A stark new warning from the 2025 Global Monitoring Report, released on December 6 at the Tokyo Universal Health Coverage High-Level Forum, has intensified global urgency around healthcare reform.
The report reveals that 4.6 billion people still lack access to essential health services, while 2.1 billion are pushed into financial hardship by health-related expenses, a burden threatening global development gains.
These findings come as countries and development partners accelerate efforts toward the World Bank Group’s goal, set in April 2024, to deliver affordable, quality health services to 1.5 billion people by 2030.
Despite the challenges, significant strides have been made. Since the goal was launched, the World Bank Group and partners have already helped countries reach 375 million people with quality, affordable care. Work is now underway with about 45 countries to scale proven primary healthcare models that strengthen health systems while generating job-rich growth.
“Strong primary health systems do more than safeguard health: they support jobs and economic opportunity,” said Ajay Banga, World Bank Group President. “Countries are stepping forward with clear priorities, and we are working alongside them to deliver practical solutions at scale. When efforts align behind what works, impact grows.”
National Health Compacts: Practical, Country-Led Roadmaps
Building on this momentum, 15 countries introduced National Health Compacts, setting out practical five-year reforms aimed at expanding primary healthcare, improving affordability, and supporting economic growth. Each Compact aligns Health and Finance Ministries on measurable targets while guiding development partners around country priorities.
The reforms focus on:
- Expanding primary care reach and quality
- Strengthening financial protection
- Building a digitally enabled health workforce
Countries have committed to mobilizing new financing, modernizing facilities, expanding insurance coverage, and adopting digital tools to enhance service delivery.
Investing in Connected, Service-Ready Facilities
- Philippines is digitally connecting health facilities nationwide.
- Uzbekistan is digitizing administrative processes to cut workloads by 30%.
- Sierra Leone will ensure every citizen can access primary care within five kilometers by constructing 300 new facilities and equipping 1,800 with solar power and digital connectivity.
Diversifying Primary Care Delivery
- Bangladesh is expanding multi-platform primary care supported by digital tools and updated regulations.
- Indonesia is scaling digital primary care, linking 600+ facilities to hospitals through telemedicine to bring services closer to households.
Digitally Enabling and Strengthening the Health Workforce
- Ethiopia will equip at least 40% of primary health centers with digital tools to support clinical care and workforce management.
- Saint Lucia is investing in a skilled, digitally enabled workforce while modernizing regulation and training through regional collaboration.
Removing Financial Barriers to Care
- Kenya plans to double public health spending over five years to reach 5% of GDP, expanding health insurance coverage from 26% to 85%, with full subsidies for vulnerable populations.
- Morocco will extend mandatory health insurance to 22 million more people.
Boosting Regional Manufacturing of Health Technologies
- Nigeria will train 10,000 pharmaceutical and biotech professionals, establish Centers of Excellence, and provide tax incentives to scale local production of vaccines, medicines, diagnostics, and technologies.
Supporting Country Priorities Through Partnerships and Financing
Progress toward the 1.5 billion target relies on coordinated global support.
To advance the Compacts:
- The World Bank Group, Gavi, and Global Fund announced aligned financing, including $2 billion co-financed with each institution.
- Philanthropic partners through the Global Financing Facility and Health Systems Transformation and Resilience Fund aim to mobilize up to $410 million to catalyze larger commitments.
- Seed Global Health is supporting workforce development, planning, and policy efforts.
- Japan, the United Kingdom, and others are offering technical support to help countries implement reforms.
To strengthen shared learning, Japan, WHO, and the World Bank Group launched the Universal Health Coverage Knowledge Hub, designed to support countries with evidence-based, practical solutions.
The Universal Health Coverage High-Level Forum co-hosted by the Government of Japan, WHO, and the World Bank Group brought together global health and finance ministers, private sector leaders, philanthropies, and civil society to drive solutions that make healthcare more equitable and resilient.
