The COVID-19 pandemic has been a stark warning to the Philippines and the rest of the world: Good health is critical to economic and societal functioning, and countries that neglected their health sectors have reaped the consequences. At the same time, societal, medical, and regulatory attitudes toward health innovations such as telemedicine were upended, and the possibilities seemed limitless, if only for a few years. As priorities in 2024 turn toward economic recovery, it falls on health systems to retain their learnings from the pandemic and invest more heavily in technologies to strengthen health and care in the long term.

In the Philippines, matters of health care are often tethered inextricably to local politics. Concurrently, the humility and candidness of public discourse can be advantageous. Politicians, academia, and nongovernmental organizations alike are explicit on what needs to improve, and even government reports can be unusually blunt about their own performance. This clear-eyed view has partly translated into a steady improvement in health system capacity over the years.

Barangay (district) health stations have proliferated since 2004, and under-five mortality has halved since 1993. Sin taxes bring in revenue larger than the entire health budget, providing much-needed funding for UHC. Malaria has been suppressed, and additional laws on reproductive health, cancer, occupational safety, mental health, and integrated health services and financing have been passed.

In particular, the 2019 UHC Act marked a major milestone in equalizing access to health care. From a meager 38 percent coverage in 2000, all Filipinos will now be automatically enrolled, with health care increasingly delivered at the community level, focused on prevention, and integrated with the rest of the health system. The Department of Health (DOH) aims for Filipinos to be “among the healthiest people in Asia by 2040.”

Despite these advances, lifespans in the Philippines have risen relatively slowly since 1990 (Figure 1), and widespread stunting of children’s growth will continue to slow future advances in healthy life expectancy. This is not entirely an issue of income or geography—poorer countries such as India and larger archipelagoes such as Indonesia have lengthened lifespans more despite spending less. Such sobering statistics represent the unfinished work in Philippines health and care.