**8. Impact of COVID-19 on health financing systems in LMICs**

SARS-CoV-2 virus, a highly infectious and deadly disease, popularly known as coronavirus (COVID-19) after it was first reported in Wuhan, China, in 2019, has devasted global public health and global health systems. In a spate of 3 months, the disease took global leaders by surprise and spread through the world like wildfire, destroying health systems, wiped out populations in advanced and developing countries. COVID-19 caused panic, anxiety, and mental health challenges, devastated families, destroyed business, increased health care financing and delivery costs, and


**Table 4.**

*Success factors of Thailand's universal health care coverage scheme.*

brought down global travels to a near halt. Several cities in both advanced countries and LMICs experienced lockdowns for several months. For the first time in the history of the world, international and domestic flight in many countries were banned for more than a year, since COVID-19 was declared a global pandemic on March 11, 2019 by the World Health Organization (WHO).

On May 2, 2022, WHO reported a global total of COVID-19 infections stood at 511,275,451 COVID-19 cases and 6,238,320 deaths with a case fatality ratio (CFR) of 1.2% in 227 countries and territories. The reported cumulative cases (percentage of global cases) from the WHO regions except Africa were Eastern Mediterranean Region 18,377,400 (4%), European Region 215,216,599 (42%), Region of the Americas 153,175,779 (30%), South-East Asia Region 57,870,460 (11%), and Western Pacific Region 54,757,461 (11%). At the same period, a total of 11,453,205 COVID-19 cases and 252,165 deaths, with CFR of 2.2%, were reported by the 55 African Union (AU) Member States (MS). Although the incidence in Africa represents only 2% of all cases and 4% of all deaths reported globally, the impact on individual AU Member States was catastrophic. Forty (73%) of individual AU Member States reported CFRs higher than the global CFR [26].

The good news is that the collaborative scientific research which led to the production of vaccines with boosters in advanced countries, such as the United States, the United Kingdom, Germany, and Russia, among others, is expected to curtail the mortality rates of the pandemic and the impact. Unfortunately, LMICs are still struggling to produce their first COVID-19 vaccine, and therefore, must rely on the collective benevolence of advanced countries through the COVAC initiative to vaccinate their populations.

The evidence suggests that over 4.6 billion people constituting 58% of the global population have been fully vaccinated. But, only 17% of the total population of Africa was fully vaccinated, as of May 2022 [27], which could be attributed to inadequate

*Health Insurance for Economically Disadvantaged People in LMICs: What are the Best Options? DOI: http://dx.doi.org/10.5772/intechopen.105679*

vaccine supply, vaccine myths and hesitancies, funding and procurement issues, among other factors. The economies of many LIMCs experienced negative economic growth, and huge negative impact on their health systems are still recuperating since the outbreak of COVID-19. The impact of COVID-19 pandemic should be a wake-up call for LMICs to adopt measures to strengthen their health systems and make them resilient.
