Worldwide, Policies Leave Health Care Inaccessible for Too Many

Twelve years ago, on December 12, the United Nations General Assembly endorsed a resolution calling on all countries to achieve universal health coverage (UHC), while also establishing a day to reflect on our collective progress towards this goal. But this year’s International Health Coverage Day comes amid global failures to dedicate adequate public resources to health care, undermining the right to health for people around the world.

UHC, a framework developed by the UN where everyone has access to affordable, good quality health care, can further the realization of the human right to health. Governments have made public commitments towards this goal, reflecting their human rights obligations to prevent and treat infectious and noncommunicable diseases, and to ensure the availability and accessibility of quality healthcare facilities and services, including maternal and postpartum care.

Human Rights Watch’s analysis of the World Health Organization’s (WHO) Global Health Expenditure Database earlier this year found that, when governments spent more on health care through public means, people had greater access to these essential healthcare goods and services.

But we also found that most governments were falling short of key public healthcare spending benchmarks, and that many were scaling back public support for health care. Shockingly, we found that in 47 countries, individuals and their households collectively paid more out of pocket for health care than their governments spent on it in 2021. These out-of-pocket expenses generally increase inequalities and create discriminatory barriers to health care based on income, widening gaps in quality of life and life expectancy. The cost of these user fees can also put other rights at risk, including public participation, housing, water, and education.

Countries around the world ought to take this year’s International Universal Health Coverage Day to heed the calls of billions around the world who lack full health care access, and ensure officials dedicate proper resources for the realization of the right to health through UHC.

This means spending the equivalent of at least 5 percent of GDP or 15 percent of government expenditures on health care and reversing reductions in funding. And to increase public resources for health care, governments need to look at eliminating tax abuses and focus on progressive taxes. It is also an opportunity for creditor governments and institutions to assess what they need to do to ensure the governments they financially support can fund their healthcare systems.