DESIGN, CONTENT AND FINANCING OF AN ESSENTIAL NATIONAL PACKAGE OF HEALTH-SERVICES

A minimum package of public health and clinical interventions, which a re highly cost-effective and deal with major sources of disease burden , could be provided in low-income countries for about US$ 12 per perso n per year, and in middle-income countries for about $22. Properly del ivered, this package could eliminate 21% to 38% of the burden of prema ture mortality and disability in children under 15 years and 10-18% of the burden in adults. The cost would exceed what governments now spen d on health in the poorest countries but would be easily affordable in middle-income countries. Governments should ensure that, at the least , poor populations have access to these services. Additional public ex penditure should then go either to extending coverage to the non-poor or to expansion beyond the minimum collection of services to an essent ial national package of health care, including somewhat less cost-effe ctive interventions against a larger number of diseases and conditions .