F igure 5 1
Universal health coverage in 2030 Universal health coverage index, 2030 29 to <48 48 to <51 51 to <57 57 to <64 64 to <67 67 to <72 72 to <84 84 to <86 86 to <92
Caribbean
ATG
VCT
BRB
COM
DMA
GRD
MDV
MUS
LCA
TTO
TLS
SYC
W Africa
MHL
KIR
SLB
FSM
VUT
WSM
FJI
TON
E Med.
MLT
Persian Gulf
SGP
Balkan Peninsula
Notes: Projections based on the reference scenario. Source: Financing Global Health Database 2017
Figure 52 shows that an estimated 4.3 (4.2–4.4) billion lives were covered under UHC in 2015. The UHC index ranged, across countries, from 26.5 (23.8–29.6) to 85.3 (81.8–88.5), and roughly half of the global population lived under health systems with a UHC index of less than 60. Current growth rates projected out to 2030 estimate that an additional 1.1 billion (0.8–1.3) people will be covered under UHC. Using the estimates for the “better” scenario, an additional 195.7 million (185.8–204.7) lives could be covered. Low-income countries such as those in sub-Saharan Africa and South Asia are projected to have the greatest gains – 303.9 million (252.7–357.2) and 274.2 million (237.0–304.5) more lives covered, respectively. High-income countries are projected to have 1.0 billion (0.9–1.0), or 79.9% (77.3–81.8) of the population covered, while uppermiddle-, lower-middle-, and low-income countries are projected to have 72.4% (68.9–75.4), 58.2% (55.3–60.2), and 48.7% (45.6–51.9) of people covered by UHC by 2030, respectively. Drivers of universal health coverage Understanding the determinants of increases in UHC is helpful for charting the appropriate course for each country. Pooled health resources and efficiency of the health service delivery process are two distinct drivers of UHC attainment. Figure 53 illustrates the drivers of estimated increases in UHC. For most lower-middle-, uppermiddle-, and high-income countries, increases in pooled spending per person make the most significant impact in increases in UHC coverage. Between 2015 and 2030,
90 Financing Global Health 2017