Many Governments Fail to Meet Global Health Spending Benchmarks, Violating Rights

The right to health care is encoded in several international human rights instruments, and successive United Nations resolutions have emphasized the inherent relationship between this right and universal health coverage (UHC). UHC entails that all people can access the health services they need without suffering financial hardship. To achieve this, many experts agree that governments should spend at least 5 percent of their gross domestic product (GDP) on health care. In addition, no more than 15 percent of a government's total budget should go to health care.

In 2021, only 63 out of 189 countries met the 5 percent of GDP spending benchmark, while only 47 met the 15 percent of the national budget benchmark. These findings indicate possible violations of countries' obligations to the human right to health.

To fulfill their human rights obligations, governments must dedicate the maximum available resources toward the progressive realization of economic, social, and cultural rights, including the right to health. They should also avoid, unless fully justified, any backward steps, including through budget cuts.

The next few months will provide multiple opportunities for governments to do more than just renew their rhetorical commitments to the realization of the right to health, including at the 77th World Health Assembly in May, at the United Nations Summit of the Future in September, and at the fourth International Conference on Financing for Development in 2025.

Governments should, among other things, set spending benchmarks such as the equivalent of at least 5 percent of GDP or 15 percent of general government expenditures on health care through domestically generated public funds, or an amount that otherwise ensures the maximum available resources for the realization of rights, including the right to health.

Many governments could increase their revenues to fund health care by levying progressive taxes, stemming tax abuses, and tackling public corruption. Wealthier creditor governments should also deliver on their commitments to international assistance and cooperation by ensuring that public debt repayments do not hinder debtor governments' ability to adequately fund health care.

The coming months also provide an opportunity to address the impact of debt payments on the ability of governments to fund human rights obligations. At the 2024 spring meetings of the World Bank Group and International Monetary Fund, creditor governments and institutions should commit to conducting assessments of such impacts and to considering debt restructuring or relief where appropriate to ensure that debtor governments can adequately protect rights, including health.

"The pandemic showed the vulnerability of healthcare systems around the world to external shocks, but it also exposed just how many of these systems were already failing people," said McConnell. "Governments need to put their money where their mouth is and commit to financing more resilient, more sustainable, and more rights-realizing healthcare systems for all."

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