International efforts to advance universal health coverage (UHC) has made great progress over the last decade. But the journey has just begun and the success is vulnerable.
Keeping the political momentum alive in countries, along with sustained investment from donor countries and international organizations and action from civil society organizations and the private sector, will be decisive in achieving the UN Sustainable Development Goal of universal health coverage. This was the unified message from the leaders of global health landscape at the UHC side event to the 72nd session of the UN General Assembly (UNGA).
The event, “World Leaders for Universal Health Coverage (UHC): A High-Level Discussion at the UN on Achieving the SDGs Through Health For All,” held September 18, 2017 on the sidelines of the UNGA in New York, examined the progress thus far and underscored the commitment of event co-hosts to achieving UHC: the Governments of France, Germany, Japan, Senegal, South Africa, Thailand, United Kingdom, WHO, the World Bank, UNICEF, UNDP, UHC2030, the Rockefeller Foundation, UHC Coalition, and the Partnership for Maternal, Child & Newborn Health.
Japan, a Leading Force for the UHC Movement
The event opened with remarks from Shinzo Abe, Prime Minister of Japan, a country that has spearheaded the global movement toward the Sustainable Development Goal (SDG) of universal health coverage and has contributed substantially to making health care a top item on the global agenda.
Abe called for “the realization of a society where no one is left behind” as he reviewed progress toward UHC and invited stakeholders from across the globe for continuing the discussions and taking concrete steps for achieving the 2030 agenda.
Japan has been at the forefront of the UHC movement, bringing global leaders together and making it a top agenda item back in 2000 at the G8 Kyushu-Okinawa Summit. Japan led international efforts to introduce “UHC in Africa” last year – a policy roadmap for achieving UHC, and the International Health Partnership for UHC2030 platform to coordinate UHC efforts across various organizations and initiatives. Working closely with stakeholders, such as the World Bank, WHO, UNICEF and UHC2030, Japan is now set to further the discussions on pragmatic measures to advance UHC at the upcoming UHC Forum 2017 hosted in Tokyo in December 2017.
Varied Perspectives, One Goal: “Health for All”
Macky Sall, President of Senegal, shared his country’s heartening progress kickstarted by the launch of its UHC agency in 2014 to offset its very low population coverage. The agency aims to ensure that every Senegalese has signed up in the registry and that a system of checks and balances is in place to avoid any malpractices. “We are looking carefully at best practices elsewhere. We have increased coverage from 20 percent to more than 47 percent and we are proud of it,” said Sall. Senegal recently became a full member of the JLN, seeking greater UHC knowledge from joint learning.
The newly elected Director General of the WHO, Dr. Tedros, pointed out that “85 percent of the costs for reaching the SDG health targets can be met with domestic resources.” A passionate advocate for UHC, Tedros lamented: “It’s a scandal that at least 100 million people are plunged into poverty every year because of out-of-pocket payments for healthcare expenses.” Calling universal health coverage “strategic,” he said UHC not only improves health but reduces poverty, creates jobs and creates gender equality.
The JLN, established in 2010 with a mission to extend health coverage to more than 3 billion people, was cited as an example of investments that are advancing the cause of UHC in countries.
Rajiv Shah, President of the Rockefeller Foundation, recalled health care as one of the Foundation’s earliest focus areas, calling out its seminal role in establishing the JLN as an example of its commitment and contribution to the cause of UHC.
In a panel discussion following the opening remarks, Ministers from Thailand and South Africa joined high-level representatives from BMZ Germany, Ministry of Europe and Foreign Affairs, GHIT, Bill and Melinda Gates Foundation, Gavi, PAI, UHC Coalition and IFMSA to share their experiences and lessons learned in moving toward UHC.
The discussion featured key takeaways for what actions are needed to drive the mission of UHC2030 forward:
- Shifting efforts from curative to preventive health care. In the case of South Africa, this shift has led to an increase in life expectancy and productivity.
- Primary health care (PHC) should be the cornerstone of health care systems in all countries.
- Moving toward UHC requires the convergence of three factors – political commitment, adequate financial resources and long-term investment in infrastructure. The merger of these three factors has helped Thailand advance its health system toward UHC.
- Improving coordination between different actors and stakeholders with strong leadership from WHO will be crucial to sustaining the UHC movement going forward.
- Resources are important but data to measure the quality of health care will be pivotal for success. Quality health care was emphasized by the Bill and Melinda Gates Foundation and has been at the heart of the Foundation's investments and approach to PHC.
The UHC stakeholders and global leaders are set to build on the progress and energize policymakers to continue the battle for heath for all at the 2017 UHC Forum in Tokyo, December 12-15, 2017.