WHO’s 2024 Global Health Expenditure Report: A Critical Look at Health Financing Post-Pandemic and the Urgency for Universal Health Coverage (UHC)
The 2024 Global Health Expenditure Report by the World Health Organization (WHO) paints a concerning picture of the state of global health financing, revealing that average government spending on health per capita decreased in 2022, following an initial surge during the pandemic years. This report, titled “Global Spending on Health: Emerging from the Pandemic”, was released in conjunction with Universal Health Coverage (UHC) Day, which is marked annually on 12 December. The WHO report underscores the importance of sustainable public health funding to achieve Universal Health Coverage and financial protection for all individuals, especially the most vulnerable.
A Decline in Government Health Spending in 2022
In its 2024 report, WHO highlights that despite the global health sector’s recovery, government spending on health declined across all income groups in 2022 compared to 2021. This decline follows the pandemic-induced surge in spending during the critical years of 2020 and 2021. While many countries ramped up health budgets to combat the health emergency, the global financial landscape has shifted, leading to reduced health expenditure in the aftermath.
Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, commented on the findings: “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.” His statement highlights the core issue: while healthcare access has improved, many individuals are still facing financial hardship due to the rising costs of health services.
The Struggles of Out-of-Pocket Health Payments
A significant concern outlined in the report is the reliance on out-of-pocket payments for healthcare, which remains the dominant source of health financing in 30 low- and lower-middle-income countries. In fact, in 20 of these countries, more than half of total health spending is financed by patients directly, exacerbating the cycle of poverty and vulnerability. WHO warns that out-of-pocket spending is a critical barrier to achieving financial protection, which is a cornerstone of Universal Health Coverage.
This issue is not confined to low-income countries alone. Even in high-income nations, the report reveals that out-of-pocket payments account for a significant portion of healthcare costs. In over a third of high-income countries, more than 20% of total health expenditure is paid out of pocket, contributing to financial strain and unmet healthcare needs, especially for the most vulnerable populations.
UHC Day 2024: A Call for Action
As part of the Universal Health Coverage (UHC) Day 2024 campaign, WHO is urging countries to prioritize the goal of UHC and eliminate impoverishment due to health-related costs by 2030. The report outlines key strategies for enhancing financial protection, such as:
- Reducing user charges for essential health services, particularly for individuals with low incomes or chronic conditions.
- Legislating protections to shield populations from impoverishing health costs.
- Establishing public funding mechanisms to ensure the full population is covered by health services.
These strategies are critical to achieving UHC, as they ensure that health services are accessible without imposing an undue financial burden on individuals and families.
The Role of Public Health Funding in Crisis Response
The pandemic revealed the value of public health funding in addressing health crises. In 2020–2022, government health budgets enabled countries to quickly respond to the COVID-19 emergency, providing critical public health interventions and saving countless lives. WHO emphasizes that government funding is vital for supporting population-based public health functions during health emergencies.
Now, emerging from the pandemic, countries are at a crossroads, facing tough decisions on how to balance strengthening their health systems for future threats while managing healthcare needs in a challenging economic environment.
Tracking Health Expenditure: 25 Years of WHO Monitoring
For 25 years, the WHO Health Expenditure Tracking Program has provided reliable data on global health spending patterns. The Global Health Expenditure Database, which covers more than 190 countries since 2000, has become the world’s most comprehensive source of health expenditure information. The Global Health Expenditure Report, published annually since 2017, continues to play a crucial role in driving informed policymaking, transparency, and accountability in global health financing.
WHO’s Continued Efforts to Achieve UHC
This year’s UHC Day also served as a milestone for WHO’s efforts to support countries in their journey toward Universal Health Coverage. From 11–13 December, national health representatives, WHO country office heads, and health policy advisors from over 125 countries gathered in Lyon, France. They discussed the challenges, agreed on priority areas, and set the agenda for the next phase of the UHC Partnership for 2025-2027.
The UHC Partnership, WHO’s flagship initiative for international cooperation on UHC, continues to bring together a wide range of partners, including the European Union, Canada, Germany, Japan, and the UK, to advance concrete actions that help countries strengthen their health systems and ensure health security globally.
The Path Forward: Achieving Financial Protection for All
The WHO report is a critical reminder that achieving Universal Health Coverage requires both adequate funding and strong political will. As out-of-pocket expenses remain a major barrier to health access, governments must adopt more effective strategies to finance healthcare through public funding, protecting their populations from health-related financial hardship.
WHO’s call to action on UHC Day 2024 is clear: make UHC a national priority, ensure financial protection for all, and work toward eliminating health-related poverty by 2030. With public health systems at the center of these efforts, it is crucial that nations commit to sustainable health financing that prioritizes the most vulnerable.
Key Takeaways:
- Global Health Expenditure Decline: WHO’s 2024 report shows a decrease in government health spending per capita in 2022 compared to the pandemic years.
- Out-of-Pocket Payments: Over half of health spending in many low-income countries is financed by patients, exacerbating poverty.
- Universal Health Coverage: WHO urges nations to make UHC a priority and eliminate health-related impoverishment by 2030.
- Public Health Funding: Government budgets were essential in responding to the COVID-19 crisis, demonstrating the importance of public health funding for future crises.
- WHO’s UHC Partnership: The UHC Partnership continues to support countries globally to advance Universal Health Coverage.
As the world looks toward UHC Day 2024 and beyond, it’s clear that achieving financial protection for all and ensuring that health services are accessible without financial hardship is essential for a healthier, more equitable world.
