Care out of reach for too many; WHO calls for action to achieve health for all

Media release

A baby gets a checkup at the Mother and Child Health Protection Centre in New Caledonia.
WHO/Y. Shimizu

Up to half the population in some countries in Asia and the Pacific are missing out on essential health services. This is a key finding of a series of country profiles released by the World Health Organization (WHO) Regional Office for the Western Pacific on the eve of World Health Day for which this year’s theme is universal health coverage. April 7, 2018 also marks the 70th anniversary of WHO—the United Nations agency founded on the principle that health is a right for all.

For the first time, the country profiles bring together data to show the status of each country’s progress towards achieving universal health coverage. The profiles will help governments identify gaps and priority areas to strengthen systems and ensure quality health services reach all people, where and when they need them, without financial hardship.

“Nobody should have to choose between getting life-saving health services and feeding their family,” says Dr Shin Young-soo, WHO Regional Director for the Western Pacific. “But unfortunately, that is still the case in several places.”

When health systems fail to ensure adequate financial protection, people can be pushed into poverty by paying out of pocket for health care.

In the Region’s high-income countries, four out of five people can get most health services, though sometimes at a high out-of-pocket cost. Meanwhile, there is considerable variation in health service coverage among middle-income countries.

Many people report spending more than 10% of their income on health services—a level WHO considers unreasonable financial hardship.

“Often the poorest are hardest hit—those with little income to spare face a higher risk of disease and they are plunged further into poverty when paying for care. This perpetuates a vicious cycle,” Dr Shin adds. “That’s why governments have committed to advancing universal health coverage, and we’re working with them to make it happen.”

Systems stronger in some areas

Generally in the Region, access to immunization and maternal and child health services tends to be better than other types of health service. Areas that need improvement include services for detecting and treating infectious diseases (such as tuberculosis and HIV) as well as those for preventing and treating noncommunicable diseases (NCDs), including heart disease, stroke, diabetes and cancer.

NCDs remain the number one cause of premature mortality in the Region. Unless the situation improves, around one in three 30-year-olds in Pacific island countries will die from NCDs before their 70th birthday, compared with one in six in the other countries in the Region. Strong health systems are needed to prevent these diseases and reverse the NCD epidemic, as well as better support those already managing these conditions.

Government spending on health

Health services in high-income countries in the Region are funded predominantly by public money, whereas people in middle-income countries often have to pay more out of pocket. Nearly half of health spending in middle-income Asian countries in the Region is out of pocket.

Government spending on health is generally increasing, faster in some countries than others. Some governments in the Region spend as little as US$ 35 per person a year or 2.8% of gross domestic product (GDP) on health, while others spend more than US$ 6000 or up to 17.1% of GDP.

Equity is key, but more data needed

The country profiles spell out the challenges to achieving universal health coverage in each country. Still, more detailed data are needed to ensure that no one is left behind. Future editions of the profiles should include information on access to health services broken down by income groups and urban vs rural residents, for example, so governments can target disadvantaged groups. This step would help ensure that the poor gain at least as much as better-off groups on the path towards universal health coverage.

What is universal health coverage?

Universal health coverage is about making sure all people have access to quality health services where and when they need them, without financial hardship. It includes the full spectrum of services needed throughout life—from health promotion to prevention, treatment, rehabilitation and palliative care.

Everyone—individuals, civil society groups, health professionals, researchers, policy-makers and media—has a part to play in calling for, developing and delivering on policies to achieve universal health coverage.

Achieving universal health coverage is one of the targets of the 2030 Agenda for Sustainable Development (SDG3.8), adopted at the United Nations in 2015. The same year, Member States of the Western Pacific Region endorsed the Action Framework for Universal Health Coverage: Moving Towards Better Health.

For further information:

Mr Ruel E. Serrano
WHO Regional Office for the Western Pacific
Tel: +63 2 528 9993
Mob: +63 908 891 4532

Note to Editors:

The 37 countries and areas of the WHO Western Pacific Region are: American Samoa (USA), Australia, Brunei Darussalam, Cambodia, China, Cook Islands, Fiji, French Polynesia (France), Guam (USA), Hong Kong SAR (China), Japan, Kiribati, Lao People’s Democratic Republic, Macao SAR (China), Malaysia, Marshall Islands, Federated States of Micronesia, Mongolia, Nauru, New Caledonia (France), New Zealand, Niue, Commonwealth of the Northern Mariana Islands (USA), Palau, Papua New Guinea, Philippines, Pitcairn Islands (UK), Republic of Korea, Samoa, Singapore, Solomon Islands, Tokelau, Tonga, Tuvalu, Vanuatu, Viet Nam, and Wallis and Futuna (France).