United Nations
Office for the Coordination of Humanitarian Affairs - Belgrade

Review of Urgent Assistance Needs for the Federal Republic of Yugoslavia (Excluding Kosovo)

Winter/Spring 2000/2001

December 5, 2000

A household survey conducted by WHO and UNICEF in August 2000 indicates that medications and sanitary materials available to the population from state pharmacies meet just 15% of needs. Shortages of sanitary materials within health centres are almost universal. Health facilities have been poorly maintained in recent years. Many are poorly insulated and heated, requiring repairs to roofs, windows and heating systems. More than two-thirds of medical equipment is poorly functioning or obsolete.

In 1990 state spending for health in Serbia was about US$200 per capita per year. This declined to $85 in 1999 and an estimated $35 in 2000. According to the Ministry of Health, 57% of expenditures go for salaries, 15% for drugs, 10% for medical consumables and equipment maintenance and 18% on food and utilities.

The Health Insurance Fund has outstanding debts of almost US$100 million, the major portion of which is owed to the pharmaceutical industry. Based on Government figures for October 2000 current revenue can cover salaries and about 25% of other costs, but generally do not cover costs of maintenance of equipment and facilities or for infrastructure.

In common with many other public services and utilities, reform will be required in order to place the system on a sound financial footing. In the interim, international assistance is required to meet outstanding needs while allowing the Health Insurance Fund to recover capacity for self-funding in the future.

Environmental damage at several manufacturing facilities in 1999 has raised concerns over environmental health risks from contaminated soil and water in several areas, now termed "hot spots". A programme is underway for environmental clean-up at four high-priority sites. Presently, US$ 7 million is available to begin this work. In the medium term, an additional US$ 12.6 million is needed to extend the programme to other sites identified as potential public health risks.

Summarizing the above information, and using the 1998 expenditure level as a basis, Table 4 shows a breakdown of urgent needs for the FRY health sector during the next six-month period, which totals approximately US$ 63 million. Costs for maintaining and renewing infrastructure and non-medical equipment (laundries, kitchens, vehicles, etc.) are not included.

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