In 2017, half of the world’s population could not obtain essential health services, according to the World Bank and WHO’s Universal Health Coverage (UHC) Global Monitoring Report. This was a figure that shocked many, making it clear that change was necessary.  

However, the 2023 Global Monitoring Report revealed an astonishing slowdown in progress, showing that even more than half of the world’s population is still unable to access basic healthcare.

Increasing global access to healthcare is a crucial step in helping individuals stay out of extreme poverty and facilitate sustainable growth in the sector. But overall, access to healthcare is an essential human right that everyone, no matter which part of the world they live in, is entitled to. So, what are the main obstacles standing in the way of progress in this key area?

Here, leading humanitarian aid and global health expert Shameet Thakkar, managing director of Unimed Procurement Services, comments on the issues behind the slowing expansion of essential health services. 

He said: “There is no doubt that resource constraints form a vital part of the problem. Overall, the poverty issues permeating low-income countries means the cost of healthcare services and medicines is prohibitive for a large portion of individuals.

“The aforementioned report shows that more than one billion people experienced ‘catastrophic’ out of pocket health spending in 2019. But regardless of the number of individuals who can afford healthcare, some countries present inadequate infrastructure, which translates to limited access to quality care.

“Shortages of medicines, as well as diagnostic equipment and preventative measures such as vaccines, are equally harmful, hindering the delivery of healthcare services.

“What’s more, WHO estimates a shortfall of 10 million health workers in 2030, predominantly in low- and lower-middle income countries. With healthcare workers being a key part of supplying effective and reliable healthcare services, shortages of doctors, nurses and other essential staff as well as disparities between rural and urban areas are particularly detrimental to our goal of achieving universal health coverage.

“Educational barriers remain, to this day, a problematic and complex challenge. Limited health literacy can prevent individuals, particularly in developing countries, from understanding health issues, and stop them from receiving appropriate care.

“Some may be restricted by low literacy rates and lack of health education programmes, meaning individuals do not receive the highest standards of education on health principles, preventative and diagnostic care, and epidemic and disease outbreak management.

“This, as well as healthcare staff shortages in some countries, may mean healthcare staff is not adequately trained or lacks suitable support. Medical schools in low- and middle-income countries may be behind with regards to technological advancements or innovation in the sector, limiting their ability to respond to evolving healthcare challenges and be effectively prepared.

“Health crises such as pandemics, epidemics and outbreaks can overwhelm healthcare systems and impede regular access to care.

“It is often the case that health systems in developing countries are already coping with the burden of healthcare crises such as epidemics of significant proportions, some of the most recent examples including cholera, dengue fever, malaria. With these emergencies taking a toll on healthcare systems, there simply aren’t as many resources available to be dedicated to improving the standard of care being provided or making care more accessible.

“This also causes an overwhelming focus on treatment instead of prevention, creating a dangerous vicious cycle whereby due to lack of preventative resources, more people get sick and need treatment, meaning it is much more difficult to shift these countries’ use of budgets and resources from treatment to prevention.

“Political unrest and conflict can significantly disrupt healthcare services, being another obstacle to achieving universal health coverage.

“Direct attacks as a result of conflict can damage healthcare facilities as well as cause supply chain restrictions and blockades, shortages of medicines, displacement of healthcare personnel, restricted movement and several other issues.

“The Israel-Hamas war offers a frightening look into this, with the conflict exacerbating the already precarious state of the healthcare system in Gaza.

“The limited number of hospitals in Gaza was already operating at full capacity, with some of these having now been closed or damaged. Moreover, restrictions have made it impossible to deliver supplies to people in need, with damage to transport systems and evacuations causing further issues.

“Coupled with the surge in hospital admissions, and the increased need for emergency medical supplies, it’s easy to see the full extent of the damage.

“A more equitable distribution of resources and access to healthcare would not only improve the well-being of individuals worldwide, but also contribute to global health security.

“By addressing disparities in healthcare infrastructure, workforce distribution, and disease prevention, countries can build more resilient healthcare systems capable of responding effectively to pandemics and emerging health threats.

“Fostering international collaboration and sharing best practices can enhance the overall effectiveness and efficiency of healthcare delivery – a world with reduced health inequalities ensures that everyone, regardless of geographic location or socio-economic status, has the opportunity to be looked after, ultimately promoting a more just and sustainable society.”