WHO is calling on leaders to make Universal Health Coverage (UHC) a national priority and eliminate impoverishment due to health-related expenses by 2030. Government spending on health is crucial to delivering UHC.
Deprioritising healthcare funding can have dire consequences in a context where 4.5 billion people worldwide lack access to basic health services and 2 billion people face financial hardship due to health costs.
Dr Tedros Adhanom Ghebreyesus, WHO Director-General states: “While access to health services has been improving globally, using those services is driving more and more people into financial hardship or poverty.
Universal Health Coverage Day implies health for all, meaning everyone can access the health services they need, without financial hardship,”
Protecting people from financial hardship due to out-of-pocket health costs is fundamental to achieving health for all. Nonetheless, WHO’s report shows that out-of-pocket spending remained the main source of health financing in 30 low- and lower middle-income countries.
In 20 of these countries, more than half of total health spending in the country was paid for by patients out of their pocket, which contributes to the cycle of poverty and vulnerability.
The challenges posed by the lack of financial protection for health are not limited to lower-income countries. Even in high-income countries, out-of-pocket payments lead to financial hardship and unmet need, particularly among the poorest households.
Most recent health accounts data show that in over a third of high-income countries, more than 20% of total health spending was paid out-of-pocket.
Effective strategies to strengthen financial protection include minimizing or removing user charges for those most in need, including people with low incomes or chronic conditions, adopting legislation to protect people from impoverishing health costs and establishing health financing mechanisms through public funding to cover the full population.
Public funding needs to budget for an affordable package of essential health services – from health promotion to prevention, treatment, rehabilitation and palliative care – using a primary healthcare approach.
Universal health coverage (UHC) means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship.
Achieving UHC is one of the targets the nations of the world set when they adopted the 2030 Sustainable Development Goals (SDGs) in 2015.
During the COVID-19 pandemic in 2020–2022, public spending on health – mainly via government health budgets –enabled health systems to respond quickly to the emergency. This reflects the advantage of government budgets in financing public health functions, in particular population-based public health interventions, versus other health financing schemes, during times of health emergencies. Government funding ensured that more people were protected and more lives were saved.
Following the pandemic, countries are at a crossroads. Governments face difficult decisions as they work to strengthen the resilience of health systems against future health threats while addressing their populations’ healthcare needs in a challenging economic environment.