“It’s on the Government!”: Universal Health Coverage Day

According to the Tracking Universal Health Coverage 2023 Report, 1.3 billion people were pushed into poverty or further into poverty in 2019 because of out-of-pocket health spending. Poverty and access to health care are deeply intertwined—health care expenses push people into poverty and poverty prevents people from being able to access health care. Reducing poverty and improving access to health services are important facets of Sustainable Development Goal (SDG) 3.8 for achieving Universal Health Coverage (UHC).

SDG 3.8 aims to ensure all people can access quality health services where and when they need it, without financial hardship; however, with a growing proportion of people globally facing financial hardship due to health spending, the world is not on track to achieve global commitments set out by the SDGs.

December 12 is Universal Health Coverage Day, a day to rally around bringing UHC to all. This UHC Day, the theme is “Health: It’s on the Government!,” highlighting how governments have a responsibility to ensure that health care is available, accessible, and affordable.

Progress towards UHC is monitored using two indicators: the UHC Service Coverage Index (SCI) and out-of-pocket health spending. The SCI summarizes coverage for essential health services in the four sub-categories of reproductive, maternal, newborn, and child health; infectious diseases; noncommunicable diseases; and service capacity and access. Although SCI scores have increased globally since 2000, gains have stalled in recent years, leaving 4.5 billion people—more than half the world’s population—not covered for essential health services.

The financial hardship aspect of UHC likewise is not improving; in fact, it seems to be getting worse. Catastrophic out-of-pocket health spending, which is defined as spending more than 10 percent of a household's budget on health expenses, has continuously increased since 2000. Although part of this increase may reflect people having more wealth to spend on health care, larger out-of-pocket payments reflect the failure of health systems to capture resources in a mechanism that provides financial protection and pools risk, such as social insurance.

For people living near or in poverty, even small expenses can push them below or further below the poverty line. According to the Tracking Universal Health Coverage Report, the proportion of people facing catastrophic health spending increased from 9.6 percent in 2000 to 13.5 percent in 2019, while the proportion of people facing impoverishing health spending at the relative poverty line increased from 11.8 percent to 16.7 percent during the same period. The growing proportion of people facing impoverishing and catastrophic out-of-pocket health spending indicates that governments are not doing enough to protect people from financial hardship.

With stalling gains in service coverage and worsening financial protection, the world is solidly off track from achieving UHC by 2030. This UHC Day, the WHO is calling on governments to redouble their efforts on UHC and invest in making basic health services and essential medicines available, accessible, and affordable for everyone. To learn more about UHC, check out our resource pack on Health Systems and Universal Health Coverage or the selected resources below.

Teaching Resource

Selected Resources

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