WHO Report Warns of Stalled Global UHC Progress - India Improves Coverage but Faces Persistent Out-Of-Pocket Burden
SDG 3: Good Health and Well-being | SDG 1: No Poverty
Ministry of Health and Family Welfare
The WHO and World Bank Tracking Universal Health Coverage (UHC) 2025 Global Monitoring Report issues a critical warning that global progress toward achieving UHC by the 2030 Sustainable Development Goal (SDG) target is not on track. The report, which presents data through 2023 for service coverage and 2022 for financial hardship, highlights that progress has slowed significantly since 2015.
Key Global Progress and Deficits:
Service Coverage: The global Service Coverage Index (SCI) rose from 54 to 71 points between 2000 and 2023. However, the annualized rate of improvement dropped drastically after 2015.
Deficit: Approximately 4.6 billion people worldwide still lack access to the full range of essential health services.
Drivers: The increase in coverage was primarily driven by advancements in infectious disease programmes, while gains in reproductive, maternal, and child health were modest.
Financial Hardship: Financial hardship due to out-of-pocket (OOP) health spending remains severe:
An estimated 2.1 billion people face financial hardship to access health care.
This includes 1.6 billion people who are living in poverty or are pushed deeper into it due to health expenses.
Growing Inequalities: Stark disparities are evident:
Poorest vs. Richest: In 2022, 3 out of 4 people among the poorest segment faced financial hardship from health costs, compared with fewer than 1 in 25 among the richest.
Vulnerable Groups: People living in rural areas, women, and those with disabilities consistently report higher unmet health needs.
Universal Health Coverage (UHC) is defined as all people receiving the essential quality health services they need, when and where they need them, without incurring financial hardship. UHC is monitored using two key indicators: the Service Coverage Index (SCI) and the Financial Hardship indicator (out-of-pocket spending).
India-Specific Relevance
Indiaβs Universal Health Coverage (UHC) Service Coverage Index (SCI) reached 69 in 2023, placing the country in the high-coverage range (60β79). This progress has been driven largely by gains in infectious disease control and the expansion of non-communicable disease (NCD) interventions, reflecting steady improvements in service access.
However, coverage gains have not translated into adequate financial protection. In 2022, 30.9% of the population experienced financial hardship due to out-of-pocket (OOP) health spending, the third-highest rate in the South-East Asia Region. Although impoverishing OOP expenditure has declined, this has been offset by a rise in large OOP payments, a trend typical of lower-middle-income country health-financing transitions.
Taken together, the findings present a clear policy mandate for India. While service coverage has expanded strongly, urgent action is needed to reduce OOP burdens, especially for vulnerable groups, by strengthening primary healthcare (PHC) and increasing public health spending toward the 2.5% of GDP target, ensuring UHC gains remain durable and resilient to future shocks.
Follow the full news here: Tracking universal health coverage: 2025 global monitoring report