Why Health Is National Infrastructure: Moving Beyond the Social Service Paradigm

The economic cost of poor health

Poor health affects far more than hospitals and clinics. It influences every aspect of national development.

When people are unable to access quality healthcare, children miss school, workers lose productive hours, businesses incur higher costs, and governments spend more on responding to preventable illnesses rather than investing in future growth.

Non-communicable diseases such as diabetes, cardiovascular disease, and cancer are rising rapidly across low- and middle-income countries, placing additional pressure on already stretched health systems. At the same time, infectious diseases, climate-related health risks, and pandemic preparedness continue to demand attention.

The result is a double burden that affects labour markets, productivity, and economic competitiveness.

Health, therefore, is not simply about treating illness. It is about ensuring societies can learn, work, innovate, and prosper.

Health infrastructure drives national competitiveness

Countries routinely invest in roads, electricity, ports, and digital infrastructure because they understand these systems enable economic activity.

Health deserves the same strategic attention.

Strong health systems improve workforce participation, reduce productivity losses, encourage private investment, and strengthen national resilience during crises. They also create jobs across healthcare, pharmaceuticals, biotechnology, research, manufacturing, and digital innovation.

This broader view positions healthcare and economic growth as linked rather than separate, with health functioning as productive capital that supports sustainable growth rather than consumption spending.

Global evidence increasingly reinforces this perspective. The World Bank’s Human Capital Index tracks 174 countries to assess how effectively health and education translate into future productivity. It shows a global average of just 0.58 out of 1.0, with top performers above 0.90 and the lowest below 0.30. That gap reflects how much economic potential is lost where health systems remain underfunded.

The Lancet Commission on Investing in Health has argued for over a decade that well-targeted health spending in low- and middle-income countries yields strong returns when measured by lives saved and productivity gains.

IMF research points in the same direction from a fiscal angle. The October 2025 Fiscal Monitor found that more efficient public spending, including in health, could raise GDP by around 11 per cent in emerging and developing economies over the long term. Separate IMF modelling projects that healthier ageing populations could add roughly 0.4 percentage points a year to global growth over the next 25 years.

Investments in human capital, including health and education, consistently contribute to stronger economic performance, higher incomes, and greater resilience against future shocks.

Building human capital through health investment

Healthy populations form the backbone of human capital.

Children who receive proper nutrition, vaccinations, and healthcare perform better in school. Adults with access to quality health services are more productive throughout their working lives. Older populations remain healthier for longer, reducing long-term healthcare costs while continuing to contribute economically and socially.

Viewed through this lens, health investment becomes an investment in people, the most valuable resource any nation possesses.

Rather than competing with economic priorities, healthcare strengthens them.

Nigeria’s healthcare value chain: a new development model

One example highlighted in the report is Nigeria’s Presidential Initiative for Unlocking the Healthcare Value Chain.

Instead of focusing solely on expanding healthcare services, the initiative seeks to build domestic pharmaceutical manufacturing capacity, strengthen medical supply chains, encourage research and innovation, create skilled employment opportunities, and reduce dependence on imported medical products.

This approach demonstrates how health policy can simultaneously improve health outcomes while supporting industrial development, economic diversification, and national resilience.

It reflects a broader trend across many countries seeking to integrate healthcare into national development strategies rather than treating it as a separate policy area.

Treating health like roads, power and water

The future of global health depends on moving beyond outdated assumptions about how health systems are financed and governed.

Health should be treated with the same long-term planning applied to transport networks, energy systems, and digital infrastructure. This means investing in resilient institutions, modern facilities, skilled health workers, research capacity, digital technologies, and local manufacturing.

International partners will continue to play an important role, particularly in supporting global public goods and countries facing significant fiscal challenges. However, the long-term goal is increasingly clear: stronger domestic investment, greater national ownership, and health systems that remain resilient regardless of fluctuations in donor funding.

Recognising health as infrastructure represents more than a policy adjustment. It is a new way of thinking about development itself.

Countries that invest strategically in health are investing in stronger economies, more productive societies, and more resilient futures.

Frequently asked questions

What does “health as infrastructure” mean?

Health as infrastructure means viewing healthcare systems as essential national assets that enable economic growth, strengthen human capital, and improve resilience, similar to investments in roads, electricity, or digital networks.

How does health spending affect economic growth?

Strategic health investment improves workforce productivity, reduces preventable illness, supports education outcomes, creates employment, and increases long-term economic competitiveness.

What is the Human Capital Index?

A World Bank measure estimating how productive a child born today can expect to be as a future worker, based on the health and education available to them. Scores run from 0 to 1, with 1 representing full health and education. It covers 174 countries and benchmarks how effectively nations convert investment in people into future economic output.

Based on research by Muhammad Ali Pate, Donald Kaberuka, and Peter Piot, published in “Transforming the Global Health Ecosystem: Lessons Learned and a Vision for the Future.“