Today, for the first time, we celebrate Universal Health Coverage (UHC) Day. Sometimes hailed as a ‘new’ concept, the right to health was actually included in the Universal Declaration of Human Rights, 1948, as well as the Alma Ata Declaration on Primary Healthcare, 1978, which sought to protect and promote the health of all people.
But nearly four decades later we still have a long way to go. 150 million people still face catastrophic healthcare costs because of direct cash payments – charges that push 100 million people into poverty each year.
And a staggering 1 billion people have never seen a health worker in their lives. Yet we know – not least from the recent Ebola outbreak – that without a strong health system and sufficient funding for public health, the poorest and most vulnerable people die unnecessarily.
The revival of the principle that everyone, wherever they live, whatever their age, gender or ability, no matter how rich or poor they are, should have equitable access to good-quality healthcare is incredibly exciting – especially as the next set of development goals are currently being drawn up.
In a nutshell, UHC aims to ensure that services are accessible based on need and not on individuals’ ability to pay. It puts the onus on governments to ensure that health systems are more effective at providing a package of essential services – and not to leave healthcare to chance, with some able to afford it while poor people are left behind.
Within our means
Those who oppose UHC challenge the idea that poor countries can afford to ensure free-at-the-point-of-use, good-quality healthcare.
Questions around affordability and financing abound. There’s certainly a funding gap. But countries have opportunities to raise more revenue, including through fairer taxation, curbing illicit financial flows and ending tax evasion. They also need to prioritise and invest in health as a matter of urgency.
Donors, meanwhile, must continue providing effective, targeted development assistance that supports systems of UHC. No one thinks that every possible health service could be provided instantly, but UHC means making evidence-based decisions about what to prioritise to have the greatest effect on health.
At the 2012 World Health Assembly, WHO Director-General Margaret Chan described UHC as the ‘single most powerful concept that public health has to offer’. Since then it has gathered momentum among campaigners, academics, health experts, UN agencies and policy-makers, who recognise that ‘health for all’ is not pie in the sky. And at a time when access to healthcare is often deprioritised politically and healthcare costs are mounting, this renewed focus on UHC warrants our attention and support.
Tomorrow (Friday 12th) I’ll be attending an event at the London School of Hygiene and Tropical Medicine, held in partnership with Action For Global Health and the Rockefeller Foundation and supported by Save the Children, to hear how UHC can reduce inequity and end all maternal, newborn and child deaths.