WHO Universal Health Coverage Report Shows Billions Still Lack Access to Health Services

A new report from the World Health Organization (WHO) and the World Bank shows that while global access to health services has expanded over the last two decades, billions of people still struggle to get the care they need. The Universal Health Coverage Global Monitoring Report 2025, published on December 6, highlights both progress and widening inequalities.

According to the report, countries at all income levels have increased service coverage and financial protection since 2000. The global Service Coverage Index improved from 54 to 71 between 2000 and 2023. At the same time, the share of people facing financial hardship from medical expenses dropped from 34 percent to 26 percent.

Billions Still Lack Essential Care

Despite these gains, huge gaps remain. The report estimates that 4.6 billion people do not have access to essential health services. In addition, 2.1 billion face financial hardship when seeking care. Among them, 1.6 billion people either live in poverty or fall into it because of out-of-pocket medical costs.

WHO Director-General Dr Tedros Adhanom Ghebreyesus said universal health coverage expresses the right to health, yet billions still cannot afford or access basic services. He also warned that cuts in international aid continue to strain already fragile health systems.

Households spending more than 40 percent of their income on medical care are classified as facing financial hardship. Medicines make up the largest share of these costs. They account for at least 55 percent of out-of-pocket spending globally and up to 60 percent among the poorest households. Consequently, many families cut back on food, education or housing.

Even middle-income families now face growing pressure, as health expenses take up more of their budgets.

Progress Slows, Inequalities Persist

The report notes that progress toward universal health coverage has slowed since 2015. Only one-third of countries increased service coverage while reducing financial hardship. All WHO regions increased access, but only Africa, South-East Asia and the Western Pacific reduced financial strain on households.

Low-income countries achieved the fastest improvements, largely in infectious disease responses. Noncommunicable disease care and maternal, newborn and child health services improved more slowly. Although poverty levels dropped due to better sanitation, income growth and social protections, inequalities remain high. Women, rural communities, displaced populations, informal settlement residents, the less educated and people with disabilities still face the greatest barriers.

The WHO report calls on governments to expand essential services, reduce medicine prices and strengthen primary care systems.