Can a UN resolution help countries to move towards universal health coverage?

Later today, the UN General Assembly will be meeting in New York to adopt a resolution on universal health coverage (UHC).

The resolution draws attention to the 100 million people who are driven below the poverty line every year as a result of paying for healthcare, and shows the extent to which direct, out-of-pocket payments discourage people – particularly the poorest – from seeking or continuing care.

It calls on countries to adapt the way in which health systems are financed in order to increase coverage of health services and ensure that individuals are not impoverished as a result of accessing healthcare.

Negotiating a resolution

The resolution was drafted and championed by the Foreign Policy and Global Health Group (Brazil, France, Indonesia, Norway, Senegal, South Africa and Thailand) who have been highlighting the relevance and importance of health for foreign policy and development.

There were initial fears that it would be difficult for governments to negotiate a meaningful resolution on UHC, particularly when many countries are so far from achieving it themselves. However, the opposite turned out to be the case. Many countries, including the USA, have strongly supported the issue and even co-sponsored the resolution.

Towards the end of the negotiations, there was a a sticking point as some countries wanted to weaken recommendations for the inclusion of UHC in discussions on the post-2015 development framework.

Wishing to prioritise specific health challenges (such as non-communicable diseases), some governments are yet to be convinced that working towards UHC is the best long-term strategy for addressing all health challenges for the whole population.

Turning recommendations into action

By adopting this UN resolution, governments have recognised their responsibility to urgently scale up efforts towards making universal coverage of affordable and quality healthcare services a reality, with special emphasis on reaching those populations most in need.

Although the resolution falls short of calling for the total removal of direct, out-of-pocket payments, it does demonstrate overwhelming global consensus that working towards UHC is not only possible, but necessary for realising the right to health and achieving the health-related Millenium Development Goals (MDGs).

If all countries implemented the recommendations to develop more equitable health financing policies, increase resources for health and invest in more skilled health workers, we could dramatically reduce the number of children who die each year from preventable causes.

A key question now is how the recommendations and principles of the resolution will be put into practice. Hopefully the Foreign Policy and Global Health Group, along with the other sponsors of the resolution, will not consider their job done now that the resolution has been adopted, and will take concrete steps to support those countries with the greatest health challenges to adapt their health systems to meet the needs of the whole population.

Building on the resolution in 2013

As discussions about a post-2015 development agenda gain pace, this timely resolution will help to ensure that UHC stays high on the agenda and is included in discussions about new goals and targets for health after the MDG deadline is reached.

The resolution calls for further high-level discussions on UHC to be held on 2013, which will help to further define how countries should interpret UHC and the best steps to achieve it.

Civil society has followed this process closely to date and will continue to ensure that momentum and political support for UHC continues to grow.