Universal health coverage (UHC) is about ensuring that people have access to the health care they need without suffering financial hardship. It is key to achieving the World Bank Group’s (WBG) twin goals of ending extreme poverty and increasing equity and shared prosperity, and as such it is the driving force behind all of the WBG’s health and nutrition investments.
UHC allows countries to make the most of their strongest asset: human capital. Health is a foundational investment in human capital and in economic growth—without good health, children are unable to go to school and adults are unable to go to work. It is one of the global economy’s largest sectors and provides 50 million jobs, with the majority held by women.
Global movement towards UHC
Health is also an essential part of the Sustainable Development Goals (SDGs). For example, the SDG 3.8 target aims to “achieve universal health coverage, including financial risk protection, access to quality essential health care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all.” In addition, SDG 1, which calls to “end poverty in all its forms everywhere” could be in peril without UHC, as almost 90 million people are impoverished by health expenses every year.
In recent years, the UHC movement has gained global momentum, with the first-ever UN High-Level Meeting on UHC held in September 2019. A Political Declaration was unanimously adopted by member states, affirming their high-level political commitment to UHC and outlining a number of necessary actions. Twelve co-signatories including the WBG also launched the Global Action Plan for Healthy Lives and Well-being for All (GAP) to jointly support countries in delivering on the SDG3 targets. In January 2020, the second UHC Forum was held in Bangkok, aiming to enhance political momentum on UHC in international fora.
At the same time, World Bank/World Health Organization (WHO) research from 2019 shows that countries must increase spending on primary health care by at least 1% of their gross domestic product (GDP) if the world is to close glaring coverage gaps and meet the health targets agreed under the SDGs. There can be no UHC without affordable, quality primary healthcare. The research also warns that, if current trends continue, up to 5 billion people will still be unable to access health care in 2030.
In June 2019, the first-ever G20 Finance and Health Ministers joint session was hosted by the Presidency of Japan. The discussion aimed to galvanize G20 countries towards the common goal of financing UHC in developing countries. It was informed by a World Bank report showing that people in developing countries spend half a trillion dollars annually — over $80 per person — out of their own pockets to access health services. Such expenses hit the poor the hardest and threaten decades-long progress on health.
A lack of universal access to quality, affordable health services also endangers countries’ long-term economic prospects and makes them more vulnerable to pandemic risks. Without urgent action, developing countries faced with aging populations and growing burdens of non-communicable diseases will find themselves increasingly challenged to close the gap between the demand for health spending and available public resources, and will prolong the reliance on out-of-pocket spending by patients and their families.
Last Updated: Apr 02, 2020