By Kuda Pembere
At a time when African Governments are seized with the scourge of drug and substance misuse, Zimbabwe included, they are spending less than US$0.10 per capita on mental health, compared to more than US$50 in other regions of the world.
Government expenditure per capita refers to the total government spending divided by the total population, representing the average amount of public money spent per person in a country.
This stark underinvestment was highlighted in the World Mental Health Atlas 2024, released earlier this month by the World Health Organization (WHO).
The report reveals a troubling stagnation in global mental health funding. Median government spending on mental health remains at just 2% of total health budgets—unchanged since 2017. Disparities between countries are significant: while high-income countries spend up to US$65 per person, low-income countries allocate as little as US$0.04. The global median number of mental health workers stands at 13 per 100,000 people, with severe shortages in low- and middle-income countries.
In Africa, mental health receives less than 1% of Gross Domestic Product (GDP), compared to over 4% of total government health expenditure in other regions. The European Region leads in mental health investment, followed by the Americas, Eastern Mediterranean, Western Pacific, and South-East Asia. The African Region ranks lowest.
According to the report, Low-Income Countries (LICs) spend just US$0.05 per capita, with only 0.6% of GDP allocated to mental health. Lower-Middle-Income Countries (LMICs) spend US$0.34 per person, allocating 1% of GDP. In contrast, High-Income Countries (HICs) spend US$65.89 per person, with 4.3% of GDP dedicated to mental health.
Globally, after conversion of all national spending into a common comparable currency, median reported expenditure on mental health was US$2.69, which is similar to that estimated for the Atlas survey in 2017 (US$2.50) but appreciably lower than that reported in the 2020 survey (US$7.49). This is probably due to the lower representation of relatively high-spending countries in the EUR in the current survey,” the report states.
“As in earlier Atlas surveys, public spending differed dramatically according to income group, from less than US$1 in LIC (US$0.04 per capita) and LMIC (US$0.34 per capita) to US$65.89 in HIC. Similarly, median per capita spending varied from US$0.07 in the AFR to US$51.76 in the EUR,” it adds.
“The global median percentage allocated to mental health, as a proportion of total government health expenditure, was 2.1 percent, as in both in 2017 and 2020. By country income group, the proportion ranged from less than or equal to 1.5 percent in LMIC to 4.3 percent in HIC.”
The WHO also noted that 63% of countries reported having a dedicated budget line for mental health.
“Overall government health spending is reported and monitored in an internationally agreed system of health accounting; however, there are few disease-specific sub-accounts for mental health. Therefore, Atlas focal points were requested to provide estimates of mental health spending, both as a total monetary amount and as a percentage of government health expenditure.
“Countries were also asked to report whether there was a dedicated government budget line for mental health. Of 142 countries that responded to this question, 63 percent indicated that there was a budget line, the rates differing modestly by country income (from 44 percent in LIC to 70 percent in HIC).
“Accurate reporting of mental health expenditure is difficult, as it is not always clear what it includes, especially with reference to social care and support services, and there are few good-quality data from non-specialized settings into which mental health services have been integrated, such as primary care.
“This is reflected in the relatively small number of countries (75 of 144) that provided financial data. This low response rate limits the completeness and representativeness of the conclusions,” said the WHO.
WHO calls on governments and global partners to urgently intensify efforts toward systemic transformation of mental health systems worldwide.
