State of UHC commitment

Action is more urgent than ever, given that more than half of the world’s population – 4.5 billion people – are unable to access essential health services and 2 billion are facing financial hardship due to out-of-pocket health spending. The findings on gaps in action on UHC commitments in the eight areas are provided below: 

1. Ensure political leadership beyond health: Most countries recognize UHC as a goal but have not taken concrete operational steps to achieving UHC.
2. Leave no one behind: Vulnerable individuals and groups continue to face financial and structural barriers to accessing the health services and commodities they need.
3. Legislate and regulate: While 89% of countries have made UHC a central goal in their national health policy plans and strategies, 41% have enacted UHC laws to ensure equitable, affordable access to health services.
4. Uphold quality of care: The global shortage of health and care workers, lack of support for the health and care workforce and inadequate health-care resources remain challenges to providing effective, safe, people-centred care for all.
5. Invest more, invest better: Despite continued increases in overall health expenditure for the COVID-19 response, governments’ current investment commitments and public spending for health are inadequate to achieve UHC.
6. Move together: Few countries have a formal, effective accountability mechanism for UHC, with inadequate multistakeholder engagement.
7. Gender equality: Although women represent the majority of the health and care workforce, there is lack of commitment to achieving gender equality in the health and care workforce and to increasing women’s representation in overall political leadership for health.
8. Emergency preparedness: Countries do not invest sufficiently in health systems strengthening based on primary health care to achieve UHC and health security.