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Report/ Albanian healthcare between limited transparency and under-financing

Politiko 2025-06-26 18:34:34

The Together for Life Association published its annual report “Health Sector Expenditure Monitoring for 2024”, an in-depth document that analyzes not only last year’s budget figures, but also how they affect the real provision of health services to citizens. This report, like previous ones, raises concerns about the under-financing of health, the lack of transparency in reporting, and the incomplete alignment between commitments and concrete results.

While the Ministry of Health and Social Protection’s budget for 2024 reached nearly 80 billion lek, an increase of 1.8 billion lek from the initial plan, analyses show that public funding for health continues to remain among the lowest in the Region, at only 2.8% of GDP and 9.6% of total public spending. Furthermore, more than 51% of healthcare spending continues to be borne out of citizens’ pockets.

In particular, the report highlights that funding for Primary Health Care has been reduced by 245 million lekë during 2024, without any analysis or official explanation from the authorities as to the reasons for this reduction. This is particularly concerning, given that a new service – home health care for patients with mobility impairments – has also been included in this category, which should be accompanied by an increase in funding.

The report also raises concerns about the continued financing of the check-up concession, which continues to be based on the planned number of beneficiaries and not on the actual number of citizens receiving the service. For 2024 alone, 23.8 million lek were paid to 13,624 citizens who did not actually benefit from the service.

The removal for the second consecutive year of financial support for the “Patients with Down Syndrome” product in the secondary healthcare program, without any explanation or justification from the authorities, raises serious concerns. The lack of transparency regarding the reasons for this decision could have significant consequences for access to necessary healthcare for a category that requires continuous and specialized follow-up, and risks deepening inequalities in the healthcare system.

The findings of the report "Monitoring Health Sector Expenditures for 2024", carried out by the Together for Life association, with the financial support of the National Endowment for Democracy, were shared at a roundtable attended by representatives of institutions, patient organizations and organizations operating in the field of transparency and accountability, experts in the field, and the media.

The representative of the People's Advocate, Ms. Lindita Xhillari, a participant in the roundtable, praised the role of the TFL reports in the process of drafting institutional recommendations: “Your reports are very detailed and have been a reference point for the recommendations that the People's Advocate addresses to the Ministry of Health every year. The findings you have presented are specific and different from the nature of our work, but will be included in our future work.” Focusing in particular on the lack of data on the budget for children with Down Syndrome, the representative of the People's Advocate emphasized that the issue identified in the report on the removal of the budget for patients with Down Syndrome “will be in focus for monitoring and for exerting positive pressure for a solution.”

Emerlinda Pema, representative of the Office of the Commissioner for the Right to Information, praised the report's role in increasing transparency: "Such reports are valuable not only for citizens, but also for institutions. Your findings and recommendations are read with great attention by us." She added that, based on the TFL reports, 12 recommendations were made this year for transparency programs in public hospitals, to ensure the publication of annual budgets, audit results and procurement plans. "We oversee the implementation of the law on the right to information and now also of the new law on open data. This law requires that all public data be published in 'open data' format, so that researchers and citizens have full access."

The report provides a valuable basis for independent institutions, which focus their work on the protection of human rights, where the right to access public health services is one of the basic rights, and comes as a call for responsible institutions, in particular the Ministry of Health and Social Protection, to increase accountability in the management of public funds in the health sector in order to achieve the primary objective of universal health coverage.