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A new WHO report reveals that governments are deprioritizing health spending
The Global Health Expenditure Report 2024 The World Health Organization (WHO) shows that average government health spending per capita across all income groups in the country fell in 2022 compared to 2021 after rising in the early years of the pandemic. The report entitled “Global Health Spending After the Pandemic” was published in accordance with Universal Health Care (UHC) Day. campaign that is celebrated every year on December 12. The focus of the 2024 campaign is to improve financial protection for people everywhere so they can access the health services they need.
Government spending on health is key to achieving UHC. Its deprioritization can have dire consequences in a context where 4.5 billion people worldwide do not have access to basic health services and 2 billion people face financial hardship due to health costs.
“While access to health services is improving globally, the use of these services is driving more and more people into financial hardship or poverty. Universal Health Care Day is a reminder that health for all means that everyone can access the health services they need, without financial difficulties,” said Dr. Tedros Adhanom Ghebreyesus, Director General of WHO.
Who pays for health care?
Protecting people from financial hardship due to out-of-pocket health costs is essential to achieving health for all. However, the WHO report shows that out-of-pocket spending remains the main source of health financing in 30 low- and lower-middle-income countries. In 20 of these countries, more than half of the country's total health spending was paid by patients out of pocket, contributing to a cycle of poverty and vulnerability.
The challenges posed by the lack of financial health protection are not limited to lower-income countries. Even in high-income countries, out-of-pocket payments lead to financial hardship and unmet needs, particularly among the poorest households. The latest data on health bills show that in more than a third of high-income countries, more than 20% of total health spending is paid out of pocket.
On the occasion of UHC Day, WHO calls on leaders to make UHC a national priority and eliminate poverty due to health-related costs by 2030. Effective strategies to strengthen financial protection include reducing or eliminating user fees for those most in need, including people with low incomes or chronic conditions, passing laws to protect people from debilitating health costs and establishing health financing mechanisms through public funding to cover the entire population.
Public financing should ensure an affordable package of basic health services – from health promotion to prevention, treatment, rehabilitation and palliative care – using a primary health care access.
Lessons from the pandemic
During the 2020-2022 COVID-19 pandemic, public spending on health—mainly through national health budgets—allowed health systems to respond quickly to emergencies. This reflects the advantage of state budgets in financing public health functions, especially public health interventions on the population, compared to other health financing schemes, during emergency health situations. Government funding ensured that more people were protected and more lives were saved.
Emerging from the pandemic, countries are at a crossroads. Governments face difficult decisions as they work to strengthen the resilience of health systems to future health threats, while simultaneously addressing the health needs of their populations in a challenging economic environment.
Twenty-five years of WHO monitoring global health spending
The key to making better choices about future healthcare investments is timely and reliable evidence on the level and pattern of healthcare spending. For 25 years, WHO's health expenditure monitoring program has had a major impact on how critical information on health expenditure is collected and reported at the country level and globally.
Among his most significant achievements is the establishment Global Health Expenditure Database – the world's richest source of health expenditure data covering more than 190 countries since 2000 – and the Global Health Expenditure Report, published annually since 2017. These global public goods encourage informed policy-making, transparency and accountability throughout the world.
WHO and partners advance UHC impact efforts
This year's UHC Day also provides a platform to discuss a milestone in WHO's efforts to advance support and collaboration with countries in realigning their health systems to advance UHC and achieve health security in countries, regions and globally. From 11 to 13 December, national health representatives, heads of WHO country offices and health policy advisors from more than 125 countries are meeting in Lyon, France to review progress and challenges, agree priority areas and methods of work, and set agenda for the next phase UHC partnership from 2025-2027.
The UHC Partnership is WHO's flagship initiative on international collaboration for UHC, bringing together WHO and partners to support concrete actions to achieve UHC. It is financed by the European Union, Belgium, Canada, the French Ministry for Europe and Foreign Affairs, Germany, Irish Aid, the Government of Japan and the United Kingdom – Foreign, Commonwealth & Development Office.
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