Bulletin of the World Health Organization

The Bulletin series: Health systems financing

Bulletin special collection: health systems financing
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Health systems financing and the path to universal coverage

Donor commitments to health have increased more than fourfold since the Millennium Declaration was signed in September 2000, reaching more than US$ 20 billion in 2008. Despite this, progress towards some of the health Millennium Development Goals (MDGs) has been disappointing in many settings. The simple act of raising more international funds cannot, by itself, achieve the Goals if the health system is too weak to support the rapid scale-up of service coverage. Where there are insufficient health workers and health facilities, or where people can’t obtain health care because they cannot afford to pay, supporting actions are needed.

Domestic health financing systems must be robust enough to attain and sustain increased coverage. Financing for universal coverage is based on two interlinked foundations. The first is to ensure that financial barriers do not prevent people from using the services they need – prevention, promotion, treatment and rehabilitation. The second is to ensure that they do not suffer financial hardship because they have to pay for these services.