In line with its global strategy for health, nutrition and population, the World Bank Group supports countries’ efforts to achieve universal health coverage (UHC) and provide quality, affordable health services to everyone —regardless of their ability to pay— reducing the financial risks associated with ill health, and increasing equity. The path to universal health coverage is specific to each country. Whatever the path, the World Bank Group’s aim is to help countries build healthier, more equitable societies, as well as to improve their fiscal performance and country competitiveness — in order to build human capital, end poverty and boost shared prosperity.
Globally, there has been significant progress towards UHC. Most parts of the world have seen an expansion in the access to health services and coverage of key interventions over the last two decades. There have also been notable improvements in financial protection. Yet, the challenges remain immense.
In many countries there are still large coverage gaps, in particular for poor and marginalized communities. Half the world's population cannot access needed health services, while 100 million people are pushed into extreme poverty each year because of health expenses, shows WBG/World Health Organization (WHO) research from 2017. In addition, 800 million people spend at least 10 percent or more of their household budget on healthcare expenses, often forcing them to choose between their health and other needed expenses for their family. Even if health services are available, countries at all incomes levels often struggle to ensure quality in health services.
Health expenses are an important reason families around the world are pushed into poverty. UHC is thus fundamental to achieving the WBG’s twin goals of ending extreme poverty and increasing equity and the overarching Sustainable Development Goal of ending poverty. As long as millions are impoverished each year because of health expenses, neither goal can be reached.
Health systems in many countries are also confronting the challenges of aging populations and a growing burden of lifestyle diseases. The burden of non-communicable diseases (NCDs), such as cancer, cardiovascular disease, diabetes and mental health, is growing. NCDs are now the cause of 70 percent of deaths globally, with the majority of these deaths occurring in low- and middle-income countries. At the same time, despite advances in reducing the burden of communicable disease, rates still remain high in many parts of the world for malnutrition, unmet need for sexual and reproductive health services, and maternal mortality.
Achieving universal health security, which protects all people from threats to their health, is an essential component of providing UHC. Universal health security means protecting everybody, not just because that is the equitable thing to do, but because with infectious diseases, true health security can only be achieved if everyone is protected. It both depends on and complements broader efforts to strengthen health systems and make them more resilient, so it needs to be pursued as part of an integrated plan.
Last Updated: Jan 31, 2019