Moving towards universal health coverage
The 65th World Health Assembly (WHA) opens today with a big discussion on the theme of ‘Towards Universal Coverage’.
Universal health coverage (UHC) is a bold and aspirational goal: a world where all people have access to health services, without fear of falling into poverty.
Save the Children strongly welcomes the focus on this issue and hopes that all governments attending the WHA will use the opportunity to publically state their commitment to working towards universal health coverage, driven by the right of every child and family to essential healthcare.
Healthcare continues to push millions into poverty
Around the world, healthcare is unaffordable for millions of people. Continued reliance on out-of-pocket payments, including user fees, is by far the greatest obstacle to progress to UHC. They are regressive, deter necessary care, and exacerbate poverty.
Progress towards UHC must therefore be equitable, placing financial risk protection of the poor and vulnerable at the front and centre of any approach.
To achieve UHC, countries must expand pre-payment with large risk and resource pools, for both efficiency and equity.
As the 2010 World Health Report states, tax financing is required to extend coverage to the poor.
This means that everyone should contribute to the cost of healthcare on a fair basis according to their wealth or income. But accessing healthcare must be based solely on need and not related to ability to pay.
Global and national targets need to be established to direct an equitable path towards UHC, with disaggregated indicators to track whether every community and every wealth quintile receives the services they need without financial hardship.
Sufficient resources must also be made available to implement progressive reforms: this involves increasing public resource allocation to health and making better use of existing resources.
Establishing equitable financing mechanisms can be particularly challenging in low-income countries where resources are sparse and needs are high.
In such contexts, donors and multilaterals should provide support for the medium- to long-term, adhering to principles of aid effectiveness, while also working to help develop the national tax base. Only then can sustainable gains really be made.
Time for action on UHC
Momentum behind UHC is growing. More and more countries are making attempts to achieve UHC for their citizens and even low-income countries are making impressive progress.
UHC is increasingly seen as an equitable way to frame an approach to health that builds on the progress made towards the Millennium Development Goals.
Many governments are now calling for a resolution on UHC to happen at the UN General Assembly in 2013.
To make UHC a reality, there’s still the need for greater political will both at national level – to put in practice the reforms needed – and at international level to promote and revitalise a general consensus towards ‘health for all’, facilitating technical support and additional resources.
For these reasons, a group of NGOs lead by Action for Global Health, and including Save the Children UK, has been working on a common statement for UHC, asking for greater political support and promoting a joint movement for UHC.