…423 million Africans face financial hardship due to medical bills — Janabi

The World Health Organization (WHO) has raised alarm over the growing burden of healthcare costs on African households, warning that over 423 million people on the continent faced financial hardship in 2022 due to out-of-pocket health spending.

WHO Regional Director for Africa, Dr. Mohamed Janabi, issued the warning in his message commemorating Universal Health Coverage (UHC) Day 2025, marked globally on 12 December, under the theme “Unaffordable health costs? We’re sick of it!”

Janabi said healthcare has become so expensive that millions of Africans are now forced to choose “between care and food, between medicines and school fees, between dignity and survival.”

He noted that out-of-pocket payments still dominate health financing in the region, accounting for more than a quarter of total health expenditure in 31 African countries, more than half in 11 countries, and more than 70% in two.

“Africa accounts for over 20% of the world’s population facing financial hardship due to health costs, and nearly a quarter of global health-driven poverty,” he said.

The WHO chief lamented that health costs continue to push households into poverty, with 384 million Africans slipping into or deeper into poverty due to medical expenses.

“These are not statistics. They are lived realities of households selling assets, postponing care, or slipping deeper into vulnerability,” he noted.

Janabi acknowledged that Africa has made gains in expanding access to essential health services between 2015 and 2022/23 especially in maternal and child health, infectious diseases, and noncommunicable diseases. The region recorded the world’s strongest improvements in NCD service coverage, largely driven by reduced tobacco use.

However, he warned that “progress is uneven” and that financial protection remains the continent’s “most stubborn challenge,” with women, children, older persons and rural communities bearing the greatest burden.

To reverse the trend, the Regional Director urged African governments and partners to accelerate reforms that will make healthcare affordable for all. His key recommendations include:

Increasing domestic investment in health to reduce out-of-pocket payments

Expanding universal prepayment and risk-pooling systems for vulnerable populations

Strengthening primary health care

Investing in health workers, facilities, supply chains and data systems

Prioritizing equity and underserved communities

Improving transparency and accountability in health spending

“With new regional and global evidence in hand, 2025 offers a pivotal opportunity to accelerate financial protection reforms and advance health for all,” he said.

Janabi reaffirmed WHO’s readiness to support African governments with policy guidance, technical expertise and data-driven decision-making.

“As we mark UHC Day 2025, we renew our shared promise: Health for All. No One Left Behind,” he concluded.