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Universal Health Coverage Day 2025

Message from WHO Regional Director for Africa, Dr Mohamed Janabi

Today, as we mark Universal Health Coverage (UHC) 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.

Yet, for too many people across the African Region, the cost of care remains a barrier that determines whether they seek treatment, delay it, or forgo it entirely.

Out-of-pocket payments still dominate health financing in much of our Region. In 31 Member States, they account for more than a quarter of all health expenditure; in 11 countries, more than half; and in two countries, more than 70%.

These financial pressures force families into impossible choices, between care and food, between medicines and school fees, between dignity and survival.

Africa accounts for over 20% of the world’s population facing financial hardship due to health costs, and nearly a quarter of global health-driven poverty. The latest global 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.

These are not statistics. They are the lived realities of households selling assets, postponing care, or slipping deeper into vulnerability.

The same report also highlights encouraging progress. Between 2015 and 2022/23, the African Region improved across all components of the UHC Service Coverage Index: maternal and child health, infectious and noncommunicable diseases (NCDs), and service capacity and access. Africa recorded the world’s strongest gains in NCD service coverage, driven significantly by lower tobacco use.

These advances show what is possible with sustained commitment.

But progress is uneven, and financial protection remains our most stubborn challenge. High health costs continue to undermine efforts to reduce poverty, prevent disability and increase survival. Women, children, older persons and rural households bear the greatest burden.

On this UHC Day, I call on governments, partners, civil society and communities to accelerate the reforms that will make health care affordable for everyone. Our priorities must include:

  • Increasing domestic investment in health to reduce the burden from out-of-pocket spending.
  • Expanding universal prepayment and risk-pooling systems, with a focus on the poorest and most vulnerable.
  • Strengthening primary health care, which remains the most equitable and cost-effective path to UHC.
  • Investing in the health workforce, facilities, supply chains and data systems to ensure not only access to care, but access to quality care.
  • Prioritizing equity, to reach communities that are consistently left behind.
  • Improving transparency and accountability, using disaggregated data to track progress and direct resources where they are most needed.

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

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.

On UHC Day 2025, we renew our shared promise: Health for All. No One Left Behind.

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