The 2024 Global Health Expenditure Report by the World Health Organization (WHO) reveals a concerning trend: government spending on health per capita decreased in 2022 across all income groups after an initial surge during the early years of the COVID-19 pandemic.
The report, titled “Global Spending on Health: Emerging from the Pandemic,” has been released in conjunction with this year’s Universal Health Coverage (UHC) Day, observed annually on December 12. The 2024 campaign focuses on improving financial protection to ensure everyone can access the healthcare they need.
Why government spending matters
Government funding is a cornerstone of delivering Universal Health Coverage. Yet, deprioritizing health budgets poses dire risks in a world where 4.5 billion people still lack access to essential health services, and 2 billion face financial hardship due to healthcare costs.
“Access to health services is improving globally, but these services are driving many people into financial hardship or poverty,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “Universal Health Coverage Day reminds us that health for all means everyone can access the care they need without financial hardship.”
Who pays for healthcare?
Protecting people from the burden of out-of-pocket health costs is fundamental to achieving UHC. However, WHO’s report shows that in 30 low- and lower-middle-income countries, out-of-pocket spending remains the primary source of health financing. In 20 of these countries, over half of the total health expenditure comes directly from patients, perpetuating cycles of poverty and vulnerability.
This issue is not confined to low-income nations. Even in high-income countries, out-of-pocket payments often lead to financial strain and unmet healthcare needs, especially for the poorest households. Data reveals that in more than a third of high-income nations, over 20% of total health spending comes from individuals’ pockets.
What do we do?
On UHC Day, WHO is urging leaders to prioritize Universal Health Coverage and eliminate impoverishment caused by healthcare expenses by 2030. Key strategies include:
- Reducing or removing user charges for low-income individuals and those with chronic conditions.
- Passing legislation to protect people from catastrophic health costs.
- Establishing public health financing mechanisms to ensure coverage for entire populations.
Governments must allocate public funds to provide affordable essential health services, ranging from prevention and treatment to rehabilitation and palliative care, with a strong focus on primary healthcare.
Lessons from the pandemic
The COVID-19 pandemic underscored the importance of public spending on health. During the crisis, government-funded health systems proved crucial for swift responses and population-wide public health interventions. These investments saved countless lives and protected many more. As the world emerges from the pandemic, governments must navigate the dual challenge of addressing immediate healthcare needs while strengthening resilience against future health threats.
25 years of tracking health spending
For a quarter of a century, WHO’s Health Expenditure Tracking program has provided vital insights into global health spending patterns. Its Global Health Expenditure Database, which covers over 190 countries since 2000, and annual expenditure reports have become essential tools for policymakers worldwide. These resources promote transparency, accountability, and evidence-based decision-making.
Charting the future of UHC
This year’s UHC Day also marks a significant milestone in WHO’s collaborative efforts to advance UHC. From December 11–13, representatives from over 125 countries are convening in Lyon, France, to assess progress, discuss challenges, and set priorities for the next phase of the UHC Partnership (2025–2027).
Funded by partners such as the European Union, Japan, Canada, and others, the UHC Partnership aims to turn global commitments into tangible actions. By aligning efforts, it seeks to transform health systems and secure health for all.
The path ahead
As we reflect on the findings of this report, one thing is clear: governments must recommit to health funding as a critical investment in their populations’ future. Achieving Universal Health Coverage is not just a moral imperative—it is a strategic choice to create healthier, more resilient societies.
Let UHC Day 2024 serve as a reminder that equitable healthcare is within reach when nations prioritize the well-being of their people.
