More than 100 million people are plunged into poverty every year by illness or "catastrophic" medical bills, the World Health Organisation said on November 22, launching a global drive for universal health care. "In my view, universal coverage is an admirable goal and a timely one. We have to bite the bullet," said WHO Director General Margaret Chan, presenting the report in Berlin.
"This year's WHO report is designed to encourage every country in the world to adopt policies that will extend policies to more people and reduce the number of people who risk financial ruin," added Chan.
The agency's annual report, devoted this year to financing health systems, underlined that the need for universal health coverage "has never been greater" with the economic slowdown, globalisation of disease and ageing populations that need more care for chronic conditions.
"If health systems do not find the right answers now, the bill further down the line is going to keep getting higher and bigger," Chan warned.
Since 2005, the WHO's 192 member states have decreed that everyone should have access to health services and no one should suffer financial hardship as a result.
"On both counts the world is a long way from universal coverage," the report said.
The UN health agency found that in countries that depend heavily on people paying for their services when they seek care, "health bills push 100 million people into poverty each year" as many suffer "catastrophic costs."
The most successful health care systems in Europe, Japan, Chile, Mexico, Rwanda and Thailand were based on pooled resources, helping to spread the financing burden, it added.
The report highlighted three "fundamental, interrelated" problems that stopped countries moving closer to universal coverage.
They included an over-reliance on such direct payments, the absence of the full range of care and treatment, and the "inefficient and inequitable use" of resources.
"At a conservative estimate, 20 to 40 percent of health resources are being wasted," the report said.
Although the poorest countries are the hardest hit, the report also underlined that disparities even within some of the richest nations also harmed care.
The report cited a study by Harvard University in 2007 indicating that medical bills contributed to 62 percent of family bankruptcies.
"It's just not acceptable. And it is not only not acceptable but it's not necessary, because something can be done about it," David Evans, director of health systems financing at the WHO told journalists in Geneva.
The report highlighted the link between low maternal mortality and the presence of a skilled health worker during childbirth, a feature more likely to occur in richer countries.
Closing the gap in health cover between rich and poor in 49 poor countries would save the lives of more than 700,000 mothers by 2015, while more than 16 million lives would be saved by bridging the poverty gap in infant care, including immunisation.
The WHO insisted there was scope even for poor nations to allocate 15 percent of state spending for health and double the funds available, while international development aid should be brought to promised levels.
"All countries can take immediate steps to move towards universal coverage," Chan said.