Global Health Coverage: Progress and Persistent Inequalities
Despite overall global progress, achieving universal health coverage (UHC) remains a significant challenge, particularly for the world’s poorest populations. A recent report highlights advancements in health service coverage,but underscores a growing disparity in access and affordability,threatening the realization of the human right to health by the 2030 Lasting Development Goals (SDG) deadline.
The report, utilizing revised SDG indicators for health service coverage (3.8.1) and financial hardship (3.8.2) introduced in 2025,analyzed data from 195 countries and territories (service coverage from 2000-2023) and 168 countries (financial hardship from 2000-2022). While demonstrating improvements in service coverage globally, it reveals a concerning trend: health costs are increasingly causing financial hardship, especially among lower-income groups.
In 2022, a stark inequality was evident – 3 out of 4 people in the poorest segment of populations experienced financial hardship due to health costs, compared to fewer than 1 in 25 among the wealthiest. This disparity extends beyond income, with women, individuals living in poverty, those in rural areas, and people with less education reporting greater difficulty accessing essential health services. While the gap between women in the richest and poorest income quintiles has slightly narrowed over the past decade (from 38 to 33 percentage points), vulnerable groups continue to face barriers even in high-performing regions like Europe, including those with disabilities.
The report acknowledges that these findings likely underestimate the true extent of health inequalities, as data often excludes the most vulnerable populations like displaced people and those living in informal settlements.
To accelerate progress towards the 2030 UHC goal, the report emphasizes the need for urgent action and strong political commitment. Six core areas are identified as crucial:
* Ensuring free access to essential healthcare at the point of service for people living in poverty and vulnerable situations.
* Increasing public investment in health systems.
* Addressing high out-of-pocket spending on medicines.
* Accelerating access to essential services for non-communicable diseases (NCDs), given the rising disease burden.
* Strengthening primary healthcare to promote equity and efficiency.
* Adopting multisectoral approaches,recognizing that health determinants extend beyond the healthcare sector.
The UHC Global Monitoring Report 2025 was presented at the UHC High-Level Forum in Tokyo, Japan, jointly hosted by the Government of Japan, the World Bank Group, and WHO. The forum also marked the launch of the UHC Knowledge Hub in Tokyo, supported by the Government of Japan, offering capacity strengthening programs for Ministries of Health and Finance to support health financing reforms.A technical webinar,”Tracking Universal Health Coverage: 2025 Global Monitoring Report,” will be held on December 8,2025,hosted by WHO,the World Bank Group,UHC2030 and the Joint Learning Network for Universal Health Coverage.
Further data on monitoring universal health coverage can be found at https://www.who.int/data/monitoring-universal-health-coverage and details about the UHC High-level Forum 2025 are available at https://www.who.int/news-room/events/detail/2025/12/06/default-calendar/universal-health-coverage-(uhc)-high-level-forum-high-level-forum). The webinar can be joined via https://worldbankgroup.zoom.us/j/98694745632?pwd=XaTlyV3Y4q1HwOvjkEiQwFap6IaowS.1 (Passcode: .W1MJT=@r3).
