare costs. According to WHO, progress in mitigating the financial burden of healthcare in Southeast Asia is key to fostering the same sort of progress worldwide.

– Ashley Wagner
Photo: Flickr


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