COVID-19 continues to pose challenges to people’s health and well-being globally and is impeding progress in meeting Goal 3 targets. Before the pandemic, gains were evident in many areas of health, including reproductive, maternal and child health, immunization coverage and treatment of communicable diseases, though progress was marred by huge regional disparities. As of mid-2022, COVID-19 had infected more than 500 million people worldwide. The latest estimates show that global “excess deaths” directly and indirectly attributable to COVID-19 could have been as high as 15 million by the end of 2021. The pandemic has severely disrupted essential health services, triggered an increase in the prevalence of anxiety and depression, lowered global life expectancy, derailed progress towards ending HIV, tuberculosis (TB) and malaria, and halted two decades of work towards making health coverage universal. As a result, immunization coverage dropped for the first time in 10 years, and deaths from TB and malaria increased. Urgent and concerted action is needed to set the world back on a trajectory towards achieving Goal 3.

Available data do not indicate an increase in suicide rates during the first months of the COVID-19 crisis. However, the pandemic has had a severe impact on the mental health and well-being of people around the world. In 2020, the global prevalence of anxiety and depression increased by an estimated 25 per cent, with young people and women most affected. At the same time, countries reported that services for mental, neurological and substance use conditions were the most disrupted among all essential health services, which widened gaps in mental health care. By the end of 2021, the situation had improved somewhat, but many people remain unable to get the care and support they need for both pre-existing and new mental health conditions.

Even before the pandemic, depression, anxiety and other mental health challenges affected far too many children. It is estimated that, in 2019, more than 13 per cent of adolescents aged 10 to 19 had a diagnosed mental disorder as defined by the WHO; this translates into 86 million adolescents aged 15 to 19 and 80 million adolescents aged 10 to 14. The pandemic has added to the mental health issues facing children and young people, since many of them are still experiencing school closures, disruption of daily routines, stress over food insecurity and loss of family income, and uncertainty about the future. For the most vulnerable children, the impact of COVID-19 may also increase their exposure to multiple forms of violence and exploitation.

It is imperative that COVID-19 response plans include mental health and psychosocial support. Increased attention and investment are particularly needed to improve mental health care for children and young people and to protect the most vulnerable children.

Universal health coverage (UHC) is achieved when all people can receive the good-quality health services they need without facing financial hardship from having to pay for them. Even before COVID-19, alarming trends in universal coverage were evident. The UHC service coverage index improved from a global average of 45 out of 100 in 2000 to 64 in 2015 and 67 in 2019. However, almost 1 billion people spent more than 10 per cent of their household budget on out-of-pocket health expenses in 2017, and more than half a billion were pushed into extreme poverty due to these out-of-pocket payments.

Data are not yet available to provide a detailed and comprehensive look at the impact of COVID-19 on progress towards UHC. However, since the pandemic has led to significant disruptions in essential health services, the continuous progress made over the last two decades has likely come to a halt. With the combined health and economic impacts of COVID-19, people may be facing greater financial constraints in accessing care. Among those paying out of pocket for health services, financial hardship is likely to worsen further, particularly for those already disadvantaged.

Health and care workers remain on the front lines of the COVID-19 response. Between January 2020 and May 2021, the pandemic may have claimed the lives of 115,500 health and care workers worldwide. Greater efforts are needed for equitable distribution of COVID-19 vaccines to ensure that they have access to vaccination and personal protective equipment.
Data for 2014–2020 show that the density of nursing and midwifery personnel in Northern America remains the highest in the world, at over 152 per 10,000 people. This is almost 4 times the global average, 8 times that of Northern Africa and Southern Asia, and over 15 times that of sub-Saharan Africa. Despite a steady increase in the density of medical doctors per 10,000 people globally, the disparities among regions remain high – from an estimated 40 medical doctors per 10,000 people in Europe to only 2 in sub-Saharan Africa.