Health

The COVID-19 (coronavirus) pandemic indicated more than ever the need to strengthen national health systems’ preparedness and capacities, and to ensure continuity of essential health services, particularly for women, children, and adolescents.

Achieving Universal Health Coverage (UHC) is at the core of these efforts. The World Bank Group (WBG) is supporting countries’ efforts towards this goal and to provide quality, affordable health services to everyone —regardless of their ability to pay — by strengthening primary health care systems and reducing the financial risks associated with ill health and increasing equity.

The latest World Bank/World Health Organization research shows that already before the pandemic more than half a billion people were pushed or further pushed into extreme poverty because they had to pay for health services out of their own pockets. The COVID-19 pandemic will likely have made  the situation worse and halt two decades of global progress towards Universal Health Coverage.

In addition, by disrupting the delivery of essential health services, the pandemic affected years of hard-won gains in health and human capital outcomes, especially for the most vulnerable groups such as women, children, and adolescents. Ensuring that every woman and child has access to health care is also fundamental to ending poverty, building robust economies, and achieving UHC.

The Global Financing Facility for Women, Children and Adolescents (GFF), a multi-stakeholder partnership hosted at the World Bank has been supporting countries with the world’s highest maternal and child mortality burden and financial needs. Since the GFF was founded in 2015, partner countries have made significant progress to improve maternal and child health.

COVID-19 has also brought social isolation, financial hardship, and interrupted health care services – which are negatively impacting the mental well-being of people. A recent WHO report indicates that during the first year of the COVID-19 pandemic, global prevalence of anxiety and depression increased by 25 percent.

Recent estimates indicate that, in 2020, governments worldwide spent on average just over 2% of their health budgets on mental health and many low-income countries reported having fewer than 1 mental health worker per 100 000 people. The World Bank is supporting efforts to put mental health at the center of global health, in addition to as an integral element of human capital accumulation.

The burden of non-communicable diseases (NCDs), such as cancer, cardiovascular disease, and diabetes is growing. NCDs are the cause of 70 percent of deaths globally, with most of these deaths occurring in low- and middle-income countries. Despite advances in reducing communicable diseases, rates remain high in many parts of the world for malnutrition, unmet need for sexual and reproductive health services, and maternal mortality.

While UHC is crucial to building human capital and central to an effective response and recovery from the pandemic, strong primary health care services are also essential to preventing, detecting, and managing diseases, as well as promote health.

But health systems in many countries are  confronting challenges caused by the pandemic, climate change, aging populations, and a growing burden of lifestyle diseases.

More than ever, pandemic preparedness and disease surveillance anchored in strong and resilient health systems that reach everyone—especially the most vulnerable—are crucial to ensure better protection from major disease outbreaks. A recent World Bank report charts an agenda toward reimagined, fit-for-purpose primary health care. It reflects a renewed understanding of global and local vulnerabilities and opportunities in the post-COVID world. Another report Change Cannot Wait: Building Resilient Health Systems in the Shadow of COVID-19 builds on this analysis and presents a new framework for making health systems resilient and where countries and partners can best target investments to improve health outcomes.

Last Updated: Mar 29, 2023

The World Bank is committed to helping developing countries achieve universal health coverage through stronger, more resilient health systems and provide quality, affordable health services to everyone – especially to the most vulnerable during a time of crisis. We also support countries in their efforts to prevent pandemics by strengthening veterinary and human health systems, as well as the bridges between them in a One Health approach.

Our $34 billion global health portfolio includes over 240 projects that help countries take a comprehensive approach to improving health outcomes, especially for poor and vulnerable people, by strengthening primary care and key public health functions.

The WBG has focused its health sector investments and research in areas that are especially vital to helping countries achieve UHC by 2030 by helping them strengthen their health systems and putting primary health care at the center.

The ambitious agenda and future directions for the World Bank to support pandemic prevention, preparedness and response (PPR) at country, regional, and global levels as part of a broader approach to strengthen health systems, aims to strengthen PPR through actions in three interconnected domains: financing; global engagements and partnerships; and analytics, evidence, and dialogue.

The World Bank is working closely with donors, development partners, governments, and the private sector on several key focus areas including, ending preventable maternal and child mortality; reducing stunting and improving nutrition for infants and children; strengthening health systems and health financing; and ensuring pandemic preparedness and response.

Last Updated: Mar 29, 2023

Strengthening health systems and pandemic preparedness

Pandemics pose a serious threat not only to global health security and to achieving UHC, but also to economic security. While deadly disease outbreaks are inevitable, strong health systems help countries to better detect and respond to diseases and prevent an outbreak from becoming a pandemic.

The COVID-19 pandemic has inflicted devastating health and economic costs, but also created a once-in-a-generation chance for transformational health system changes. The World Bank is committed to helping developing countries achieve universal health coverage through stronger, more resilient health systems and provide quality, affordable health services to everyone – especially to the most vulnerable people. 

The World Bank is the largest single funder of the global COVID-19 health response with $14.3 billion committed to over 100 countries, including in  32 countries impacted by fragility, conflict and violence.  Through this financing, the Bank is assisting governments strengthen health systems, disease surveillance, and public health interventions, and work with the private sector to reduce the impact on economies. See more information here. 

In September 2022, the new Pandemic Fund was officially established. Housed at the World Bank, the fund will provide a dedicated stream of additional, long-term financing to strengthen PPR capabilities in low- and middle-income countries and address critical gaps through investments and technical support at the national, regional, and global levels.

Health Financing

World Bank research shows that following global economic shocks from the COVID-19 pandemic and the Russian invasion of Ukraine, the spending capacity of governments will decline or stagnate in many low- and lower middle-income countries. Without bold choices, these countries will be unable to make the necessary investment to strengthen public health preparedness and make progress toward universal health coverage.

In 41 countries, government spending until 2027 is projected to remain lower than before COVID-19, restricting their ability to invest in critical areas, including health.  In addition, rising interest payments on public debt further threaten the capacity of many countries to invest in health.

Without immediate action, many low- and lower middle-income countries will be left behind on the path to health and economic recovery leading to growing inequalities between countries, threatening global stability, and prosperity.

Climate and Health

The impacts of climate change—disease outbreaks, extreme weather events, increasing conflict and food insecurity—are having a negative impact on human physical and mental health. These impacts are expected to rise over the coming decades unless rapid and profound action is taken. An additional 132 million people could be living in extreme poverty by 2030 due to climate change. The most vulnerable are particularly affected: those living in poverty, the elderly, people with pre-existing health conditions, ethnic minorities, and indigenous groups. Climate impacts on health are conservatively predicted to cause around 250,000 additional deaths per year between 2030 and 2050.

The health sector is a first responder to climate shocks and provides people with fundamental services to reduce climate-related health impacts. That’s why countries urgently need to build stronger, more integrated health systems that are resilient to a variety of acute health shocks – including climate change and pandemics. The World Bank is the biggest financer of climate action in developing countries. This includes health-related climate activities. But much more financing is needed to ensure that the poorest people are protected from severe climate impacts on their health.

Nutrition

Nutrition interventions are consistently identified as one of the most cost-effective development actions. However, an estimated 149 million children under 5 are stunted (low height for age), which compromises not only child’s health and survival but also brain development, learning, and adult earnings, leading to long-term impacts on countries’ human capital formation.  Over 70% of countries—the vast majority of which are low- and lower-middle-income countries—currently face a double burden of malnutrition: a high prevalence of both undernutrition and obesity.

Last Updated: Mar 29, 2023

Improving health outcomes is a key focus at the World Bank Group. Between 2010 and 2022, IDA, the World Bank’s fund for the poorest countries, financed essential health interventions for more than 1 billion people, and immunizations for close to 440 million children. This is the result of the World Bank’s strong focus on preserving and strengthening primary health care systems to cope with health emergencies, and providing services for the most vulnerable, crisis-hit, and hardest-to-reach populations. 

Under the IDA19 cycle (July 2020 – June 2022), $76.7 billion were committed in just two years, reaching 213 million people with essential health, nutrition, and population services, including 82 million people in fragile and conflict affected situations. This included 78 million children who received immunizations, 114 million women and children accessing nutrition services, and 21 million deliveries with skilled personnel. These results were achieved despite the COVID-19 pandemic, unfolding conflicts, and increasing impacts from climate change. 

The World Bank is also the single largest funder of the global COVID-19 health response with $14.3 billion committed to nearly 100 countries, including 32 countries impacted by fragility, conflict and violence. This includes more than $10 billion for COVID-19 vaccine projects.

Honduras: The $75 million Restoring Essential Services for Health and Advancing Preparedness for Emergencies (RESHAPE) Project ($60 million IDA and $15 million from the GFF), helps improving the country’s reproductive and child health services. It also strengthens public health capacities for emergency preparedness to ensure prompt and effective response in case of a crisis or an emergency for all Honduran residents. The project will directly benefit an estimated 3 million women of childbearing age, 640,000 children under five years and 600,000 adolescents aged 15-19 years with improved health services. 

Lao PDR: The $41.4 million IDA-financed Lao PDR Health Governance and Nutrition Development Project helped increase coverage of reproductive, maternal and child health, and nutrition services in selected regions. The project tackled the problem of inequity by boosting vaccination rates in 50 remote districts that have historically been lagging behind the rest of the country. As a result, these districts saw an increase of 22% of measles vaccinations and a 30% increase of DTP and hepatitis B vaccinations. Read more here

Nigeria: The $650 million IDA-financed Nigeria Improved Child Survival Program for Human Capital (IMPACT) is a 10-year engagement, spanning from 2020 to 2030 to improve and increase immunization and malaria services in selected states. By September 2022, the project had already surpassed its two-year targets, despite the disruption of services as a result of COVID-19. For example, the percentage of children (12-23 months old) vaccinated fully vaccinated against DPT and hepatitis B increased from 49% in June 2020 to 57% in August 2022. Similarly, the percentage of children under age 5 who slept under insecticide nets increased from 28% to 41% over the same period. The second phase of the project will begin in 2025 and will support the country’s new primary health care financing reform.

Yemen: The $300 million IDA-financed Emergency Human Capital Project builds on previous projects and helps strengthen decentralized systems for better service delivery and improving public health, water and sanitation functions, including surveillance and water quality. The project partners with UNICEF, UNOPS, and WHO to deliver these services.  

Between October 2021 and June 2022, about 2.8 million people received essential health, nutrition, and population services through the project’s support. Approximately, 1.5 million women and 1.7 million children under five years old received life-saving services, such as antenatal care, safe birth delivery, immunization, and preventive and curative nutrition services. Over 400,000 people received access to improved water and sanitation services.

Last Updated: Mar 29, 2023