Taking a broad view of health

The World Bank is looking to support health in more diverse ways, broadening the types of support it offers, focusing on more remote regions and removing financial barriers. Only bold action will bring us closer to reaching the SDGs

A combination of fiscal, disease and demographic challenges pose new threats to health systems around the world, with the greatest impact in low- and middle-income countries. The Covid-19 pandemic eliminated a decade of progress in life expectancy and exposed or exacerbated chronic health system constraints. More people in low-income countries now live in extreme poverty than before the pandemic.

The world is ageing rapidly, with the population over 60 years old expected to nearly double between 2015 and 2050, especially in low- and middle-income countries. This shift will increase non-communicable diseases, morbidity and demand for long-term care, posing economic risks. Fiscal pressures and debt distress have reduced health spending in many poor countries. Without action, the number of those without access to essential health services could rise to 5 billion by 2030.

There is a deliberate choice to be made: do we learn from the lessons of Covid-19 and make resilience the core of our efforts, or do we allow business as usual to continue? At the World Bank, we understand resilience as the ability of health systems to respond swiftly to sudden crises, while continuing to deliver essential health services, adapt and recover. Only bold reforms and a radical transformation of health systems can bring within reach the 2030 goals of universal health coverage and Sustainable Development Goal 3 on health.

How the World Bank is helping

We are raising our ambition. Over the next five years, the World Bank will help countries reach 1.5 billion people with more and better health services. It is a massive and long-term goal. In response to today’s realities, we are broadening our focus from reproductive, maternal and child health to include coverage throughout a person’s lifetime, including non-communicable diseases and mental health. We are expanding operations to hard-to-reach areas, including remote villages, cities and countries. We are reducing financial barriers to health care so families do not have to choose between lifesaving care and putting food on the table. All these efforts must be made with concerted efforts on pandemic preparedness and response. It is only a matter of time before the next pandemic hits us.

This means ensuring the integration of health emergency preparedness and response capabilities into the core health infrastructure, ensuring that health facilities, workforce and supply chains are robust, agile and adaptable. But driving all these efforts are the communities, and progress will only be measured there. Building trust in services and the institutions behind them among the communities served is a fundamental element for building stronger, sustainable health systems.

Accessible, affordable and quality access – that is our vision.

Supporting care and resilience

Our current global health portfolio reaches $32 billion across 100 countries. The World Bank takes a systems approach with a sustainable financing aspect, across sectors, focusing on equity and following governments’ leadership.

The World Bank is supporting India’s government to advance reforms to strengthen public health and pandemic preparedness, and to improve the quality of care, governance, and accountability in the health sector. These central-level engagements are further supported by several state-level health system strengthening projects that are helping realise improvements in both effective service coverage and financial risk protection.

In Indonesia, the World Bank’s analytics and financing support the Ministry of Health’s transformation agenda, focusing on nutrition, early years, primary healthcare quality, digital health, financial protection, strategic purchasing, local financial management and public health infrastructure. These efforts aim to build a resilient health sector that can effectively respond to crises.

In Rwanda, the World Bank supported a multisectoral approach to tackle child stunting and malnutrition. Social protection and health projects targeted poor women with young children, promoting health and nutrition services. The impressive declines in child stunting have made Rwanda the only country to achieve the SDG target on child wasting.

The World Bank is supporting Morocco in an ambitious effort to expand quality-care coverage to underserved communities, strengthen the health workforce and improve governance of the health system. It also contributes to making the system more resilient to climate change with an explicit focus on gender equity.

Facilitating partnerships

Delivering at scale with strong partnerships – that is the path.

First, we are utilising all World Bank financing instruments, such as the International Development Association and the International Bank for Reconstruction and Development, to encourage countries to boost health investments, while also engaging with the International Financing Corporation for private sector involvement. Additionally, we will leverage two World Bank–hosted partnerships – the Global Financing Facility for Women, Children and Adolescents, and the Pandemic Fund – to attract more financing aimed at ending preventable deaths and ensuring better pandemic preparedness. Both partnerships implement a health systems approach: the GFF model emphasises country leadership and national investment prioritisation, and the Pandemic Fund focuses on critical system dimensions such as trained human resources, stronger laboratory capacity and enhanced surveillance, all contributing to building resilience.

Second, we are engaging ministries of finance, health and other sectors through knowledge, learning and strengthening data for decision-making to guide policy reform and achieve more efficient and effective spending for health. A recently announced universal health coverage hub, supported jointly with the World Health Organization and the government of Japan, will launch in the coming months to provide a platform to bring health and finance ministers together to strengthen their capacity to achieve universal health coverage.

Third, there is a huge opportunity to do better and an impetus for more effective collaboration across countries and international organisations. The World Bank is supporting the Lusaka Agenda by increasing co-financing opportunities and strengthening collaboration with global health partners including the WHO, the Global Fund and Gavi, the Vaccine Alliance to ensure alignment of strategies, avoid duplication of efforts and maximise impact.

Achieving this vision requires strong political and technical leadership at all levels – from national to regional and local levels – supported by growing institutional capacity and effective management. These critical elements must lead the way to more resilient health systems, ensuring a healthier future for all.