The UHC Global Monitoring Report 2025 shows that health service coverage, measured by the Service Coverage Index (SCI), rose from 54 to 71 points between 2000 and 2023. Meanwhile, the share of people experiencing financial hardship due to large and impoverishing out-of-pocket (OOP) health payments declined from 34% to 26% between 2000 and 2022.
"Universal health coverage is the ultimate expression of the right to health, but this report shows that for billions of people who cannot access or afford the health services they need, that right remains out of reach,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “In the context of severe cuts to international aid, now is the time for countries to invest in their health systems, to protect the health of their people and economies. WHO is supporting them to do that.”
While the burden of OOP health costs falls mostly on poorer people, it also affects better-off segments of the population that allocate a large share of their budgets to health expenses, particularly in middle-income countries where this group of people is growing.
Despite positive direction, the global progress rate has slowed since 2015 with only one-third of countries improving in both increasing health coverage and reducing financial hardship. All WHO regions have improved service coverage, but only half – Africa, South-East Asia, the Western Pacific – also reduced financial hardship. Low-income countries achieved the fastest gains in both areas but are still facing the largest gaps.
The report notes that improved sanitation has supported service coverage gains. At the same time, inclusive economic growth, rising incomes, and stronger social protection mechanisms have driven poverty reduction, especially in low-income countries, contributing to declines in financial hardship. However, health costs have increasingly become a source of financial hardship among the poor.
Inequalities are getting starker
Women, people living in poverty, or in rural areas, or with less education, reported greater difficulty accessing essential health services. The gap between women in the richest and poorest quintiles narrowed slightly, from about 38 to 33 percentage points over the past decade. Even in high-performing regions such as Europe, vulnerable groups – including the poorest and people with disabilities – continue to report higher unmet health needs.
Achieving the UHC goal by 2030 is central to realizing the human right to health. With five years remaining on the SDG agenda, urgent action is now needed to drive progress. The report underscores the critical role of political commitment in every country and community, and calls for action in six core areas:
ensure essential health care is free at the point of care for people living in poverty and vulnerable situations;expand public investments in health systems;address high out-of-pocket spending on medicines;accelerate access to essential NCD services, especially as the disease burden rises;strengthen primary health care to promote equity and efficiency; and adopt multisectoral approaches, recognizing that determinants of health and UHC drivers extend beyond the health sector.Editor’s note
This edition of the UHC Global Monitoring Report 2025 reflects the first round of UHC tracking to incorporate revised SDG indicators for health service coverage (SDG 3.8.1) and financial hardship (SDG 3.8.2), introduced in 2025. Using the revised indicators, and reproduction of the full time series, the report has presented global and regional trends in service coverage from 2000 to 2023, based on time series data for 195 countries or territories, and global and regional trends in financial hardship from 2000 to 2022, based on primary country time series for 168 countries. More about monitoring universal health coverage.
WHO, the World Bank Group, UHC2030 and the Joint Learning Network for Universal Health Coverage will organize a technical webinar “Tracking Universal Health Coverage: 2025 Global Monitoring Report” on 8 December 2025, at 8:00–9:30am EST | 14:00–15:30 CET. You can join the webinar through this link. (Passcode: .W1MJT=@r3)
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