In 2022, the latest year for which full data are available, the world spent just short of US$10 trillion on health care. The United States was by far the largest single spender, representing 43% of the total. At the other end, around 75 of the poorest countries spent less than 4% of the global total, and many are not allowed to increase this. That’s because they owe huge sums to richer countries — and the lending agreements say that paying off debts has to be prioritized ahead of public spending.
This is just one example of how inequity is baked into the world’s financial system — creditors can dictate lending terms to some of the most vulnerable countries without any oversight. However, in June and July 2025, the international community will have an opportunity to ensure that this situation can be consigned to history.