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User fees for health care are a life or death issue for millions of people in poor countries. Too poor to pay, women and children are paying with their lives. People who can’t pay are often imprisoned in hospitals until their families can clear their bills. For those who do pay, over 100 million are pushed into poverty each year. User fees for health care continue to exist in most poor countries despite rarely contributing more than 5% of running costs for health services. This month will witness a global opportunity for world leaders to really make a difference to poor people by backing the expansion of free health care in a number of countries. The opportunity marks a true test of leaders’ commitment to save lives and accelerate progress towards health care for all in our lifetime. The question is, will they pass it?


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