Universal health coverage is not a new concept; from Ancient Egypt to the world today, most societies have recognized the importance of ensuring all individuals have access to quality health care. Our understanding of UHC has been shaped by philosophers, economists, and political scientists as much as it has been by the health sector, individuals, caregivers and communities. We have enshrined health as a human right, linked the need for strong health systems to achieving health equity, and built a global health architecture that supports collaboration and mutual accountability.
Scroll below for an overview of a few global milestones in our collective path toward UHC.
The United Nations General Assembly endorsed a resolution urging countries to accelerate progress toward UHC as an essential priority for international development on 12 December 2020.
It is essential to take into consideration the needs of vulnerable segments of society, including the poorest and marginalized segments of the population, indigenous peoples and persons with disabilities.”
When managing the transition of the health system to universal coverage, each option will need to be developed within the particular epidemiological, economic, sociocultural, political and structural context of each country in accordance with the principle of national ownership.”
World leaders at a historic UN Summit in September adopted 17 Sustainable Development Goals (SDGs) as part of of the 2030 Agenda for Sustainable Development. These include:
SDG 3: Good Health and Well-being: Ensure healthy lives and promote well-being for all at all ages
- Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
To promote physical and mental health and well-being, and to extend life expectancy for all, we must achieve universal health coverage and access to quality health care. No one must be left behind.”
– 2030 Agenda for Sustainable Development, paragraph 26
WHO and the World Bank released the first global monitoring report to assess countries’ progress toward UHC. The report noted that in 2013, at least 400 million people lacked access to at least one essential health service. It examines global access to health services, such as access to clean water and sanitation, family planning, skilled birth attendance, antenatal care, child immunization, antiretroviral therapy and tuberculosis treatment.
Leaders at the 42nd G7 summit hosted by Japan committed to taking concrete actions to advance global health and strengthen the global health architecture. The statement “Vision for Global Health” recognized the importance of achieving UHC and the necessary connection to health systems strengthening (HSS), and supported the establishment of UHC2030 (see above, IHP+ launch in 2007).
We recall universal health coverage is a goal adopted in the 2030 Agenda and recognize that strong health systems are important to effectively address health crises. We call on the UN to keep global health high on the political agenda and we strive for cooperative action to strengthen health systems worldwide, including through developing the health workforce.”
2017 First UHC Day
The United Nations proclaimed 12 December as International Universal Health Coverage Day (UHC Day) by resolution 72/138. On 12-15 December, the UHC Forum in Tokyo brought together governments, multilateral and bilateral institutions, academia, private sector and civil society to mobilize around the global call for UHC.
40 years after the historic Alma-Ata Declaration, world leaders pledged to strengthen their PHC systems at Astana, Kazakhstan. The declaration includes commitments in four key areas: (1) make bold political choices for health across all sectors; (2) build sustainable primary health care; (3) empower individuals and communities; and (4) align stakeholder support to national policies, strategies and plans.
We find it ethically, politically, socially and economically unacceptable that inequity in health and disparities in health outcomes persist…We envision primary health care and health services that are high quality, safe, comprehensive, integrated, accessible, available and affordable for everyone and everywhere, provided with compassion, respect and dignity by health professionals who are well-trained, skilled, motivated and committed.”
The Group of Friends of UHC was established in December 2018 as an informal platform for UN Member States to build momentum towards achieving UHC by 2030. This Group contributed to the Political Declaration of the High-level Meeting on Universal Health Coverage in September 2019. The Group has 64 member countries and areas, and is currently co-facilitated by Japan, Thailand and Georgia.
Political Declaration commits to achieve UHC by 2030
We commit to […] Ensure that no one is left behind, with an endeavour to reach the furthest behind first, founded on the dignity of the human person and reflecting the principles of equality and non-discrimination, as well as to empower those who are vulnerable or in vulnerable situations and address their physical and mental health needs which are reflected in the 2030 Agenda for Sustainable Development, including all children, youth, persons with disabilities, people living with HIV/AIDS, older persons, indigenous peoples, refugees and internally displaced persons and migrants.”
Held in Osaka, Japan in June 2019, the first-ever joint session brought together health and finance ministers of G20 member countries and invited guest countries to focus on health financing for achieving UHC. Outcomes included the G20 Shared Understanding on the Importance of UHC Financing in Developing Countries.
The United Nations General Assembly held a special session to discuss the impacts of the COVID-19 pandemic on people, societies and economies and outline a multifaceted, coordinated response required to address this crisis.
Looking ahead, the recovery from COVID-19 must address the pre-existing conditions it has exposed and exploited, from gaps in basic services to an overheated planet. Stronger health systems and Universal Health Coverage must be a priority”
– Statement by UN Secretary-General António Guterres
The policy brief, ‘COVID-19 and Universal Health Coverage’ emphasizes the critical link between global goals to achieve UHC and the response to the COVID-19 pandemic. At the launch of the brief, UN Secretary‑General António Guterres noted:
All countries have agreed to work towards universal health coverage as part of the 2030 Agenda for Sustainable Development. But, we cannot wait 10 years. We need universal health coverage, including mental health coverage, now, to strengthen efforts against the pandemic and prepare for future crises.”
The Global Action Plan for Healthy Lives and Well-being for All brings together 13 multilateral health, development and humanitarian agencies to better support countries to accelerate progress towards the health-related SDGs. Although each agency has a specific mandate, the agencies as a group complement each other. Together, the agencies work to advance all the SDG3 targets and collectively, they channel around one-third of development assistance for health annually.
The 13 agencies are:
- World Health Organization
- World Food Programme
- United Nations Development Fund
- United Nations Population Fund
- United Nations Children’s Fund
- Gavi, the Vaccine Alliance
- Global Financing Facility for Women, Children & Adolescents
- International Labour Organization
- The Global Fund to Fight AIDS, Tuberculosis & Malaria
- Joint United Nations Programme on HIV/AIDS
- United Nations Entity for Gender Equality & the Empowerment of Women
- World Bank Group
The Coalition of Partnerships for UHC and Global Health unites health leaders and advocates in a common goal to align advocacy and accountability efforts to achieve UHC and advance the SDGs. The Coalition will work together to assist Member States and other stakeholders in: (a) Accelerating high-level political efforts around socio-political accountability to ensure UHC delivers for vulnerable populations (b) Supporting coordination among the various existing health initiatives and joint follow-up actions of UN HLMs for the preparation of the future UN HLMs on the health agenda (c) Strengthening existing SDG accountability mechanisms to scale up efforts on health-related SDGs by 2023 and beyond.