WHO Report: 4.6 Billion Lack Essential Care as Eastern Mediterranean Crisis Deepens
With 4.6 billion people still lacking essential care, universal health coverage is no longer a policy goal—it is a global stress test for health systems. (Source: Pexels)
The World Health Organization and World Bank Group's 2025 Universal Health Coverage Monitoring Report reveals that 4.6 billion people worldwide still lack access to essential health services, while 2.1 billion face financial hardship from healthcare costs—with the Eastern Mediterranean's 750 million residents emerging as a critical case study in converging health system challenges.
Eastern Mediterranean: The Perfect Storm
The WHO Regional Director for Eastern Mediterranean disclosed at the Doha Forum that the region confronts unprecedented barriers: 42% of globally displaced persons, widespread economic sanctions, chronic conflicts, and accelerating healthcare workforce migration.
"The health sector was already fragile before COVID-19," WHO regional leadership stated. "Sanctions, conflicts, wars, and displacement have created extraordinary challenges."
The region faces critical service gaps:
Essential medication and blood product stockouts
Healthcare facility accessibility barriers
Gender-based violence and mental health service inadequacies
Workforce migration depleting provider capacity
Universal Health Coverage: Progress Stalls Globally
Global health service coverage rose from 54 to 71 points between 2000 and 2023, yet annual improvement rates plummeted from 1.5% pre-2015 to just 0.5% currently. At this pace, UHC service coverage will reach only 74 by 2030, falling short of Sustainable Development Goal targets.
Financial Hardship Concentrates Among Poor:
75% of people in the poorest quintile face healthcare financial hardship
Only 4% of wealthiest populations experience similar burden
Rural populations show 14% higher median hardship rates than urban areas
1.6 billion people pushed into or deeper into poverty by medical expenses
Regional Success and Failure Cases
Côte d'Ivoire Success: World Bank support expanded National Health Insurance enrollment from 10% (2023) to 62% (April 2025) through mobile campaigns and public-private partnerships—demonstrating rapid progress is achievable.
Sub-Saharan Africa Challenges: 50 of 54 countries implement UHC frameworks, yet high poverty rates, inadequate human resources, and insufficient financial allocations limit progress. COVID-19 stagnated advancement, with rural areas most vulnerable.
Asia-Pacific Disparities: Low- and middle-income countries comprising 80% of global population demonstrate significant regional health disparities in distribution, accessibility, and quality.
Disease Eradication and Outbreak Response
The Eastern Mediterranean hosts the last two countries without polio eradication: Pakistan and Afghanistan. WHO collaborates with the Gates Foundation, Rotary International, and UN agencies, yet conflict and displacement impede progress.
Cholera Crisis: The region accounts for 55% of global cholera cases and deaths in 2025. Sudan reports 65,291 cases and 1,721 deaths; Yemen records over 271,000 suspected cases since March 2024. WHO's new Cholera Preparedness and Response Strategy (2025-2028) addresses root causes but faces chronic underfunding and vaccine shortages.
Noncommunicable Diseases: The Silent Burden
NCDs cause 1.7 million annual deaths in the Eastern Mediterranean—42% occurring before age 70. Projections suggest four main NCDs will cause 2.4 million deaths by 2025 without urgent intervention.
Globally, NCDs account for over 70% of deaths in low- and middle-income countries. Two-thirds of premature NCD mortality links to modifiable behavioral risks: tobacco use, unhealthy diet, physical inactivity, and harmful alcohol use.
The UHC service coverage index shows improvements concentrated in infectious disease control, while NCD management remains severely underdeveloped across all income categories.
Healthcare Workforce Crisis
Healthcare worker migration depletes already constrained systems. The Eastern Mediterranean faces critical shortages exacerbated by higher-income nations recruiting from lower-resource countries—mirroring global patterns where workforce inadequacy constitutes a primary UHC implementation barrier.
WHO Strategic Response
The 71st Session of WHO's Regional Committee for Eastern Mediterranean (October 2024, Doha) endorsed strategic initiatives through 2028:
Six Strategic Priorities:
Health promotion and disease prevention
Quality healthcare access expansion
Emergency preparedness and response capacity
Polio eradication achievement
Knowledge sharing and evidence systems
Digital health advancement
Three Flagship Initiatives:
Expanding equitable access to medical products
Investing in resilient health workforce
Accelerating public health action on substance use
The Regional Strategic Operational Plan 2025-2028 emphasizes outcome-driven, country-led implementation prioritizing self-sufficiency through capable regulatory authorities and coordinated pharmaceutical production.
Health as Economic Investment
WHO leadership emphasizes health as investment rather than cost: "If we think about health as an investment for healthier lifestyles and more productive communities that can support the economy, prioritizing the public health agenda can serve member states in their ability to thrive and be self-sufficient."
This economic argument gains urgency as populations age globally. By 2050, at least one-third of the world's population will exceed 60 years, requiring investment in working-age population health and wellbeing.
Critical Success Factors for UHC
Policy Priorities:
Strengthening primary healthcare infrastructure as foundation for accessible, equitable quality care
Integrated service delivery addressing NCDs, mental health, reproductive health, and infectious diseases
Public-private partnerships engaging private sectors in service expansion
Digital health innovation bridging access gaps
Climate-resilient health systems adapting to environmental challenges
Financial risk protection through public prepaid financing and free access for poor populations
Implementation Requirements:
Political will and government commitment to health equity
Adequate public investment reducing out-of-pocket expenditure burden
Human resources development through training, retention, and equitable distribution
Community engagement with local organizations driving implementation
Data infrastructure improving collection and evidence-based policymaking
Conflict resolution addressing displacement and health system destruction
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Sources by CNN World
