Morocco and the World Bank 2026–2035: a lever for universal health coverage?

Basic medical coverage now reaches nearly 88% of the population, or around 32 million beneficiaries. This registration rate nevertheless conceals a persistent gap between formal coverage and effective access: according to the Court of Accounts’ 2024–2025 report, 30.4% of Moroccans, nearly 11 million people, do not effectively benefit from coverage, either because they are not registered or because their entitlements are inactive. Against this backdrop, the World Bank Group and the Government of Morocco announced a new Country Partnership Framework (CPF) for 2026–2035 in Rabat on 9 July 2026. The central issue for this ten-year framework is not the headline financial commitment, but its capacity to convert a multi-year commitment into measurable gains in access to care. This brief places the partnership within Morocco’s health reform architecture and examines its points of tension.

Strategic context

The CPF 2026–2035 builds on more than sixty-five years of cooperation between the World Bank and Morocco and succeeds the 2019–2024 framework. It is explicitly aligned with the Kingdom’s New Development Model, which seeks to shift the growth trajectory from a model driven by public investment towards one led by the private sector. The framework’s overarching objective is to create more and better jobs, particularly for young people and women, in a country where youth unemployment reached 37% in 2024.

The framework has three structural priorities: more competitive businesses, through reduced regulatory barriers and broader access to finance for SMEs; better-connected, more inclusive territories, by reducing spatial disparities; and stronger human capital, through reforms to education, universal health coverage (UHC) and a more comprehensive social protection system. Structurally, most of the partnership’s health ambitions sit within this third pillar. This positioning reflects an institutional policy choice: health is presented as a component of human capital serving economic competitiveness, rather than as a right in its own terms with a dedicated pillar.

The financing architecture combines three of the Group’s instruments. The World Bank envisages an indicative envelope of nearly $15 billion for its public-sector operations over the decade. According to the institution, International Finance Corporation (IFC) commitments to the private sector are expected to exceed that amount over the same period, bringing the combined commitment to a level that could exceed $30 billion. This would be complemented by Multilateral Investment Guarantee Agency (MIGA) guarantees, notably political risk insurance. Implementation will therefore combine loans, technical expertise and private capital mobilisation, with actual disbursement remaining conditional on the country’s performance and financing needs.

Case analysis: the gap between formal coverage and effective access

The extension of mandatory health insurance (AMO), enshrined in Framework Law 09-21 on social protection, is the principal achievement on which the CPF seeks to build. It has extended coverage to previously uncovered groups, including the self-employed, professionals in independent practice and students, and absorbed former RAMED beneficiaries. In its January 2026 opinion on AMO reform, the Economic, Social and Environmental Council (CESE) nevertheless stresses that unifying the managing body cannot, on its own, ensure the effectiveness of a system intended to be universal, equitable and sustainable. Performance is measured not by the number of people registered, but by fairness and quality in actual access to care.

Progress in formal coverage is constrained by supply-side bottlenecks. In its report ‘Basic health care: towards equitable and universal access’, CESE has long identified the need for substantial investment in human resources, with regionalised training and recruitment and incentives to retain health workers in disadvantaged areas. Extending entitlement to coverage therefore does not automatically translate into effective access. Without the capacity to train and distribute health workers, AMO’s expansion risks running up against a supply of care too thinly spread to absorb demand newly backed by insurance funding.

This supply constraint has a marked territorial dimension. Research by the Policy Center for the New South on Morocco’s health system highlights persistent disparities between urban and rural areas, attributable to the uneven distribution of infrastructure and health professionals. Yet returns on the private capital that IFC and MIGA are mandated to mobilise tend to be concentrated in urban centres with purchasing power. Without corrective state mechanisms to ensure universal geographical access, a predominantly private financing model could reinforce, rather than reduce, the system’s segmentation between major cities and rural areas.

At this stage, the public announcement of the CPF 2026–2035 does not detail a specific mechanism to finance hospital capacity or health workforce training. This omission is a blind spot in the partnership: the commitment concerns outcomes, namely wider access to care, without making public the operational levers, such as infrastructure investment, medical training funding or incentives to practise in underserved areas.

Policy pillars and recommendations

First pillar: align external financing with territorial planning of the supply of care. For the CPF’s ‘human capital’ pillar to deliver measurable gains in access, the funding mobilised should be explicitly directed towards the areas and care pathways identified as priorities in the National Health Strategy, rather than treated as a general budget envelope.

Second pillar: treat workforce retention as a financing objective in its own right. The shortage of health workers in rural and peripheral areas calls for dedicated funding for budgeted posts and incentive schemes, separate from allocations for initial training. Otherwise, the expansion of formal coverage will continue to encounter insufficient capacity.

Third pillar: make private capital mobilisation subject to inclusion requirements. The role of IFC and MIGA in the health component of the partnership does not, in itself, guarantee equitable access. It must be accompanied by price regulation mechanisms and obligations to cover areas that are unprofitable for private investment, to prevent the financial exclusion of the most vulnerable patients.

Fourth pillar: steer by actual access and ensure transparent monitoring. Following CESE’s recommendations, the indicators announced by the World Bank should measure quality, sustainability and an effective reduction in unmet need for care, and should be published accessibly to allow independent monitoring, beyond administrative registration rates alone.

Institutional challenges and conclusion

The CPF 2026–2035 places Morocco’s health sector within a multi-year, multi-stakeholder financing approach linked to a macroeconomic job-creation objective. This offers the advantage of budget predictability over a decade in a sector where structural reforms, including workforce training and the territorial reorganisation of care, take effect over long cycles.

The main institutional challenge remains coordination between the economic competitiveness agenda underpinning the CPF and the health sector’s own agenda, led by the Ministry of Health and Social Protection. As CESE recalls in its progress review of the extension of AMO, the programme’s sustainability remains dependent on securing lasting financial resources and gradually converging schemes to ensure real equity. In the absence, at this stage, of operational detail on financing the supply of care, the stated ambition for universal health coverage can be assessed only against implementation instruments that have yet to be specified.