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The World Health Organization (WHO) has released its 2024 Global Health Expenditure Report, showing a concerning decline in government spending on health worldwide in 2022, following a surge during the early years of the COVID-19 pandemic. The report, titled “Global Spending on Health: Emerging from the Pandemic,” underscores the challenges faced by many nations in maintaining adequate health funding in the post-pandemic era. Published in conjunction with Universal Health Coverage (UHC) Day, the report calls for a renewed commitment to universal health coverage to ensure equitable access to essential health services, free from financial hardship.
Declining Health Expenditure
The WHO’s latest findings show that the average per capita government spending on health decreased across all income groups in 2022, marking a reversal from the increased spending seen during the pandemic. This reduction in health funding is particularly concerning given the global health needs that persist, with 4.5 billion people still lacking access to basic health services and 2 billion people experiencing financial strain due to out-of-pocket healthcare costs.
Dr. Tedros Adhanom Ghebreyesus, WHO’s Director-General, emphasized that while access to health services has generally improved, rising costs have pushed many people into financial hardship or poverty, making the goal of universal health coverage even more critical. “Health for all means that everyone can access the health services they need without financial hardship,” he stated.
Out-of-Pocket Payments: A Global Concern
The report highlights the continued reliance on out-of-pocket spending, particularly in low- and middle-income countries, where such payments remain the primary source of health financing. In 30 low- and lower-middle-income countries, out-of-pocket expenses account for over half of total health spending. This reliance on direct payments exacerbates poverty and deepens vulnerability, creating a vicious cycle of financial strain for individuals and families.
In higher-income nations, out-of-pocket payments still represent a significant burden, especially for poorer households. In more than a third of high-income countries, over 20% of total health spending is paid directly by patients. This scenario underscores the need for a more inclusive approach to health financing, where public funds are used to ensure access to quality care for all, regardless of income.
Strengthening Financial Protection for Health
To achieve health for all, the WHO is urging countries to prioritize Universal Health Coverage (UHC) by eliminating financial barriers to care. WHO’s recommended strategies include reducing or eliminating user fees for vulnerable populations, implementing legislation to shield individuals from impoverishing health expenses, and increasing public health financing to ensure comprehensive coverage for all citizens.
The focus on financial protection is essential not only to mitigate the economic burden of healthcare but also to promote more equitable health outcomes across society. Countries are encouraged to design health financing systems that rely on public funding to cover essential services such as health promotion, prevention, treatment, and rehabilitation.
Lessons from the Pandemic
The COVID-19 pandemic underscored the critical role of government health spending in responding to health emergencies. Public funding enabled governments to scale up health systems rapidly, ensure widespread access to care, and protect populations during the global crisis. The pandemic highlighted the advantages of using public health budgets to finance large-scale public health interventions, particularly in emergencies.
As the world moves beyond the pandemic, governments face a complex balancing act. While responding to the ongoing health needs of populations, they must also build resilience against future health threats. The decisions made today regarding health financing will have lasting effects on the ability of countries to manage both routine and emergency healthcare needs in the future.
The Road Ahead: Prioritizing Universal Health Coverage
As part of the UHC Day campaign, WHO is calling on global leaders to make health a national priority and to commit to ensuring that no one is pushed into poverty due to health costs. The UHC Day campaign’s focus for 2024 is on improving financial protection, urging governments to take actionable steps to provide equitable healthcare to all citizens.
The WHO’s Health Expenditure Tracking program, which has been monitoring global health spending for 25 years, remains a vital tool in guiding policy decisions. Its efforts to collect and analyze health expenditure data across more than 190 countries provide crucial insights into global health trends and allow policymakers to track progress in achieving UHC.
WHO’s Efforts Toward UHC
In line with its ongoing efforts to promote UHC, WHO is hosting a series of high-level meetings from December 11–13, 2024, in Lyon, France. National health representatives, WHO country offices, and health policy advisers from over 125 countries are gathering to review progress, set priorities, and outline strategies for the next phase of the UHC Partnership. This initiative, supported by the European Union, Belgium, Canada, France, Germany, Ireland, Japan, and the UK, aims to drive concrete actions to ensure UHC and strengthen health systems globally.
As governments confront the post-pandemic economic realities, WHO’s call to prioritize UHC is more urgent than ever. The future of global health depends on the ability to maintain sustainable, equitable, and accessible health systems for all people, irrespective of their economic status.
