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Universal Health Coverage

Universal health coverage (UHC) means that all people have access to necessary health care regardless of their ability to pay and without facing financial hardship.

Universal health coverage is essential to ensuring social protection, achieving equitable development, and protecting the right to health. The commitment to UHC is grounded in the view that no person should develop, suffer, or die from a preventable or treatable condition because of lack resources, and treatment should not lead to financial hardship. Currently about half the people in the world do not receive the health services they need and over 100 million people fall into extreme poverty each year because of out-of-pocket healthcare expenses.

The Charter for Equitable and Sustainable Universal Health Coverage (UHC Charter)

In September 2015 world leaders adopted the 2030 Agenda for Sustainable Development (SDG) which includes a target to achieve universal health coverage for all by 2030. This adoption constitutes a landmark in international commitment to the movement towards UHC. With this in mind, and taking into account that there is now a wealth of experience through several decades across a wide range of countries that point to some promising practices as well as pitfalls on the path to UHC, there is a tremendous opportunity to synthesize lessons and guiding principles.

With support from the Rockefeller Foundation, the YCSG is creating a “UHC Charter.” The idea is, on the one hand, to offer governments making the commitment to UHC a reference to guide policy discussions and an instrument to evaluate whether their UHC strategies are moving in the right direction; and on the other hand, to support organizations or institutions to benchmark efforts towards the objective of UHC. This Charter also can serve as a resource for advocacy, a framework for training and capacity building, and as a guide for further research. Read about the UHC Charter (PDF — opens in new window)

Nota Bene: The YCSG’s work on the UHC Charter, while ongoing, predates the Covid-19 pandemic which has obviously had an enormous impact on any evaluation of countries’ health care systems.

The Four Pillars to Ensure Inclusive Universal Health Coverage

In the plenary session at the 2017 Prince Mahidol Award Conference entitled “In the quest for social inclusion,” Ernesto Zedillo highlights the significance of pursuing institutional policies to ensure universal health care.

Emphasizing alignment among financially sustainable and unequivocally compatible social development objectives, he describes four pillars for effective social policies: clarity of purpose, clarity of design, clarity of financing, and clarity of incentives. He further stresses that a commitment to UHC is also a commitment to justice, equality of opportunity, rule of law, and good governance. Zedillo speech on UHC (external link — opens in new window)

Global Monitoring Report on Financial Protection in Health 2019

Financial protection in health means that everyone can obtain the health care services they need without experiencing financial hardship. It is a key health system objective and an important dimension of universal health coverage. Over the past two decades, the World Health Organization (WHO) and the World Bank have been tracking financial protection using household survey data to compare how much people spend out of pocket on health care with their household’s ability to pay. For the first time, this joint report establishes global and regional 2015 baselines for an SDG indicator of catastrophic health spending and infers from previous trends the challenges to come in protecting people from the financial consequences of paying out of pocket for the health services they need. Read report here (PDF — opens in new window)

Economists’ Declaration on UHC

A declaration in support of UHC by Larry Summers on behalf of 267 economists from 44 countries. Read the Summers Declaration on UHC (PDF — opens in new window)