Progress Towards Universal Health Coverage: Countries Embrace National Health Compacts
The global push for universal health coverage has taken a significant leap forward as 15 countries have introduced National Health Compacts, aiming to provide affordable, quality healthcare to 1.5 billion people by 2030. These compacts, endorsed by high-level governments, outline practical five-year reforms focusing on primary care expansion, affordability improvements, and job-rich economic growth.
Since the World Bank Group's ambitious goal was announced in April 2024, remarkable progress has been made. With the support of partners, countries have already reached 375 million people with accessible, quality healthcare. The current focus is on scaling successful primary care approaches across 45 countries, ensuring improved health outcomes and job creation in various sectors.
The 2025 Global Monitoring Report highlights the dire need for coordinated long-term reforms. It reveals that 4.6 billion people lack essential health services, and 2.1 billion face financial burdens due to healthcare expenses. This underscores the importance of building resilient and equitable health systems.
Ajay Banga, World Bank Group President, emphasizes the impact of strong primary health systems, stating, 'They safeguard health and foster economic opportunities.' Countries are taking the lead with clear priorities, and the World Bank Group is collaborating to deliver scalable solutions. When efforts align behind proven strategies, the impact multiplies.
National Health Compacts: Practical, Country-Led Initiatives
In Tokyo, the 15 participating countries showcased their National Health Compacts, endorsed by top government officials. These compacts unite Health and Finance Ministries behind measurable goals, providing a roadmap for coordinated action and attracting support from development partners aligned with country-specific priorities.
The reforms emphasize three key areas: expanding primary care reach and quality, enhancing financial protection, and strengthening the health workforce. Countries have committed to various initiatives, including:
Investing in connected, service-ready facilities, such as:
- Philippines' nationwide digital health facility connectivity.
- Uzbekistan's process digitization for workload reduction.
- Sierra Leone's goal of providing quality primary care within five kilometers, with new facility construction and solar-powered digital connectivity.
Diversifying primary care delivery, as seen in:
- Bangladesh's expansion of multi-platform primary care models with updated regulations and digital tools.
- Indonesia's telemedicine initiative, connecting over 600 facilities to hospitals for closer patient care.
Digitally enabling and strengthening the health workforce, including:
- Ethiopia's plan to equip primary health centers with digital tools for clinical support and workforce management.
- Saint Lucia's investment in a skilled, digitally enabled workforce, coupled with modern regulation and education through regional cooperation.
Removing financial barriers to care, with examples like:
- Kenya's plan to double public health spending over five years, reaching 5% of GDP, and expanding social health insurance coverage.
- Morocco's extension of mandatory health insurance to 22 million additional people.
Boosting regional manufacturing of health products and technologies, as Nigeria aims to train 10,000 professionals, establish Centers of Excellence, and offer tax incentives for local vaccine, medicine, and technology production.
Mobilizing Support Through Partnerships and Financing
The journey towards the 1.5 billion goal requires coordinated support. The World Bank Group, Gavi, and the Global Fund have announced aligned financing, including $2 billion co-financed with each institution. Philanthropic partners are mobilizing up to $410 million through the Global Financing Facility and the Health Systems Transformation and Resilience Fund to encourage greater commitments in critical health areas.
Seed Global Health is working with compact countries to build capacity and support assessments, planning, and policy development, with a focus on advanced health workforce development. Japan, a champion of universal health coverage, along with the UK and others, is providing technical assistance for reform implementation.
To enhance knowledge sharing, Japan, WHO, and the World Bank Group launched the Universal Health Coverage Knowledge Hub, offering practical, evidence-based solutions and peer learning. The Universal Health Coverage High-Level Forum, co-hosted by Japan, WHO, and the World Bank Group, brought together diverse stakeholders, fostering collaboration and progress towards universal health coverage.
The countries that launched National Health Compacts are Bangladesh, Egypt, Ethiopia, Fiji, Indonesia, Mexico, Morocco, Nigeria, Philippines, Sierra Leone, Syria, Tajikistan, Uganda, Uzbekistan, and Zambia. Explore the National Health Compacts in detail at [https://www.worldbank.org/en/programs/health-works/country-reform].
