The 2024 Global Heath Expenditure Report by the World Health Organization (WHO) shows that 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. 

The report entitled, “Global spending on health Emerging from the pandemic” has been published in alignment with the Universal Health Coverage (UHC) Day campaign marked annually on December 12 with its campaign’s focus for 2024 is on improving financial protection for people everywhere to access health services they need. 

WHO Director-General, Dr Tedros Adhanom Ghebreyesus said while access to health services had been improving globally, using the services was 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.” 

Government spending on health is crucial to delivering UHC and its de-prioritization 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’s report shows that out-of-pocket spending remained the main source of health financing in 30 low- and lower middle-income countries and in 20 of the countries, more than half of total health spending was paid for by patients out of their pocket, which contributes to the cycle of poverty and vulnerability. 

The challenges posed by the lack of financial protection for health are not limited to lower-income countries since even in high-income countries, out-of-pocket payments lead to financial hardship and unmet need, particularly among the poorest households. 

“Most recent health accounts data show that in over a third of high-income countries, more than 20 per cent of total health spending was paid out-of-pocket”. 

WHO called on leaders to make UHC a national priority and eliminate impoverishment due to health-related expenses by 2030.  

The Organisation noted that effective strategies to strengthen financial protection include minimising or removing user charges for those most in need, including people with low incomes or chronic conditions, adopting legislation to protect people from impoverishing health costs and establishing health financing mechanisms through public funding to cover the full population. 

It said public funding needed 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. 

WHO said lessons from the COVID-19 pandemic in 2020–2022, public spending on health – mainly via government health budgets –enabled health systems to respond quickly to the emergency reflected the advantage of government budgets in financing public health functions, in particular population-based public health interventions, versus other health financing schemes, during times of health emergencies.  

This year’s UHC Day also provided a platform for a milestone discussion in WHO’s efforts to advance support and collaboration with countries in reorienting their health systems to advance UHC and achieve health security in countries, regions and globally. 

The UHC Partnership is WHO’s flagship initiative on international cooperation for UHC, which brings WHO and partners together to support concrete actions to achieve UHC. 

It is funded 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.