12 June 2015: At least 400 million people lacked access to at least one essential health service in 2013, according to a joint report by the World Health Organization (WHO) and the World Bank. The report also highlights the effect of health services spending by the poor, noting that health spending tips people in low and middle-income countries into extreme poverty and threatens the post-2015 development agenda’s ambition of eliminating extreme poverty.

‘Tracking Universal Health Coverage: First Global Monitoring Report’ is the first report to assess countries’ progress towards universal health coverage (UHC). It examines global access to health services, such as access to clean water and sanitation, family planning, skilled birth attendance, antenatal care, child immunization, antiretroviral therapy and tuberculosis treatment.

The report also analyzes the effect of health spending on poverty levels. Across 37 countries, six percent of the population was tipped further into extreme poverty ($1.25/day) as a result of paying for health services. When using a poverty measure of $2/day, 17% of people in these countries were impoverished, or further impoverished, because of health expenses.

“This report is a wakeup call: It shows that we’re a long way from achieving universal health coverage,” said Tim Evans, Senior Director of Health, Nutrition and Population, the World Bank. “A commitment to equity is at the heart of universal health coverage,” explained WHO’s Marie-Paule Kieny, who also added that “the world’s most disadvantaged people are missing out on even the most basic services.”

The report recommends that countries aim to achieve at least 80% population coverage of essential services, and 100% protection from catastrophic and impoverishing health payments. It further proposes including a specific target on achieving UHC in the Sustainable Development Goals (SDGs), underscoring that UHC represents an avenue for supporting the right to health, ending extreme poverty and improving equity. Within this context, the report recommends that health policies and programmes focus on progress among the poorest people, women and children, people living in rural areas and minority groups. Other recommendations address the importance of monitoring progress on UHC and financial protection.

This report is the first in a series of annual reports that WHO and the World Bank will produce to track progress towards UHC. The Rockefeller Foundation and the Japanese Ministry of Health provided support for the report.

Also in 2015, WHO released ‘State of Inequality: Reproductive, maternal, newborn and child health,’ which underscores the need for additional progress on reducing inequalities in these areas. The report finds within-country inequality differs across health indicators, with maternal health indicators exhibiting the most pronounced inequalities within countries and large gaps in coverage for births attended by skilled health personnel. [WHO Press Release] [UHC Report Website] [Publication: Tracking Universal Health Coverage: First Global Monitoring Report] [Publication: State of Inequality: Reproductive, Maternal, Newborn and Child Health]