Currently, 800-million people spend at least 10% of their household budgets on health expenses for themselves, a sick child or other family member. For almost 100-million people these expenses are high enough to push them into extreme poverty, forcing them to survive on just $1.90 or less a day.
"It is completely unacceptable that half the world still lacks coverage for the most essential health services," says Dr Tedros Adhanom Ghebreyesus, director-general of the World Health Organisation (WHO). "And it is unnecessary. A solution exists: universal health coverage (UHC) allows everyone to obtain the health services they need, when and where they need them, without facing financial hardship.
"The report makes clear that if we are serious – not just about better health outcomes, but also about ending poverty – we must urgently scale up our efforts on universal health coverage," says Dr Jim Yong Kim, World Bank Group president.
"Investments in health, and more generally investments in people, are critical to build human capital and enable sustainable and inclusive economic growth. But the system is broken: we need a fundamental shift in the way we mobilise resources for health and human capital, especially at the country level. We are working on many fronts to help countries spend more and more effectively on people, and increase their progress towards universal health coverage."
There is some good news: The report shows that the 21st century has seen an increase in the number of people able to obtain some key health services, such as immunisation and family planning, as well as antiretroviral treatment for HIV and insecticide-treated bed nets to prevent malaria. In addition, fewer people are now being tipped into extreme poverty than at the turn of the century.
Progress, however, is very uneven
There are wide gaps in the availability of services in sub-Saharan Africa and Southern Asia. In other regions, basic healthcare services such as family planning and infant immunisation are becoming more available, but lack of financial protection means increasing financial distress for families as they pay for these services out of their own pockets.
This is even a challenge in more affluent regions such as Eastern Asia, Latin America and Europe, where a growing number of people are spending at least 10% of their household budgets on out-of-pocket health expenses. Inequalities in health services are seen not just between, but also within countries: national averages can mask low levels of health service coverage in disadvantaged population groups. For example, only 17% of mothers and children in the poorest fifth of households in low- and lower-middle income countries received at least six of seven basic maternal and child health interventions, compared to 74% for the wealthiest fifth of households.