WHO flags deepening poverty as major barrier to healthcare access in Africa

The World Health Organization (WHO) has raised fresh concern over the scale of financial hardship caused by healthcare costs across Africa, warning that millions are being pushed deeper into poverty because they cannot afford basic medical treatment.

The latest global Universal Health Coverage (UHC) report shows that in 2022, more than 423 million people in Africa faced financial hardship due to out-of-pocket health spending, with over 384 million pushed into or further into poverty.

Africa also accounts for over 20 percent of the world’s population experiencing financial distress from medical bills and nearly a quarter of global health-driven poverty.

Out-of-pocket payments still dominate health financing across the continent. In 31 countries, they make up more than a quarter of total health expenditure; in 11 countries, more than half; and in two countries, more than 70 percent.

According to the organization, these pressures force families into agonizing choices that undermine well-being and widen inequality.

Marking Universal Health Coverage Day 2025, the WHO Regional Director for Africa, Dr Mohamed Janabi, in his message on Friday, said the figures reflect a crisis that demands urgent political action.

“Today, as we mark Universal Health Coverage Day under the banner Unaffordable health costs? We’re sick of it; we are reminded that health is not a privilege for the few. It is a fundamental human right and should be accessible to all,” he said.

He warned that for too many people, the cost of care determines whether they seek treatment, delay it, or avoid it completely, noting, “These are not statistics. They are the lived realities of households selling assets, postponing care, or slipping deeper into vulnerability.”

He noted that financial barriers continue to pit essential care against basic survival needs, forcing impossible choices between care and food, between medicines and school fees, between dignity and survival.

Despite these challenges, Janabi pointed to areas of progress, noting that between 2015 and 2022/23, the African Region recorded improvements across all components of the UHC Service Coverage Index, including maternal and child health, infectious and non-communicable diseases, and access to care.

He added that Africa achieved the world’s strongest gains in NCD service coverage, largely due to a decline in tobacco use. “These advances show what is possible with sustained commitment,” he said.

However, he cautioned that progress remains uneven and that financial protection is still the region’s most persistent barrier, stressing that women, children, older persons, and rural households continue to bear the highest burden of health costs.

“High health costs continue to undermine efforts to reduce poverty, prevent disability, and increase survival,” he said.

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Calling for urgent reforms, Dr Janabi urged governments, partners, and civil society to accelerate efforts to make healthcare affordable for everyone.

He said priorities should include increasing domestic investment in health, expanding universal prepayment and risk-pooling systems, strengthening primary healthcare, and investing in the health workforce, facilities, supply chains, and data systems to guarantee not just access to care but access to quality care.

He also called for stronger accountability and the use of disaggregated data to ensure resources reach underserved communities.

“With new regional and global evidence in hand, 2025 offers a pivotal opportunity to accelerate financial protection reforms and advance health for all,” he said, adding that the WHO African Region stands ready to support governments with policy guidance, technical expertise, and data-driven decision-making.

Dr Janabi urged African countries to move from commitment to concrete implementation, adding, “Let’s turn commitment into action. Let’s build resilient, inclusive, and equitable health systems that shield people from financial hardship – systems that uphold dignity, expand opportunity, and ensure that every person can exercise their right to health, without financial barriers.”

He said this year’s UHC Day reaffirms a collective continental pledge, “On UHC Day 2025, we renew our shared promise, ‘Health for All. No One Left Behind.”