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World Bank: Aging and immigration are increasing pressure on health financing

2026-07-13 07:23:00, Kosova & Bota CNA

World Bank: Aging and immigration are increasing pressure on health financing

An aging population, emigration and a growing burden of chronic diseases are creating new demands on the Albanian healthcare system, while public financing remains among the lowest in the Western Balkans, according to a World Bank report. In 2025, Albania's population was about 2.36 million, down from 2.9 million in 2010.

The report attributes this decline to emigration and low birth rates. In 2022, the fertility rate was just 1.2 children per woman. If these trends continue, the population could fall to around 2 million by the end of the century.

About 16% of the population was 65 years of age or older in 2023. According to the report, aging is increasing the burden of noncommunicable diseases, including ischemic heart disease, stroke, cancer, lung disease, and Alzheimer's. These developments are increasing the demand for long-term services, chronic disease management, and continuing care.

The World Bank notes that the current service delivery model remains largely hospital-oriented and only limitedly linked to performance.

Without change, these pressures could widen inequalities and limit the system's ability to provide better value for public funds. In 2023, total health spending reached about 4.9% of Gross Domestic Product.

Of this amount, public spending, including budgetary funds and health insurance contributions, accounted for about 3.5% of GDP.

Health benefits from about 9.7%-9.9% of total government spending. According to the report, Albania spends about $301 per capita of public funds on health, about half the level of some other countries in the region. The World Bank emphasizes that financial constraints are not the only problem.

The report argues that existing funds are distributed suboptimally, with the majority of spending directed to hospitals and a smaller share to primary care and prevention.

Another weakness is the limited contribution base. Health insurance contributions account for only about 0.8% of GDP, while government transfers to subsidized groups amount to about 1.6% of GDP. The report recommends improving contribution collection, reviewing public transfers to subsidized groups, and using taxes linked to health-damaging products.

However, the World Bank describes these measures as supportive rather than a substitute for efficiency and equity reforms. The document proposes that Albania focus on primary care, prevention, strategic procurement of services and optimization of the hospital network. According to the report, the sustainability of the system will depend on the ability to better use existing funds, mobilize new revenues and adapt services to a smaller and older population./ Monitor





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