Making the Case for Investment in Health
Overview
Every year, millions of lives are affected by diseases that could have been prevented or treated, leading to not only premature death but also significant disability and suffering. At the same time, poor health exacts a broader toll on sustainable development, intersecting with issues such as poverty, inequalities and economic growth, hindering the achievement of the 2030 Agenda for Sustainable Development. Acknowledging the complexity of our world today, the United Nations Development Programme (UNDP) established the Strategic Plan 2022-2025 to support countries navigate the changing context, overcome dynamic challenges through strategic solutions and advance sustainable development.
To forge a new path forward, UNDP, World Health Organization (WHO) and partners support countries to develop national investment cases for health. Since 2015, UNDP, WHO and partners have collaborated with national governments in 56 countries to develop 85 national investment cases on health issues.
Investment Cases Drive Action
Policymakers in countries around the world are using their UNDP- and WHO-supported investment cases to address health as an accelerator of sustainable development and drive policy change.
UNDP is actively tracking how countries are taking action in line with investment case recommendations and their impact.
After the launch of the 2018 Investment Case for Prevention and Control of NCDs in the Kingdom of Saudi Arabia, the Saudi Food and Drugs Authority initiated the Strategic Plan for Healthy Food.
In Uganda, the country announced a government plan to include access for diabetic retinopathy surgery at all regional hospitals in 2022, in line with the Investment Case for Prevention and Control of NCDs
Following recommendations in the Tobacco Control Investment Case, Ghana passed the Excise Act in 2023, increasing the excise tax on tobacco, as well as on alcohol and sugar-sweetened beverages.
Featured Global Indicators
Countries Making the Case for Investment in Health
Map of countries where 135 investment cases are finished or ongoing
Focus Areas
UNDP- and WHO-supported investment cases address a range of health-related focus areas.
Health Investment Cases
Explore Research on Health Investment Cases
What is a Health Investment Case
The investment cases quantify the toll of poor health – the impact on people’s lives, the strains on the health sector and the ripple effects on the economy – and measure the immense benefits of a stronger approach. In doing so, they make the case for stronger investments and partnerships for health. Investment cases provide countries with the tools and evidence-based data needed to advance policy that reduces inequalities, fosters inclusive governance and supports sustainable systems - in line with the UNDP HIV and Health Strategy 2022-2025.
What
A quantitative analysis of the economic advantages of investing in prevention and control of a certain risk factor or disease. Investment cases are nationally-owned, replicable, tailored, simple, based on local data.
Why
Demonstrate that implementing cost-effective policies will have substantial economic rewards in upcoming years. Provide recommendations on actions, tailored to the country.
For Whom
Generally, for the Ministry of Health to present to the Ministry of Finance. Can be used as an advocacy piece for policymakers.
Investment Case Methodology
There are two main components to the investment cases:
This includes an estimation of the cost of the burden of certain risk factors or diseases, like non-communicable diseases risk factors such as tobacco use and diseases like heart disease or cancer, to the economy and society as a whole. This is followed by an assessment of costs of evidence-based interventions to reduce and prevent these risk factors and diseases and the economic benefits of investing in and implementing them.
Economic Analysis Step-by-Step
- Economic burden analysis. Estimate the cost of the burden associated with a disease or risk factor to the health sector, the economy and society.
- Intervention costing. Estimate the financial costs of implementing the recommended interventions at the target coverage levels.
- Health benefits analysis. Calculate the health benefits of implementing or scaling up interventions in terms of deaths averted, healthy life years gained and changes in prevalence of disease.
- Return-on-investment (ROI) analysis. Calculate the economic benefits of implementing or scaling-up interventions to determine the ROI by comparing intervention costs with the economic benefits.
This identifies the context and situation in the country related to the risk factors or diseases in the investment case and the key political and economic factors in the country that may advance policy action or that may obstruct it. This provides for strategic investment cases recommendations tailored to the country context.
Learn more:
For more details on the methodology of investment cases, please see:
- WHO and UNDP (2019). Non-Communicable Disease Prevention and Control: A Guidance Note for Investment Cases
- WHO and UNDP (2021). Mental Health Investment Cases: A Guidance Note
- Hutchinson, B., Brispat, F., et al. (2022). The case for investment in tobacco control: lessons from four countries in the Americas
Tobacco Control Investment Case
| Context |
|---|
| Total spending on health in country |
| Government total spending on health in country |
| Total spending on NCDs in country |
| Government spending on NCDs in country |
| Burden |
| Percentage of adult population that uses any type of tobacco |
| Percentage of adult population that smokes cigarettes |
Annual number of tobacco-attributable deaths • Percentage of annual tobacco-attributable deaths that are premature |
| Total tobacco-related economic losses over 15 years if no intervention, in USD |
Annual total economic burden of tobacco-related illness, in USD • Annual economic productivity losses from tobacco-related illness, in USD • Annual economic productivity losses per capita, in USD PPP • Annual tobacco-attributable healthcare expenditures, in USD |
| Annual economic burden of tobacco-related illness, as a percentage of GDP |
| Annual economic burden of tobacco-related illness per capita, in USD PPP |
| Annual economic burden of tobacco-related illness per adult smoker, in USD |
| ROI/Impact |
| Total investment required over 15 years for investment case interventions, in USD |
| Return-on-investment over 15 years if all interventions are implemented |
| Decrease in cigarette smoking prevalence over 15 years if all interventions implemented |
Total deaths averted over 15 years from implementation of interventions • Average annual deaths averted from implementation of the modeled interventions • Total deaths averted over 15 years for every USD 10,000 invested |
| Decrease in economic losses from scaling up interventions over 15 years |
Total economic benefits over 15 years from implementing the interventions, in USD • Total economic benefits over 15 years from implementing the interventions per capita, in USD |
Total avoided economic productivity losses from implementing the interventions over 15 years, in USD • Annual avoided economic productivity losses from implementing the interventions, in USD |
NCD Investment Case
| Context |
|---|
Annual NCD deaths, total Annual NCD deaths, per 1000 population Annual NCD deaths, % of all deaths |
| Risk of premature mortality from NCDs |
| Burden |
Annual economic burden of NCDs, in USD Annual economic burden of NCDs, % of GDP Annual economic burden of NCDs per capita, in USD PPP |
Annual health-care costs from NCDs, in USD Annual health-care costs from NCDs per capita, in USD PPP |
Annual government health expenditure on NCDs, in USD Annual healthcare costs from NCDs, % of total NCD burden |
Annual economic productivity losses due to NCDs, % of total NCD burden Annual economic productivity losses due to NCDs, in USD Annual economic productivity losses due to NCDs per capita, in USD PPP |
| ROI/Impact |
Required investment over 15 years, in USD Required investment over 15 years per capita, in USD adjusted by PPP |
Total healthy life-years gained over 15 years from implementation of interventions Total deaths averted over 15 years from implementation of all interventions Total strokes averted over 15 years from implementation of interventions Total ischaemic heart disease averted over 15 years from implementation of interventions |
Total economic benefits over 15 years from implementing all interventions, in USD Total economic benefits over 15 years from implementing all interventions, % of GDP Total economic benefits over 15 years from implementing all interventions per capita, in USD |
Return-on-investment over 15 years from tobacco package Return-on-investment over 15 years from alcohol package Return-on-investment over 15 years from salt package Return-on-investment over 15 years from physical activity package Return-on-investment over 15 years from clinical package |
Recovered economic output from averting deaths and after implementing all interventions over 15 years, Recovered economic output from reducing presenteeism and after implementing all interventions over 15 years, Recovered economic output from reducing absenteeism and after implementing all interventions over 15 years, |
