Tracking Universal Health Coverage: 2025 Global Monitoring Report
Universal health coverage, ensuring that all people have access to the quality health services they need without facing financial hardship, is both a cornerstone of the Sustainable Development Goals and a prerequisite for realizing the broader health and human development agenda. This joint WHO/World Bank report, the most comprehensive global assessment of UHC progress, finds that approximately 4.6 billion people worldwide still lack access to essential health services, and that progress toward UHC has stalled and in some regions reversed following the disruptions of the COVID-19 pandemic and the contraction of official development assistance.
The report tracks performance across two dimensions of UHC: service coverage, measured through an index of essential health services spanning reproductive, maternal, and child health; infectious disease prevention and treatment; NCD management; and service capacity and access; and financial protection, measured through the incidence of catastrophic and impoverishing health expenditure. The findings reveal persistent and in some cases widening gaps between high- and low-income countries, and between urban and rural populations within countries, in both dimensions.
A particularly concerning finding concerns health financing: as international aid for health declines and domestic fiscal space remains constrained in low-income countries, the report identifies a growing financing gap that threatens to reverse hard-won gains in coverage and financial protection. Debt servicing obligations now exceed health spending in dozens of countries, and preliminary estimates suggest that 2025 levels of official development assistance were the lowest in over 15 years, a trend with direct implications for the sustainability of health system capacity in the most vulnerable settings.
The report calls for urgent action on health financing, including increased and more efficient domestic health spending, innovative financing mechanisms, and a reformed approach to international health assistance that better reflects the scale and urgency of UHC shortfalls. It provides country-level data and regional analysis to guide policymakers, donors, and global health partners in directing resources toward the highest-priority gaps.
