Universal health coverage (UHC) is a global goal based on the fundamental human right to health. Everyone is entitled to the health services they need without facing financial hardship.
This right is enshrined in many international covenants and treaties, including the Constitution of the World Health Organization (WHO) and, as well as those the constitutions of many countries around the world:
“The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” – WHO Constitution
A billion people worldwide remain unable to access even basic health services due to weak health systems and other barriers. Many fall into poverty due to ill-health or the high cost of medical care.
UHC is the aspiration that all people can obtain the health services they need, of good quality, without suffering financial hardship when paying for them.
The goal of UHC is to make healthcare more accessible, more equitable and more affordable by improving how it is financed and delivered. Strong, equitable health systems that leave no one behind are essential for global progress, as COVID-19 has made clear.
According to the World Health Organisation (WHO), UHC will have been achieved when all individuals and communities receive the health services they need without suffering financial hardship. It must include the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.
Progress to Date
Commitment to UHC is not something only wealthy countries can afford. Following the poverty and devastation of World War II, many nations, such as Canada, Japan and much of Europe, committed politically to UHC for their citizens. They financed health budget expansions through taxation and national insurance schemes. This investment has arguably contributed to their economic growth. Poorer nations, especially those impacted by the debt crisis of the 1980s, have been forced to rely on user fees or out-of-pocket payments to fund their health systems or to supplement meagre government resources.
However, in recent decades over a hundred low- and middle-income countries, home to three-quarters of the world’s population, have taken steps toward delivering UHC. Some countries have implemented plans to make basic health services free of charge to all citizens, including Brazil, Mexico, Rwanda and Thailand. Other countries that have made good progress include Ghana, the Philippines and South Africa.
There is no ‘one size fits all’ approach to UHC. Health needs and demands vary across nations. Each country must find its own path.
National ownership is essential for UHC—country governments understand and are therefore best placed to plan the delivery of health to all that is specific to their country contexts. When governments raise domestic resources and own the policy-making process for health, they become less reliant on foreign aid and donor priorities. This allows them to better fulfil their obligations to safeguard the health of their populations.
For a long time, the prevailing wisdom in global development circles was that UHC was unaffordable, unmeasurable and unachievable. But thanks to the tireless efforts of advocates working at the global and national levels, the last decade has seen a dramatic shift toward consensus that UHC is morally right, economically smart and urgently needed.”
– UHC2030 Advocacy Strategy 2018
In 2004, Ghana introduced the first National Health Insurance Scheme (NHIS), a system funded by government tax income and individual memberships. The scheme covers 95% of diseases, including treatment for malaria, respiratory diseases, diabetes and hypertension....
Japan celebrated the 50th anniversary of its compulsory health insurance policy in 2011. All residents are required by law to have health insurance coverage, either through their employer or via the government National Health Insurance (NHI) system. The scheme is...
Brazil provides free, universal access to medical care to anyone legally living in the country. Known as Sistema Único de Saúde (SUS), the Unified Health System was created in 1989 and is the largest non-discriminatory government-run public health care system.