Universal health coverage: from technical report to global movement

WHO/Tina Kiaer

WHO/Europe promotes policies that move towards or sustain universal coverage

While many countries have achieved universal coverage in the WHO European Region, 19 million people still make out-of-pocket health payments that place a catastrophic burden on their household budgets, and have impoverished more than 6 million.

Many people with chronic diseases, especially those with low income and other vulnerabilities, face significant barriers to accessing high-quality, continuous care. This often delays them in seeking services, which in turn contributes to the health divide throughout the Region. The continuing financial and economic crisis has brought increasing challenges to work for universal health coverage (UHC), even in well-performing European countries, putting its underlying values of equity and solidarity to the test.

In November 2010, WHO launched ‘The world health report 2010 – Health systems financing: the path to universal coverage’. The concept of UHC has galvanized the wider global public health community, uniting a wide range of governmental and nongovernmental actors striving to improve human welfare. In the European Region, UHC is a central strategy for achieving the goals of Health 2020.

How WHO/Europe promotes UHC

WHO/Europe supports countries with a range of products and services to promote policies that help them move towards or sustain UHC.

WHO/Europe offers tailored advisory services and policy dialogues in Member States on key issues in health financing policy. For example, a recent report analyses Ireland’s policy responses to the crisis, and proposes a wide range of measures not only to mitigate the negative impact on the health system and population health but also to strengthen their resilience. WHO/Europe works with a number of countries, and is developing lessons and policy recommendations to prepare health systems to manage future crises and strengthen their resilience. In April 2013, it will hold a meeting in Oslo, Norway to present the key evidence for discussion.

WHO/Europe offers targeted capacity-building opportunities through national, regional and multicountry courses. The most popular training event is the Barcelona Course on Health Financing, whose theme is UHC. This is an advanced course for professionals interested in deepening their understanding of policy options.

  • does analytical work and knowledge brokering on country-specific and regional cross-country estimates and analysis of public and private health expenditure;
  • makes in-depth analyses of public and private expenditures to assess levels of financial protection and equity; and
  • builds capacity and gives advice to institutions on improving health expenditure data and reporting at the country, regional and global levels.

It has published a series of policy papers on health financing.

Definition of UHC

A working definition has two important elements: people should be able to access high-quality services when they need to, without risking financial ruin. Although health policy-makers debate how to define and measure need, high-quality care and financial ruin, the core concept of UHC is not in question.

“Universal coverage is the hallmark of a government’s commitment, its duty, to take care of its citizens, all of its citizens. Universal coverage is the ultimate expression of fairness,” said Dr Margaret Chan, WHO Director-General, at the Sixty-fifth World Health Assembly.