Global Health Access Challenges: A Closer Look
Over 4.6 billion people globally still lack basic health services, according to a 2023 report from the World Health Organization (WHO) and the World Bank. This is over half the world’s population. Unfortunately, about 2.1 billion people struggle to afford necessary health care.
Achieving Universal Health Coverage (UHC) by 2030 seems increasingly unlikely. Data show that without significant changes, the global service coverage index—which evaluates access to essential health services—will only reach 74 out of 100 by 2030. This figure is barely an improvement over current levels, and about one in four people worldwide may continue facing financial difficulties when seeking care.
Historical Context and Trends
Looking back to the period from 2000 to 2015, there was a notable increase in health service access and a reduction in financial hardship. However, progress has stagnated since then. The COVID-19 pandemic exacerbated existing issues, pushing many healthcare systems to the brink.
Gabriella Saint-Germain, the WHO’s financial protection team leader, explains that the service coverage index combines 14 indicators to assess overall health system performance. This broad measure highlights access gaps that persist.
A recent report highlighted that among low-income countries, public health spending is often alarmingly low, averaging merely $17 per person. This is significantly below the estimated $60 needed to provide basic health services. Monique Vledder from the World Bank emphasized that if funding trends do not change, spending could drop even further.
Financial Trends in Health Spending
Despite these challenges, some positive trends are emerging. From 2000 onwards, 53% of countries reported improvements in service access and financial burden reduction. While low-income countries saw the largest enhancements, they still face considerable gaps compared to wealthier nations.
Moreover, domestic public health spending has seen slight increases across most countries. In fact, in 2023, such spending exceeded pre-pandemic figures in all but the lowest-income nations. Here, reliance on international aid has increased, with some countries reporting that aid constitutes over half of their health budgets.
An Actionable Path Forward
At a recent UHC conference, several low-income nations announced new strategic plans, termed “national health compacts.” These initiatives aim to enhance health financing and focus on sustainable growth in healthcare systems. Co-chaired by the Government of Japan, these compacts highlight new strategies and include commitments from major donors like Gavi and the Gates Foundation to mobilize additional funds.
Key strategies include:
Digital Health Integration: Countries like the Philippines are connecting health facilities digitally, which improves service delivery.
Virtual Care Expansion: Remote healthcare services are being rolled out to reach underserved populations.
Health Insurance Initiatives: For example, Morocco plans to extend mandatory health coverage to millions more.
Boosting Local Manufacturing: Nigeria is focusing on training professionals to enhance local production of essential medicines and healthcare technologies.
These actions provide a framework for addressing current gaps and moving towards better global health accessibility.
Conclusion
While significant barriers to healthcare access remain, advancements in policy, funding, and healthcare delivery models show promise. Continuous collaboration between nations and health organizations will be vital as we move forward. Enhanced funding, innovative approaches, and commitment to equitable health solutions can help transform global health landscapes.
For further information on essential health services, check out the WHO Global Expenditure database.
