Page 268 - GHES-3-3

Global Health Economics and
Sustainability
Sustainability of Rwanda’s UHC: 2011–2021 and vision 2050

d. Analysis of funding challenges (World Bank, 2020), it is noteworthy that Rwanda’s health-

Rwanda’s per capita health expenditure in 2024/2025 is care system, with a score of 58.2, already exceeds the global
predicted to be USD 81.17, far below the required levels average health care score of 54 (Wisevoter, 2023). This
for both the UMIC and HIC targets. Achieving the UMIC is a notable record despite Rwanda operating at a lower
standard by 2035 would take about 22.65 years instead of expenditure level.
11 years from the 2024/2025 base year, and achieving the This study predicts that if Rwanda’s health expenditure
HIC standard would require about 49.14 years instead of per capita reaches Thailand’s current level of USD 305.09,
25 years. To bridge the gap, Rwanda would need to mobilize its health-care system will surpass the current UMIC’s
significantly more funds. For example, to meet the UMIC health-care system standards and may even exceed those
standard, an additional USD 149.83 per capita is required, of some current HICs health-care system standards,
and to meet the HIC standard, an additional USD 569.83 as Thailand achieved in 2020. Therefore, a feasible
per capita is needed. This gap is beyond Rwanda’s current approach involves using Thailand’s health-care system as
financial reach. a benchmark under normal circumstances, applying the
e. Home-grown resources health expenditure per capita as a key metric. Indeed, under
normal conditions and based on the current predicted per
This paper highlights the importance of Rwanda leveraging capita health expenditure of USD 81.17 (up from USD
its tangible resources (men, money, and material) and 57.5 in 2020, with an AGR of 9%), Rwanda would need
intangible resources (methods, research, and innovations) to approximately 15/16 years (ln [305.09/81.17]/0.09) to
address the challenges of financing health care. Given that reach Thailand’s current health-care system standard, i.e.,
external aid is declining, particularly following the COVID- by 2040/2041.
19 pandemic and global inflation, Rwanda must rely on
internal resources to meet the ambitious HRV 2050 goals. g. Feasibility assessment of achieving Rwanda’s UHC
model and HRV 2050 targets with the CBHI system
f. Performance comparisons among global, Thailand,
and Rwanda Rwanda faces challenges in achieving high-quality
health-care and meeting the HRV 2050 targets.
Rwanda has made significant progress in the health Transitioning from an FFS model to a sustainable FASP
sector, moving from a per capita GDP of USD 255 in 2000 PPM model, leveraging internal resources, and reinforcing
to USD 826.39 (World Bank, 2020) in 2020, USD 896.27 in the CBHI system through a compulsory “minimum 1%
2021, USD 948.38 in 2022, and USD 1,004 in 2023 (World specific tax for UHC and HRV 2050” will be critical to
Bank, 2023), see The country ranked 70 globally for driving progress. Key outcomes and impacts include:
th
health-care system performance in 2023. (i) Overcoming delays from COVID-19 and global
Interestingly, Thailand, with a per capita GDP of USD inflation
7,067 and health expenditure per capita of USD 305.09, (ii) Rwanda’s UHC model meeting WHO’s UHC CUBE
has achieved impressive health-care outcomes, ranking and SDG Target 3.8 (UHC index) by 2030/2031
13 globally, higher than several HICs: (iii) Near-free health care at public and faith-based
th
• Norway (15 ), per capita GDP USD 89,242 and health services
th
expenditure USD 9,020 (2020) (iv) Maintaining individual premiums (RWF 3,000 –
• New Zealand (16 ), per capita GDP USD 48,824 and 7,000) until 2040/2041
th
health expenditure USD 4,201.68 (2020) (v) Revised milestones for 2040/2041, ahead of the
• Germany (17 ), per capita GDP USD 51,073 and 2050 target
th
health expenditure USD 5,503.36 (2020) (vi) Achieved the HRV 2050 targets 10 years ahead of
• Switzerland (18 ), per capita GDP USD 93,525 and schedule
th
health expenditure USD 10,309.76 (2020) (vii) Improved welfare and health status
• United States (30 ), per capita GDP USD 63,530.63 (viii) Enhanced productivity and economic growth.
th
and health expenditure USD 12,530 Inspired by countries such as Thailand, Rwanda
• The world registered an average per capita GDP of can achieve effective health universalism by 2030
USD 10,898.7 and per capita health expenditure of at the latest, surpassing UMIC and HIC standards
USD 1,177.15 (2020). by 2040/2041. This progress will depend on strong
If the global average reached a per capita GDP of USD governance, political commitment to UHC and HRV
12,688 (World Bank, 2020) from USD 5,717.1 in 2000 and 2050 goals, and the adoption of the recommendations
recorded a health expenditure per capita of USD 1,177.15 outlined in this study.

Volume 3 Issue 3 (2025) 260 https://doi.org/10.36922/ghes.5842