Milestones on the road to universal health coverage


In the last year, the universal health coverage (UHC) movement has seen an unprecedented groundswell of political commitment.

While countries continue to grapple with the realities of providing their populations access to quality care with limited available economic resources, it has become increasingly clear that political will is crucial if UHC is to gain ground.

On Universal Health Coverage Day, the world looks poised to carry the cause forward in new and innovative ways and to make the vision a reality.

Global push for UHC

In December 2017, the Government of Japan convened the Tokyo Universal Health Coverage Forum. There, WHO and the World Bank launched a global monitoring report tracking UHC. “It is completely unacceptable that half the world still lacks coverage for the most essential health services,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO, at the Forum.

“A solution exists,” he continued. “UHC allows everyone to obtain the health services they need, when and where they need them, without facing financial hardship.”

UHC then received a large boost with Member States’ adoption of WHO’s new 5-year strategic plan in May 2018. One of the 3 targets set out in the 13th General Programme of Work is for 1 billion more people to be benefitting from UHC by 2023.

WHO European Region reinforces political support for UHC

“Health is our most precious asset. It must not be a luxury enjoyed by the privileged,” commented Dr Zsuzsanna Jakab, WHO Regional Director for Europe, on World Health Day in April this year. “We all benefit socially, economically and environmentally from a world that seeks health for all. It is time we come together and make this a common goal.”

High-level events in 2018 reflected this sentiment and generated increased political commitment to UHC in the Region. In April, the regional meeting Health Systems Respond to Noncommunicable Diseases (NCDs) brought together 200 experts and policy-makers from 43 countries to examine how various components of a health system can be aligned to respond to NCDs.

The most effective and affordable NCD interventions – known as the best buys – must be implemented if WHO’s goal of ensuring better health and well-being for 1 billion more people is to be achieved.

Equity, a key tenet of UHC, was the central theme of the June 2018 high-level meeting Health Systems for Prosperity and Solidarity: leaving no one behind. Organized in Estonia on the occasion of the 10th anniversary of the Tallinn Charter, the event concluded with countries of the Region expressing clear commitment to building health systems based on solidarity.

At the meeting, Dr Hans Kluge, Director of the Division of Health Systems and Public Health at WHO/Europe, outlined 3 concrete ways in which countries can take action on this commitment:

  • redouble efforts to advance UHC;
  • work harder to provide people-centred health services; and
  • plan ahead to make sure that health systems are prepared to deal with crises.

Revitalizing primary health care for the 21st century

Primary health care plays a vital role in bringing health services closer to people’s homes and communities, thereby improving access. In October this year, 1200 delegates from more than 120 countries around the world gathered in Astana, Kazakhstan, for the Global Conference on Primary Health Care. Together they adopted the Declaration of Astana, vowing to strengthen their primary health care systems as an essential step towards UHC.

In her closing speech at the Conference, Dr Jakab said, “The Declaration of Astana is a call to step up action, which should empower us to make primary health care a reality in all our countries. Our shared goal to pursue UHC depends on our commitment and ability to put this Declaration into practice.”

Looking ahead

In the coming years, WHO will support countries to implement the Declaration of Astana, which provides direction for the development of primary health care as the basis of health care systems. This support will form part of WHO’s ongoing work to help countries move towards UHC, including efforts to better understand the causes of financial hardship and to make a strong case for investment in health systems.

Political commitment for UHC is set to increase further in 2019 with the planned high-level meeting on UHC on the third day of the United Nations General Assembly in New York, United States of America, in September. The theme of the meeting will be “UHC: moving together to build a healthier world.”