Countries must increase spending on primary healthcare by at least 1% of their gross domestic product if the world is to close glaring coverage gaps and meet health targets agreed in 2015, according to a new report from the World Health Organization (WHO) and partners. Countries must also intensify efforts to expand services countrywide.
The world will need to double health coverage between now and 2030, according to the Universal Health Coverage Monitoring Report 2019. It warns that if current trends continue, up to 5 billion people will still be unable to access healthcare in 2030—the deadline world leaders have set for achieving universal health coverage (UHC). Most of those unable to access healthcare are poor and already disadvantaged.
“If we are really serious about achieving universal health coverage and improving people’s lives, we must get serious about primary healthcare,” says Dr. Tedros Adhanom Ghebreyesus, WHO director-general. “That means providing essential health services like immunization, antenatal care, healthy lifestyle advice as close to home as possible—and making sure people do not have to pay for this care out of their own pockets.”
Investing an additional U.S.$200 billion a year on scaling up primary healthcare across low- and middle-income countries would potentially save 60 million lives, increase average life expectancy by 3.7 years by 2030, and contribute significantly to socio-economic development. It would represent about a 3% increase on the U.S.$7.5 trillion already spent on health globally each year.
Most of that funding would come from countries themselves. The report says that most countries can scale up primary healthcare using domestic resources––either by increasing public spending on health in general, or by reallocating spending toward primary healthcare—or by doing both. Currently, most countries are underinvesting in primary healthcare.
But for the poorest countries, including many affected by conflict, this may not be feasible. These countries will continue to require assistance from outside. This funding must be carefully targeted to result in a lasting improvement to health systems and services—via a systematic strengthening of primary healthcare countrywide.