Universal Health Coverage

With the eight Millennium Development Goals (MDGs) set to expire in 2015, health advocates are keen to ensure that the human right to health makes it onto the post-2015 global development agenda. First codified in the 1966 International Covenant on Economic, Social and Cultural Rights, the right to health provides for ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’.

But what does this mean in concrete terms? How can this right be translated into concrete public policy?

A collective of actors from government, civil society, and finance has proposed adding the goal of Universal Health Coverage (UHC) as a way of achieving the right to health. On September 30, 2013, fifteen global organizations – including Oxfam and Save the Children, among others – published a joint letter urging United Nations member states to include UHC in the post-2015 development framework.

This letter draws attention to startling inequities in the global delivery of health services: a billion people worldwide are unable to obtain quality health care and 150 million every year are forced into poverty due to out-of-pocket health costs.

Universal Health Coverage is intended as a direct response to this reality. UHC is founded on the premise that all people ought to receive the health care they need, without suffering financial hardship in order to pay for it. As stated in the joint letter: ‘[UHC reforms] empower country leaders with greater ownership over their health sectors, while focusing attention on governments’ responsibility to fulfill progressively the right to health.’ Building on this, the Director-General of the World Health Organization Dr. Margaret Chan recently referred to UHC as ‘the single most powerful concept that public health has to offer’.

Nevertheless, the issue of how to implement Universal Health Coverage is the subject of much debate. Should there be a minimum threshold for public financing? What lessons can be learned from states – such as those in Latin America – that have enshrined UHC in their constitutions? How can UHC be pursued in tandem with the underlying determinants of health, such as good sanitation and gender equality?

These and other questions must be addressed if UHC is to gain widespread recognition as a realistic model for promoting health and reducing inequality in global society. As the Rockefeller Foundation recently observed, ‘here the debate is just starting.’

For more information on Universal Health Coverage, consult the report entitled ‘Universal Health Coverage: A Commitment to Close the Gap’.