The Global South—Economic History and Health Systems Development

The low-and-middle-income-countries (LMICs) of the Global South witness rapid health system development with substantial heterogeneity of affordability of medical care. Financial sustainability challenge is hard to understand without knowledge of economic history. Centuries have witnessed Colonialization, slave trade, world wars, Cold War, Non-Aligned Movement and Colonial Liberation Movements. Painful legacy shaped contemporary economic growth, and ability to invest in healthcare. There is expanding demand for health workforce-to-population ratio and supply of essential pharmaceuticals and medical devices. Despite rapid expansion of the middle class throughout the Global South, out-of-pocket spending remains excessive, while catastrophic healthcare expenditure is widespread. Most of the newly established welfare and abundance of disposable resources for healthcare investment are centered among the BRICS countries (Brazil, Russia, India, China, and South Africa). Despite significant health expenditure growth in PPP terms, LMICs’ insufficiently prioritize medicine in budgetary spending. Global South inability to meet ever-rising demand for medical care will remain constrained by wide socioeconomic inequalities and vulnerability of the poor. Sustained economic growth requires strategic interventions that prioritize equitable healthcare access and financial toxicity protection. Without comprehensive reforms that account for historical legacies and resource constraints, the promise of universal health coverage in the Global South will remain elusive.

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Publication Details

Journal
Global South & Sustainable Development
Published
2026-01-12
DOI
https://doi.org/10.53941/gssd.2026.100001
Primary Topic
Healthcare Systems and Reforms
Type
article
Field-Weighted Citation Impact
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article

The Global South—Economic History and Health Systems Development

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Global South & Sustainable Development
Healthcare Systems and Reforms
article

The Global South—Economic History and Health Systems Development

Narimasa Kumagai, Erika Yamashita, Trần Khánh Toàn, Hao Hu, Tetsuya Tanimoto, Takashi Miyachi, Ajantha Sisira Kumara, Sulaiman Mouselli, Vijay Kumar Chattu, Arcadio A. Cerda, Charles Ezenduka, Merhawi Gebremedhin Tekle, Pragyan Monalisa Sahoo, Resham Bahadur Khatri, Munjae Lee, María Jose Muñoz Torrecillas, Makoto Kosaka, Leidy Y. García, Obinna Ikechukwu Ekwunife, H. K. ROUT, E. Kouassi, Lizheng Shi, Ronny Westerman, Yudai Kaneda, Tiago Correia, Morteza Arab-Zozani, Michael Talias, João Paulo Teixeira, Salvador Cruz Rambaud, Chiranjivi Adhikari, Wenqing Wu, Jay Pan, Akihiko Ozaki, Romanus Osabohien, Javad Javan-Noughabi, Mihajlo Jakovljevic, Saeed Shahabi, Chhabi Ranabhat, Hui Jin, Tissa Wijeratne
article en

Abstract

The low-and-middle-income-countries (LMICs) of the Global South witness rapid health system development with substantial heterogeneity of affordability of medical care. Financial sustainability challenge is hard to understand without knowledge of economic history. Centuries have witnessed Colonialization, slave trade, world wars, Cold War, Non-Aligned Movement and Colonial Liberation Movements. Painful legacy shaped contemporary economic growth, and ability to invest in healthcare. There is expanding demand for health workforce-to-population ratio and supply of essential pharmaceuticals and medical devices. Despite rapid expansion of the middle class throughout the Global South, out-of-pocket spending remains excessive, while catastrophic healthcare expenditure is widespread. Most of the newly established welfare and abundance of disposable resources for healthcare investment are centered among the BRICS countries (Brazil, Russia, India, China, and South Africa). Despite significant health expenditure growth in PPP terms, LMICs’ insufficiently prioritize medicine in budgetary spending. Global South inability to meet ever-rising demand for medical care will remain constrained by wide socioeconomic inequalities and vulnerability of the poor. Sustained economic growth requires strategic interventions that prioritize equitable healthcare access and financial toxicity protection. Without comprehensive reforms that account for historical legacies and resource constraints, the promise of universal health coverage in the Global South will remain elusive.

Global South & Sustainable DevelopmentVol. 1(1)
Eastern Kentucky University (US), Tulane University (US), University of Nigeria (NG), Planetary Science Institute (US), Zhejiang Sci-Tech University (CN), University of Talca (CL), University of Kragujevac (RS), Seinan Gakuin University (JP), Pokhara University (NP), Haramaya University (ET), Tianjin University (CN), Health Sciences University of Hokkaido (JP), Manipal Academy of Higher Education (IN), The University of Queensland (AU), University of Sri Jayewardenepura (LK), University of Toronto (CA), Shaanxi University of Technology (CN), Shiraz University of Medical Sciences (IR), Akita University (JP), University of Macau (MO), Sichuan University (CN), Arab International University (SY), University of Oxford (GB), Universidade Politécnica de Bragança (PT), The World Academy of Sciences (IT), Jyoban Hospital of Tokiwa Foundation (JP), Instituto de Medicina Tropical (PY), Development Research and Projects Centre (NG), Western Health (AU), Imamura Hospital (JP), Medical Governance Research Institute (JP), Federal Institute for Population Research (DE), Indian Institute of Public Health Gandhinagar (IN), Hokkaido Institute of Public Health (JP), Université Félix Houphouët-Boigny (CI), University of Almería (ES), Ajou University (KR), Open University of Cyprus (CY), University at Buffalo, State University of New York (US), Utkal University (IN), Universiti Tenaga Nasional (MY), Universidade Nova de Lisboa (PT), Birjand University of Medical Sciences (IR)
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Openalex Percentile: Top 26%
Healthcare Systems and Reforms
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