Bulletin of the World Health Organization

The Bulletin series: Health systems financing

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.


Linking health to microfinance to reduce poverty
- Sheila Leatherman & Christopher Dunford
doi: 10.2471/BLT.09.071464

Is there a role for user charges? Thoughts on health system reform in Armenia
- Matthew Jowett & Elizabeth Danielyan
doi: 10.2471/BLT.09.074765

Women and children first: an appropriate first step towards universal coverage
- Rob Yates
doi: 10.2471/BLT.09.074401

Taskforce on Innovative International Financing for Health Systems: showing the way forward
- Robert Fryatt & Anne Mills
doi: 10.2471/BLT.09.075507

Taskforce on Innovative International Financing for Health Systems: what next?
- David McCoy & Nouria Brikci
doi: 10.2471/BLT.09.074419


Spanish health district tests a new public–private mix

China’s new health plan targets vulnerable

Thailand: health care for all, at a price

Spectre of ageing population worries economists

What? No waiting lists?

Nigerian farmers rejoice in pilot insurance plan

Reality check for American dream

India tries to break cycle of health-care debt

Rough roads to better care

Brazil’s march towards universal coverage

New Zealand cuts health spending to control costs

Bridging the gap in South Africa