Global financial fallout of pandemic slows progress toward universal health coverage

The pandemic likely has tapped the brakes on two decades of global progress toward universal health coverage. Even before the pandemic, more than a half-billion people were further pushed into extreme poverty because they have to pay for health services out of their own pockets.

New reports by the World Health Organization and the World Bank highlight the devastating impact of COVID-19 on people’s ability to obtain health care and pay for it. In 2020, the pandemic disrupted health services and stretched countries’ health systems beyond their limits as they struggled to deal with the impact of COVID-19. The pandemic also triggered the worst economic crisis since the 1930s, making it increasingly difficult for people to pay for care.

“There is no time to spare,” said Dr. Tedros Adhanom Ghebreyesus, WHO director-general. “All governments must immediately resume and accelerate efforts to ensure every one of their citizens can access health services without fear of the financial consequences. This means strengthening public spending on health and social support, and increasing their focus on primary health-care systems that can provide essential care close to home.”

The organizations also warn that financial hardship is likely to become more intense as poverty grows, incomes fall and governments face tighter fiscal constraints.

“Even before the COVID-19 pandemic struck, almost one billion people were spending more than 10% of their household budget on health,” said Juan Pablo Uribe, global director for health, nutrition and population for the World Bank. “This is not acceptable, especially since the poorest people are hit hardest. Within a constrained fiscal space, governments will have to make tough choices to protect and increase health budgets.”

Up to 90% of all households incurring impoverishing out-of-pocket health spending already are at or below the poverty line, underscoring the need to exempt poor people from out-of-pocket health spending, backing such measures with health financing policies that enable good intentions to be realized in practice, the report said. It also is crucial to improve the collection, timeliness and disaggregation of data on access, service coverage, out-of-pocket health spending and total expenditure.

Since the start of the pandemic, the World Bank Group has deployed more than $157 billion to fight the health, economic and social impacts. This financing is helping more than 100 countries strengthen pandemic preparedness, protect the poor and jobs, and jumpstart a climate-friendly recovery.