WHO Calls for Increased Investment in Universal Health Coverage Amid Funding Challenges
The ongoing 77th World Health Assembly in Geneva, Switzerland

The World Health Organization (WHO) has urged stakeholders in the health sector to collaborate in reorienting health systems towards a primary healthcare approach, a key priority in helping more people access universal health coverage (UHC). The organization has also called on countries to increase domestic spending on health and for banks to fund climate and health projects.

Speaking at a roundtable discussion during the ongoing World Health Assembly in Geneva on Wednesday, WHO Director-General Dr Tedros Adhanom Ghebreyesus emphasized that investments in health and UHC should be seen as an investment in healthy, productive, and resilient societies.

“Fundamentally, UHC is a political choice,” Tedros said. “But it’s a choice that must be translated into budgetary action.”

Currently, more than half the world’s population lacks coverage for essential health services, and nearly one in four people have suffered financial hardship or incurred catastrophic expenditures to access health services. Progress in reducing maternal and child mortality has also stalled in recent years.

“For this agenda to succeed, it must be embedded in national leadership,” said Dr. Githinji Gitahi, Group Chief Executive Officer of Amref Health Africa. “Unless the national ministers of health, ministers of planning, ministers of finance lead the way for accountability, transparency and national plans, it is going to be difficult to implement.”

Dr Githinji Gitahi, Group Chief Executive Officer of international health and development organisation Amref Health Africa

As extreme weather events rise due to climate change, attaining UHC has become even more important. Kazakhstan’s Minister of Healthcare, Dr Akmaral Alnazarova, shared their experience in handling recent floods that affected nearly 80% of the country, emphasizing the role of primary healthcare in providing 90% of basic medical services and ensuring continuous access during emergencies.

During the roundtable, Japan announced plans to establish a hub for UHC in Tokyo in collaboration with WHO and the World Bank, inviting countries and stakeholders to collaborate and share learnings from its own experience in delivering UHC.

The Finance Conundrum

Finance remains a crucial challenge to scaling up UHC, especially for low- and middle-income countries with limited capacity. The WHO is pushing for more domestic public financing as the most sustainable solution and urges countries to prioritize spending on healthcare through a multi-sectoral approach.

“There isn’t a financing gap. There is just money that is not moving towards the right things. There’s plenty of money out there,” said Mariana Mazzucato, Chair of WHO’s Council on the Economics of Health for All.

Despite Mazzucato’s assertion that there is no financing gap, the WHO itself faces a significant funding shortfall. The organization has secured only $4 billion of the $11 billion needed to fund its four-year work plan, GPW-14, which was approved by the World Health Assembly on Monday.

Mariana Mazzucato, Chair of WHO’s Council on the Economics of Health for All

Low- and middle-income countries, as well as Small Island Developing States, are grappling with the highest debt repayment rates in 25 years and the escalating costs of being on the front lines of the climate crisis. These nations have openly expressed their difficulties in raising funds to finance the ambitious goal of UHC.

More than half of the world’s poorest countries, home to 2.4 billion people, are being forced to cut public spending by a combined $229 billion over the next five years, according to Oxfam.

In 2021, low- and middle-income countries allocated 27.5 percent of their budgets to debt service, which was twice their education spending, four times their health spending, and nearly 12 times their social protection spending. Sixty-two countries worldwide currently spend more on refinancing foreign debt than on health care.

Multilateral development banks, meanwhile, are slowly beginning to prioritize climate and health projects. The European Investment Bank, which serves all 27 European Union member countries, no longer funds fossil fuels and is expanding its investments in health systems. The World Bank currently has $35 billion invested in health system financing across 100 countries and plans to expand into new geographical areas.

However, despite public commitments, many private banks continue to invest billions in coal projects, while green projects in developing countries struggle to secure funding due to perceived high risks and low profitability. The cost of borrowing money in developing countries is often prohibitively high, with interest rates two to three times higher than those in wealthy nations.

“Since 2,000, 30% of member states have made progress in expanding both service coverage and financial protection towards UHC,” Tedros said. “It is vital that all international funding is better aligned with national plans, priorities and systems.”

Image Credits: Twitter.

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