Health not so universal in the High-Level Panel

Today, the High-Level Panel (HLP) submitted a report to the UN Secretary-General saying what should be in any post-2015 development agenda to replace the Millennium Development Goals (MDGs). Overall, there is much in the report to welcome, especially on extreme poverty and disaggregation of targets by income. We are delighted that there is a clear commitment to end all preventable child mortality. However, on health, we are disappointed that the panel has not provided a framework that could transform health inequalities in poor countries.

Concerns about health

An extensive health consultation run by the HLP produced a report recommending a new approach. It said that countries should set targets to improve health in all life stages, based on national analysis of the major causes of death and poor health, and recommended that the health sector should tackle these through the principles of universal health coverage (UHC). UHC is a wonderfully simple concept – that everyone is entitled to essential healthcare – which is fast gaining traction around the world.

We therefore expected the HLP to use this framework in proposing their targets. Although they say clearly that they support it, they chose instead to propose targets that follow on from the previous health MDGs. Continuing targets on HIV, child and maternal mortality, sexual and reproductive health are supplemented by vaccination, neglected tropical diseases and non-communicative diseases. All of these are extremely important, but UHC is the framework within which we expected to see them discussed.


Donors are much more comfortable talking about specific health topics than comprehensive health systems and the HLP report reflects that. It also takes on board all the lobbying by various groups and as one of those groups, Save the Children is pleased that many of our priorities have been reflected. However, we very much wanted UHC incorporated as the framework for the health sector, ending the discrimination that leaves so many of the poor without access to quality care – even in cases when their health issues are themselves priority areas for the MDGs.

Plenty to play for

The HLP is the start of a long process and the baton now passes to the Open Working Group for the Sustainable Development Goals. There is a growing consensus on the importance of UHC; we need the next stage of the process to be more ambitious and put it at the very centre of the debate.

Leave a Reply


  • Tara Brace-John

    The really powerful and crtical aspects of the HLP report – the 5 transformative shifts – the shifts required for a different development paradigm – have not been given the attention required for them to be taken seriously. No targets or measurable objectives and unfortunately no colourful icons of their own either!

    In many ways the report will make it difficult for civil society to further advocate for a paradigm shift – given that this box has already been ticked – and yet not.

    So will equity and justice in health and something as basic as universal access to health care continue to remain a mirage for the millions of poor women and children whom we work with? Will the most vulnerable be let down – yet again?

  • The report clearly outlines the bold ambition to end poverty by 2030, promote gender quality, improve access to water and sanitation, and particularly for sub-Saharan Africa, promote good governance and build strong effective institutions. These are noble. I agree we must pursue these goals.

    However, I was disappointed, as you are, to see that it is silent on the importance of universal health coverage as an inevitable framework to scale-up the gains of a long battle against AIDS, tuberculosis, malaria, maternal and child mortality, and NCDs.

    Evidence supports universal health coverage. There is an overwhelming global consensus for UHC. So what happened at the panel discussions? This is a questions I would love answered.

    We know UHC is not an end in itself. It can never be. But it is inspiring to state a goal as ‘ensure universal access to health’ than the stated ‘ensuring healthy lives’. I think the latter is vague and sparks only little energy for action!

    It is time we arose to defend #UHC as an inevitable framework and overarching goal for post2015. What is the relevance of donor funds on particular disease entities in a country with weak healthy systems? It is like fetching water with a basket. It can never be filled! It will waste.

    Strengthen health systems. Ensure equitable access to quality health care, and victory is assured in the battle against AIDS, TB, malaria, child and maternal mortality and NCDs.