The State of Commitment to Universal Health Coverage (UHC) brings a unique multi-stakeholder view to a simple question: Are countries acting on their commitments to UHC?

A combination of country profiles and a synthesis report, The State of UHC Commitment is a political, country-focused and action-oriented tool that complements the more technical and global WHO UHC monitoring report focusing on UHC indicators on service coverage and financial protection.

It follows the UHC Political Declaration’s Key Targets, Commitments and Follow-up Actions and supports national accountability and advocacy processes to ensure political leaders are held accountable for their UHC commitments.

Download a summary of the State of UHC Commitment Review

Download the full State of UHC Commitment Review

Key findings

Action is more urgent than ever, given that more than half of the world’s population – 4.5 billion people – are unable to access essential health services and 2 billion are facing financial hardship due to out-of-pocket health spending. The findings on gaps in action on UHC commitments in the eight areas are provided below: 

  1. Ensure political leadership beyond health: Most countries recognize UHC as a goal but have not taken concrete operational steps to achieving UHC.
  2. Leave no one behind: Vulnerable individuals and groups continue to face financial and structural barriers to accessing the health services and commodities they need.
  3. Legislate and regulate: While 89% of countries have made UHC a central goal in their national health policy plans and strategies, 41% have enacted UHC laws to ensure equitable, affordable access to health services.
  4. Uphold quality of care: The global shortage of health and care workers, lack of support for the health and care workforce and inadequate health-care resources remain challenges to providing effective, safe, people-centred care for all.
  5. Invest more, invest better: Despite continued increases in overall health expenditure for the COVID-19 response, governments’ current investment commitments and public spending for health are inadequate to achieve UHC.
  6. Move together: Few countries have a formal, effective accountability mechanism for UHC, with inadequate multistakeholder engagement.
  7. Gender equality: Although women represent the majority of the health and care workforce, there is lack of commitment to achieving gender equality in the health and care workforce and to increasing women’s representation in overall political leadership for health.
  8. Emergency preparedness: Countries do not invest sufficiently in health systems strengthening based on primary health care to achieve UHC and health security.

Country profiles

Available on the UHC Data Portal, the country profiles provide a snapshot of the state of UHC commitments in individual countries, centred around the key commitment areas of the Political Declaration on UHC. An interactive dashboard (online version) and printable dashboard (offline version) are available.

See the UHC Data Portal

Useful resources