Health Care in Colombia - Status of Public Health

Status of Public Health

General government spending on health accounted for 20.5% of total government expenditures and for 84.1% of total health expenditures (private expenditures made up the balance) in 2003. Total expenditures on health constituted 5.6 percent of gross domestic product in 2005. The per capita expenditure on health care in 2005 at an average exchange rate was US$150.

Urban and rural residents experienced significant differences in access to health care. The coverage in the three largest cities—Bogotá, Medellín, and Cali—was almost 95 percent. At the rural level, the best services were delivered by the departments in the coffee-growing areas. At the bottom of the scale—in terms of quality and coverage—were the rural areas in the non-Andean regions as well as the marginal neighborhoods in medium-sized and small cities.

Since 2001–2 Colombia has halved its homicide rate, which was more than 60 per 100,000 inhabitants, or 28,837, in 2002, one of the world’s highest homicide rates. In 2006 a total of 17,206 violent deaths were recorded, the lowest figure since 1987. Other than homicide, heart disease is the main cause of premature death, followed by strokes, respiratory diseases, road accidents, and diabetes. Waterborne diseases such as cerebral malaria and leishmaniasis are prevalent in lowland and coastal areas. Child immunization for measles in 2004 as a percentage of children under 12 months of age was 92 percent.

Acquired immune deficiency syndrome (AIDS) is the fifth-leading cause of death in the working-age population. According to Colombia’s National Health Institute data reported in 2003, nearly 240,000 people — mostly women and young people — or 0.6 percent of the population had been infected with the virus since AIDS arrived in Colombia in October 1983. Estimates of the number of people living with human immunodeficiency virus (HIV), adults and children (0–49 years of age), in 2005 ranged from 160,000 to 310,000. The comparable figure for women (15–49 years of age) was 62,000. The number of AIDS and hepatitis B cases has been rising. In 2005 the estimated HIV adult prevalence rate (15–49 years of age) was 0.6 percent. As of 2006, between 5,200 and 12,000 people had died from AIDS. Services provided by the new Multisectoral National Plan, launched in July 2004, include integrated care for people living with HIV and provision of antiretroviral drugs. Under the plan, about 12,000 people have been receiving combined antiretroviral therapy (approximately 54% of those requiring it).