More than half of the world’s population lacks access to essential health care and just 29 per cent have comprehensive social security coverage, according to a new International Labour Organization (ILO) report on the implementation of social protection in more than 100 countries.

Globally, only 68 per cent of persons of retirement age receive some form of pension, and in many low-income countries this drops to just 20 per cent. Fewer than 60 per cent of countries reported that they had schemes or benefits to ensure income security for children.

The findings come in the General Survey 2019 , compiled by the ILO Committee of Experts on the Application of Conventions and Recommendations (CEACR). The Survey (published under the title Universal social protection for human dignity, social justice and sustainable development) focuses on the ILO’s Social Protection Floors Recommendation, 2012 (No. 202) , which calls for basic income security and essential healthcare guarantees from childhood to old age. It also aims to encourage greater levels of protection for as many people as possible, as soon as possible.

“Social protection is proven to be good for societies and economies. This human right clearly has strong buy-in from countries, employers and workers across the world,” said Emmanuelle St-Pierre Guilbault, Legal Specialist at the ILO’s International Labour Standards Department. “This is a ‘must’ to tackle the broad and rising inequality we see today and foster stability.”

“Social protection is proven to be good for societies and economies. The ILO stands ready to help countries address any remaining obstacles on the road to achieving sufficient social protection for all. "

Emmanuelle St-Pierre Guilbault, Legal Specialist at the ILO’s International Labour Standards Department

“The ILO stands ready to help countries address any remaining obstacles, including the major issue of financing, on the road to achieving sufficient social protection for all,” she added.

It found that while universal health coverage has been achieved in many high- and middle-income countries, in many countries the population only has access to certain components of health care.

The main deficits in essential health care access relate to the underfunding of health protection, shortages of health workers and high rates of out-of-pocket payments. This results in an increased risk of impoverishment and financial hardship, which is found in all regions of the world.

The report says that more effort is needed to establish universal health coverage in both law and practice, including the reallocation of budgets and an increase in the number of health workers.

Important gaps also remain in establishing basic income security. The report recommends that countries set clear objectives, with precise time frames, to extend adequate social protection for all, covering basic needs. Such policies should be shaped through inclusive and effective dialogue with workers’ and employers’ organisations, as well as other stakeholders.

The issue of universal social protection coverage is also key for achieving the Sustainable Development Goals , notably those targets covering the ending of poverty and inequality, health and well-being, decent work, economic growth, peace, justice and strong institutions.

Social protection is expected to be on the agenda of the 2020 International Labour Conference .

General Surveys are prepared annually by CEACR, the supervisory body in charge of monitoring ILO member States’ compliance with international labour standards. Each edition focuses on a subject chosen by the ILO’s Governing Body and takes an in-depth look at member States' national law and practice in relation to it.

The General Survey 2019 is based on responses by 114 governments and observations submitted by employers’ and workers’ organizations. Survey participants responded to 46 questions on the implementation of Recommendation No. 202 , which was the first international social protection standard of the 21st Century. Responses to the 2019 survey were analysed, good practices and obstacles were identified, and guidance offered to encourage better application of the Recommendation .

The CEACR has also released its annual report  , along with an updated edition of Rules of the Game , which gives a concise, non-specialist introduction to international labour standards and their importance in today’s global economy.