The World Health Organization (WHO) and the World Bank have jointly unveiled the findings of the 2023 Universal Health Coverage (UHC) Global Monitoring Report, shedding light on the alarming stagnation in the global effort to ensure equitable access to quality healthcare.
Anticipating the High-Level Meeting on UHC during the 78th United Nations General Assembly, this comprehensive report unveils a stark reality: more than half of the global population still lacks access to essential health services, while a staggering 2 billion people face severe financial burdens when seeking essential medical services and products.
Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, emphasized, “The COVID-19 pandemic served as a stark reminder that the well-being of societies and economies hinges on the health of their populations. The fact that a significant portion of the global populace remains unable to access affordable, quality healthcare not only jeopardizes their own health but also poses risks to the stability of communities, societies, and economies. Urgent action is required – we need unwavering political commitment, substantial investments in healthcare, and a transformative shift toward healthcare systems rooted in primary health care.”
The 2023 report reveals that, over the past two decades, less than one-third of nations have made progress in expanding health service coverage while mitigating catastrophic out-of-pocket health expenses. Alarmingly, the majority of countries with available data on UHC dimensions—96 out of 138—are off-track in either service coverage, financial protection, or both.
Mamta Murthi, Vice President for Human Development at the World Bank, remarked, “We understand that achieving Universal Health Coverage is pivotal in helping people escape poverty and remain out of it. However, there is an ongoing increase in financial hardships, particularly among the most disadvantaged individuals. This report paints a concerning picture but also provides evidence-based insights into prioritizing healthcare in government budgets and fortifying health systems to ensure greater equity in the delivery of essential healthcare services and financial protection.”
While healthcare service coverage exhibited progress since the turn of the century, advancements have decelerated since 2015 when the Sustainable Development Goals were adopted. Notably, no improvements were observed from 2019 to 2021. While services for infectious diseases have made substantial gains since 2000, the same cannot be said for service coverage concerning noncommunicable diseases and reproductive, maternal, newborn, and child health services in recent years. In 2021, a staggering 4.5 billion individuals—comprising over half of the global population—remained underserved by essential healthcare services. It’s important to note that this estimate does not yet encompass the potential long-term repercussions of the COVID-19 pandemic.
Financial hardship stemming from out-of-pocket healthcare expenses is an escalating issue. Catastrophic out-of-pocket health spending, defined as exceeding 10% of a household’s budget, continues to rise, affecting over one billion people, equivalent to 14% of the world’s population. Even modest expenditures, in absolute terms, can be debilitating for low-income families, with approximately 1.3 billion individuals pushed or further entrenched in poverty due to such payments—among them, 300 million people already living in extreme poverty.
Out-of-pocket healthcare payments often force individuals to forgo essential care and compel families to make agonizing choices between seeking medical attention, procuring sustenance and water, or sending their children to school. These choices can have life-altering consequences, potentially leading to the delayed treatment of preventable diseases, severe illness, or, tragically, death. To address this pressing issue, progressive health financing policies must be enacted, granting exemptions to those with limited financial capacity to cover healthcare expenses.
