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An action plan for expanding access to healthcare

Towards the end of last week, a group of partners were brought together by the World Health Organization (WHO) to feed into the development of an action plan to implement the recommendations of the World Health Report, launched in November last year. I was there as part of civil society representation, along with others from Ministries of Health and Ministries of Planning in developing countries, bilateral and multilateral aid agencies and other development partners.

Universal coverage is grounded in the human right to good-quality essential healthcare. Through key principles of pre-payment and risk pooling,  it promotes equitable access to health services, available according to an individual’s needs rather than their ability to pay.

The report notes that universal coverage will require increased government and donor allocation of resources into health. It encourages governments to explore alternative options to raise additional revenues, such as “sin” taxes on unhealthy goods, including alcohol and tobacco, and a currency transaction levy. It warns of concerns of inadequate quality. And it reassures that significant savings could be made by improving the efficiency of resource use.

Reinforce and accelerate progress
Universal coverage underpins equitable improvements in healthcare, and rather than conflicting with other major themes in health – such as the health-related millennium development goals, and non-communicable diseases – universal coverage would reinforce and accelerate progress in addressing these concerns.

Ghana, Laos PDR, Mexico, Moldova, Thailand and Uruguay spoke about their experiences of receiving technical advice and financial support from development partners on health financing. We heard appeals that the advice be tailored to the specific country context and be provided independent of any funding; that investments be made to build the capacities of those in government to empower them to make such decisions on their own; and that wider stakeholder participation is essential to dialogues about universal coverage, as there are significant implications for many sectors. For instance, Ministries of Finance must be engaged and convinced of the equity and efficiency of health gains when considering fiscal arrangements.

Countries also stressed that challenges prevail and called on the development partners to increase their provision of technical and financial support. This is the opportunity for governments that require health financing support to submit official requests in response to offers from development partners, such as the WHO, and donors, including the UK government, who have committed to provide such support. We are pleased to share that an Action for Global Health UK working group on health financing recently received a letter from the Parliamentary Under-Secretary of State, Stephen O’Brien, reiterating this commitment.

Exciting opportunity
The meeting was an exciting opportunity to forge closer partnerships and confirm commitments by development partners to collaborate and support governments on health financing policy development and implementation. It was also just the start of ongoing dialogues to work towards development partners delivering on the Paris Principles of providing more harmonised and aligned support.

Further working groups will continue many of the discussons started at the meeting – on how to better coordinate the partners at country level; on developing a common approach to estimating where countries are in terms of coverage of health services and undertaking a situational analysis; on expanding our understanding of ‘learning  by doing’; on sharing best practices with technical partners and policy makers; and on developing and implementing an advocacy strategy to ensure that universal coverage remains on the agenda at national, regional and global levels. Save the Children UK looks forward to participating in the development and implementation of this strategy.

We hope that these small steps will lead to more effective development support and empower governments to make informed policy choices to expand access to quality health services to their whole population, ensuring that the poor and most vulnerable are protected against the financial risks of ill health.

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