Global strides made in universal health coverage, but critical gaps still hinder progress, says WHO–World Bank report

DCM Editorial Summary: This story has been independently rewritten and summarised for DCM readers to highlight key developments relevant to the region. Original reporting by WHO, click this post to read the original article.

Since 2000, most countries have made progress in expanding health service coverage and reducing the financial burden of healthcare costs. A new joint report by the World Health Organization (WHO) and the World Bank Group reveals that the Service Coverage Index (SCI) improved from 54 to 71 between 2000 and 2023. During the same period, the proportion of people facing financial hardship due to out-of-pocket (OOP) health expenses fell from 34% to 26%. These gains mark key steps toward achieving universal health coverage (UHC), ensuring that everyone can access the healthcare they need without suffering financial strain.

Despite the improvements, the report warns that 4.6 billion people still lack access to essential health services, and 2.1 billion face financial hardship, with 1.6 billion pushed further into poverty by healthcare expenses. People living in poverty bear the brunt of these costs, often spending up to 60% of their OOP expenses on medicines alone. Even middle-income groups feel this pressure, especially where public health systems are limited. If progress doesn’t accelerate, a quarter of the world’s population could still struggle with healthcare costs by 2030.

Some low-income countries have made the fastest gains in both healthcare access and financial protection, but they also continue to face the biggest challenges. Service coverage improvements have largely resulted from tackling infectious diseases and improving sanitation, while advances in maternal and child health have been more modest. Economic growth, rising incomes, and stronger social protection systems have helped ease financial stress tied to healthcare, but inequalities are widening.

You’re more likely to face difficulties in accessing care if you’re poor, live in a rural area, have less education, or belong to a vulnerable group. In 2022, three out of four people in the poorest group experienced financial hardship from health expenses, compared to fewer than one in 25 in the wealthiest group. Even in well-performing regions, like Europe, unmet health needs remain high among disadvantaged populations. The report suggests that data might underestimate the actual scale of inequality because many vulnerable groups are underrepresented in national surveys.

With the 2030 deadline for the Sustainable Development Goals fast approaching, achieving UHC for all will require urgent action. The report calls on governments to ensure free essential health care for people in poverty, invest more in health systems, reduce medicine costs, expand noncommunicable disease services, strengthen primary care, and adopt broader policies that consider health impacts across all sectors. These steps are crucial to ensure you and others can access healthcare without enduring financial hardship.