Human Rights Watch (HRW) recently pointed out significant global healthcare funding inequalities, emphasizing that most nations are not fulfilling their human rights responsibilities to sufficiently finance public healthcare. This observation follows the World Health Organization’s (WHO) publication of its comprehensive Global Health Expenditure Database (GHED), which includes healthcare spending data from 194 countries and territories, focusing particularly on the fiscal responses to the COVID-19 pandemic in 2022.
HRW’s analysis revealed a concerning trend—141 governments are allocating less than 5% of their gross domestic product (GDP) towards public healthcare. This 5% spending threshold is an internationally recognized standard for adequate public healthcare funding. The implications of such underfunding are stark, with HRW underscoring that failing to meet this benchmark compromises the globally recognized right to health.
Matt McConnell, an economic justice and rights researcher at HRW, noted, “The vast majority of people around the world live in countries where their access to health care is undermined in part by low public funding” (HRW statement).
The organization also raised concerns about the increasing financial burden placed on individuals and households. This shift of healthcare costs from state mechanisms to citizens is problematic, especially for those with lower or unstable incomes, limiting access to essential services. The WHO’s report on universal health coverage from 2021 highlights that around 4.5 billion people lacked full coverage for essential health services, with about 2 billion individuals facing financial difficulties due to healthcare expenses. Furthermore, healthcare costs pushed approximately 344 million people into extreme poverty.
These financial strains are more pronounced among disadvantaged groups, with catastrophic out-of-pocket spending being more common in poorer households or rural areas, especially those with older residents. To address these disparities, the WHO advocates for the reinforcement of health systems with a primary care focus, aiming to enhance national institutions and improve service delivery.