“The fact that so many people cannot benefit from affordable, quality, essential health services not only puts their own health at risk, it also puts the stability of communities, societies and economies at risk,” said Tedros Adhanom Ghebreyesus, WHO Director-General
Geneva:
Over 4.5 billion people worldwide lack coverage for essential health services the UN health agency said on Monday, underscoring the need for stronger political commitment and increased government investment.
Moreover, two billion face severe financial hardships when paying out-of-pocket for necessary medical treatment, according to a joint World Health Organization (WHO)-World Bank report.
“The fact that so many people cannot benefit from affordable, quality, essential health services not only puts their own health at risk, it also puts the stability of communities, societies and economies at risk,” said Tedros Adhanom Ghebreyesus, WHO Director-General.
“We urgently need stronger political will, more aggressive investments in health, and a decisive shift to transform health systems based on primary health care.”
Alarm for global health goals
Financial hardship due to out-of-pocket health spending is worsening. This crisis poses a major threat to global health-related Sustainable Development Goals (SDGs) that aim to achieve universal health coverage for all by 2030.
According to the report, over the past two decades, fewer than one-third of countries globally have improved health service coverage and reduced the “catastrophic” levels of out-of-pocket health spending, which often exceed 25 per cent of household income.
Catastrophic out-of-pocket health spending, defined as exceeding 10% of a household budget, continues to rise. More than one billion people, about 14% of the global population, experienced such large out-of-pocket payments relative to their budgets. But even small expenditures in absolute terms can be devastating for low-income families; approximately 1.3 billion individuals were pushed or further pushed into poverty by such payments, including 300 million people who were already living in extreme poverty.
Out-of-pocket health payments can also cause individuals to forego essential care and force families to choose between paying for a visit to the doctor, buying food and water, or sending their children to school. Such trade-offs can spell the difference between the early treatment of a preventable disease and, at a later stage, suffering severe illness or even death. Addressing this problem requires progressive health financing policies that exempt those with limited ability to pay for health services.
Getting back on track
To get back on track toward the ambitious goals, the report calls for substantial investments in the public sector by governments and development partners.
It emphasizes the need for a “radical reorientation” of health systems, prioritizing primary healthcare, enhancing equity and financial protection.
Reform is also vital to fully address the devastating impact of COVID-19 on health systems and the global healthcare workforce, while also bracing against the challenges posed by economic downturn, the report said.
Other factors include the consequences of climate change and shifting political priorities.
“Achieving UHC also requires modern, fit-for-purpose health information systems that provide timely and reliable data to inform policy design. Such shifts are essential as we continue to respond to and recover from the COVID-19 pandemic’s impacts on health systems and the health workforce, and as the challenges posed by deepening macroeconomic, climate, demographic, and political trends threaten to reverse hard-won health gains around the world,” said Ghebreyesus who wrote the foreward of the report along with Ajay Banga, President, World Bank Group.
Helping people escape poverty
“We know that achieving universal health coverage is a critical step in helping people escape and stay out of poverty, yet there continues to be increased financial hardship, especially for the poorest and most vulnerable people,” said Mamta Murthi, Vice President for Human Development at the World Bank.
“This report paints a dire picture, but also offers evidence on ways to prioritize health in government budgets and strengthen health systems for greater equity in both the delivery of essential quality health services and financial protection.”
The report was released ahead of a UN General Assembly high-level meeting on Thursday, where world leaders are expected to renew their pledge to act and make universal health coverage a reality for all.