Honourable Deputy Minister Dr Mathume Phaahla,
Honourable Ministers, Excellencies, dear colleagues and friends,
I thank South Africa for hosting this important and very timely discussion.
The world is in a health financing emergency.
Even before the current geo-political upheavals, 4.5 billion people – more than half of the world’s population – were not fully covered by essential health services.
And two billion people face financial hardship or are impoverished due to out-of-pocket health spending.
Drastic cuts in bilateral assistance have made things even worse.
These health financing gaps put lives at risk, but they also put societies and economies at risk.
While governments play a central role in closing these gaps and realising the promise of universal health coverage, they cannot do it alone.
Around the world, the private sector is crucial, from delivering health services, to developing and distributing vaccines and medicines, to providing essential technologies.
At the same time, relying on market mechanisms and private capital for financing UHC risks making health a commodity for profit, rather than a public good and a human right.
To support equitable access to health services with private sector involvement, countries need strong regulatory frameworks and good data on financial flows, access and outcomes.
Financing UHC is the responsibility of governments; no country in the world has managed to achieve UHC through predominantly out-of-pocket or external aid financing.
And yet, for almost two decades, low-income countries have relied on out-of-pocket payments or external aid to finance their health systems, while domestic public funding has fallen well behind.
This underinvestment by governments has made health systems vulnerable to the disruptions we are now seeing.
Although they face serious challenges, many ministers have told me that they also see this crisis as an opportunity to leave behind the era of aid dependency and transition towards sustainable self-reliance.
WHO is supporting countries to make that transition, by using a wide range of tools, including health taxes, pooled procurement and public health insurance.
We’re urging countries to prioritize health in national budgets; strengthen data systems; and expand smart financing solutions;
And we ask partners to align external financing support with country-owned systems and priorities.
We know these are difficult economic times, and some may argue there is no money to increase spending on health.
But universality does not have to mean spending more; it means spending better.
UHC can generate economies of scale so countries can offer better services to their populations, in a more cost-effective way than more piecemeal private-sector insurance schemes.
Two of the countries presenting today introduced government-sponsored health insurance at times of crises: Japan, after the end of the Second World War; and Thailand, after the Asian financial crisis.
South Africa, meanwhile, boosted its commitment to UHC as the country emerged from the COVID-19 pandemic, signing the National Health Insurance Act into law in May 2024.
And Indonesia is investing record amounts in UHC with support from multilateral development banks.
These are all good examples of how political commitment can drive UHC even in difficult economic times.
And ultimately, health spending is an investment, not a cost, because UHC can drive inclusive and resilient economic growth, while also fostering social progress and stability.
I thank you.