Socioeconomic Development Chapter 6 level comforts. It is also the expression of dissatisfaction with public health services. In reality, public health expenditure is moderate. It is only 1.9 per cent of GDP, whereas the average is between 3 and 3.5 per cent of GDP in the upper middle-income countries to which Mauritius belongs. Per capita public health expenditure was USD97 and USD114 PPP in 2006, compared with USD254 and USD389 respectively in the group of upper middle-income countries. Chapter 6 Table 6.4: Annual number of new cases of HIV and AIDS detected among Mauritians Year Number 2001 55 2002 98 2003 225 2004 525 2005 921 Total health expenditure as a percentage of GDP 2006 542 2007 546 Mauritius 3.9 2008 538 Low-income countries 4.3 Low middle-income countries 4.5 Upper middle-income countries 6.3 High-income countries 11.2 Public health spending per inhabitant in USD At the average exchange rate At PPP Mauritius 97 114 Low-income countries 13 21 Low middle-income countries 42 78 Upper middle-income countries 254 389 High-income countries 1,608 2,335 Table 6.3: An international comparative perspective of health expenditure in Source: Government of Mauritius 934. The main causes of infection (more than four-fifths) since 2003 are the use of intravenous drugs. Controlling drug addiction and the exchange of syringes among drug addicts has not yet helped to curb, or at least reduce, the phenomenon. 935. With regard to education, the gross enrolment rates achieved at all levels from primary education to higher education are impressive. In 2008, the rates were 94 per cent for preprimary education, 101 per cent for primary education, 74 per cent for secondary education (academic and prevocational training) and 41.4 per cent for higher education. Education is a key value in Mauritian society. It seems to be the cornerstone of social mobility. Right from the primary level, parents organise private tuition for their children so that they can feature among prizewinners and get into the most prestigious colleges. Failing to complete academic studies is often given as the reason for poverty. 936. Education is free at all levels and the government has spent, on average, between 3.2 per cent and 3.3 per cent of GDP on education in recent years. Organisation for Economic Co-operation and Development (OECD) countries spend an average of 5.9 per cent of GDP on education. Of this, 5.2 per cent comes from the state and 0.7 per cent from the private sector or households. Of the 19 developing countries that participated in the World Education Indicators (WEI) evaluation, the average is 4.8 per cent, of which 4 per cent comes from the state. Source: WHO World Health Statistics 2009. 931. 320 Socioeconomic Development The trend is that health expenditure will increase because of the increase in noncommunicable diseases, the risk factors inherent in old age, environmental changes and changes in the lifestyles of people. 932. The public health system is under real tension. It clearly needs considerable financial resources to meet the increasing needs of the people. While it is admirable that Mauritius is able to provide free health care, the shortage of resources poses a real constraint to the quality of health care. 933. HIV and AIDS also remains a concern given that a number of new cases have been detected recently. 321