Governments deprioritizing health spending could lead to financial hardship – WHO report warns

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A new report from the World Health Organization (WHO) warns that governments deprioritizing health spending could leave people at risk of financial hardship.

The report highlights a drop in average per capita spending across all income groups, signaling a shift as countries adjust to post-pandemic fiscal realities.

The report titled, “Global spending on health Emerging from the pandemic” has been published in alignment with the Universal Health Coverage (UHC) Day campaign marked annually on 12 December.

The campaign’s focus for 2024 is on improving financial protection for people everywhere to access the health services they need.

Government spending on health is crucial to delivering Universal Health Coverage, “Its deprioritization can have dire consequences in a context where 4.5 billion people worldwide lack access to basic health services and 2 billion people face financial hardship due to health costs,” WHO report warns.

However, Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, emphasized that while access to health services has been improving globally, using those services is driving more and more people into financial hardship or poverty.

“Universal Health Coverage Day is a reminder that health for all means everyone can access the health services they need, without financial hardship,” he stated.

The financial burden of out-of-pocket health spending

The WHO report emphasizes the critical need to shield individuals from financial hardship caused by out-of-pocket health expenses, recognizing this as a fundamental aspect of achieving universal health coverage.

  • According to the report, out-of-pocket spending continues to be the primary source of health financing in 30 low- and lower-middle-income countries. In 20 of these nations, more than half of total health spending is paid directly by patients, perpetuating a cycle of poverty and vulnerability.
  • The report also highlights that the issue of inadequate financial protection for health is not exclusive to lower-income countries. Even in high-income nations, out-of-pocket payments contribute to financial strain and unmet health needs, especially among the poorest households.

Recent health accounts data indicate that in over a third of high-income countries, more than 20% of total health spending is paid out-of-pocket.

WHO’s call to action for UHC 

On UHC Day, WHO is urging leaders to prioritize UHC and eliminate impoverishment due to health-related expenses by 2030.

  • The global body outlined effective strategies to strengthen financial protection, including minimizing or removing user charges for those most in need, such as people with low incomes or chronic conditions.
  • WHO also advocates for adopting legislation to protect people from impoverishing health costs and establishing health financing mechanisms through public funding to cover the entire population.

Public funding needs to budget for an affordable package of essential health services – from health promotion to prevention, treatment, rehabilitation, and palliative care – using a primary health care approach,” the report explained.

Government health spending during the pandemic

The report highlights that during the COVID-19 pandemic (2020–2022), public spending on health, primarily through government health budgets, enabled health systems to respond rapidly to the emergency.

“The average per capita government spending on health in all country income groups fell in 2022 from 2021 after a surge in the early pandemic years.

“This reflects the advantage of government budgets in financing public health functions, particularly population-based public health interventions, during health emergencies,” WHO stated.

Government funding ensured more people were protected, and more lives were saved.

A crossroads for global health systems

Emerging from the pandemic, countries are at a crossroads.

WHO stressed that governments are facing difficult decisions as they work to strengthen the resilience of health systems against future health threats while addressing the healthcare needs of their populations in a challenging economic environment.


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