"In recent years, Morocco has made progress in the health sector, with an increase in life expectancy and a reduction in the extent of communicable diseases. That said, continued efforts are still needed, in particular to achieve certain health targets set out in the Sustainable Development Goals or to reduce regional inequalities in health provision," says the report entitled "Mobilising tax revenues to finance the health sector in Morocco, released Monday.

Added to this is the burden of the epidemiological transition and population ageing, with the number of people aged over 65 expected to triple between 2020 and 2060, increasing health spending and threatening the budget balances of compulsory health insurance funds.

According to the report, between 2020 and 2060, the number of people aged over 65 is expected to triple in Morocco, resulting in an increase in total health expenditure, and threatening the budget balances of (Compulsory Health Insurance) CHI funds. However, the upward trend in spending can be controlled if the ageing population remains healthy.

“These challenges highlight the need to strengthen health spending. In order to move closer to the SDG 3 targets by 2030, Morocco would need to increase health expenditure by 2.5 percentage points of GDP, to reach 8.2% of GDP, including 2.2 percentage points for public spending,” the report notes.

This increase would raise per capita health expenditure from USD 170 in 2016 to USD 419 in 2030, and multiply the number of doctors by 2.6 and the number of medical staff by 3.6, if keeping current health workforce policies constant.

“This is equivalent to an increase of MAD 107 billion over the same period (an annual increase of MAD 7.7 billion), including an increase of MAD 77 billion in public spending (an annual increase of MAD 5.5 billion),” adds the same source.

Analysis over a long period reveals that total health expenditure growth is driven by public funding, and that public health expenditure growth is driven by economic growth and the priority for health within the general state budget.

To fund increased in public spending on health, two areas of action will be required. First, the design of health social security contributions needs to be improved. Second, greater use will need to be made of tax revenues, with an improvement of the design of each tax, in particular taxes with strong links to the health sector such as domestic consumption taxes (through their influence on consumer behaviour) and environmental taxes (through their indirect impact on the health of populations).

However, while an increase in public resources for health is necessary in the medium term, this cannot be achieved under current conditions. The first step will be to improve the efficiency and control of public spending on health, as well as to support the development of the private health sector, but without necessarily introducing new tax incentives, the report stresses.