I like to add more about problem that World Bank ignores. This is not unusual: Maya drops out of school at 12, starts smoking at 16 when she also has first baby. The boyfriend leaves , she has to work and live in a bad neighboorhod because she has little money, she is raped, she contracts AIDS at 25, after 3rd baby. She also has malaria. She can probably have lung cancer at 50, and she will live that long thanks to free drugs for AIDS. World Bank answer: universal coverage. Maya becomes a burden on her neighbors and other fellow taxpayers. This doesn't make sense for the World Bank to promote. The first (and 2nd, 3rd, 4th...) answer is to prevent Maya's huge and expensive health problems instead of only stress on taxpayer and only reactive policym waiting for people to get sick and then paying. Government can make thes mistake by itself and does not need World Bank advice!