Ashal Alnur Ani, a nurse at the hospital, tests one of the new beds. El Daein, Sudan (UN Photo/Albert González Farran)
How can global health policy be structured to ensure that even the poorest people in developing countries have access to health services? That's one of the topics of the ongoing international debate on the new development goals for the period beyond 2015. The World Health Organization (WHO) is advocating universal health coverage (UHC) as a way of making health services affordable and accessible to all. At this year's MMS symposium, we will be discussing how UHC is defined and what form it should take in the light of the new development policy agenda.
Universal health coverage (UHC) was introduced by the WHO as a proposed top-level goal for the health sector in the debate on the next generation of goals after the MDGs. The WHO views UHC first of all as a system that ensures that all people obtain the health services they need without suffering financial hardship.
In the 2010 world health report "Health systems financing: the path to universal coverage" UHC was defined such that the focus was firmly on financing health systems. Nowadays the WHO uses the term in a more comprehensive (and hazier) way – for example to refer to strengthening health systems in general or even as a successor term to "Health For All". However, the adoption of the resolution "Transition of National Health Care Systems towards Universal Coverage" by the UN General Assembly in December 2012 indicates that the concept has had a major impact.
UHC is interesting because it links access to health services with the issue of financing and sets out a universal entitlement to services. The renewed focus on health systems is also a definite step forward compared to the vertical, disease-based aims of the MDGs.
On the other hand, there is justified criticism of the current habit of using UHC unthinkingly and effusively as a successor slogan to "Health For All" or "Primary Health Care". The concept provides too great a temptation to reduce health and its foundations (in the holistic sense) to access to heath services and initially excludes the important political, economic and social determinants of health. Furthermore, a careful examination is required of how general health services should be structured so that they generally reach all people and go beyond a mere minimal package, and at what point responsibility for implementation of UHC in resource-poor countries should pass from the states in question to the international community. "Anything goes on the path to universal health coverage? No." was the title of a recent article in the WHO Bulletin.
David B. Evans, WHO
Gerhard Siegfried, SDC
Remco van de Pas, wemos/MMI
Pia Fankhauser Zenhäusern, Member of the parliament of the Canton Basel-Landschaft
Claude Meyer, P4H
Blague Dadjim, Chad
Hélène Aye Mondo, Cameroon
Thomas Gass, FAIRMED
Manfred Stoermer, Swiss TPH
Eduardo Lambertín, SRC, Bolivia
Michael Gerber, SDC
Tania Dussey-Cavassini, FOPH
Martin Leschhorn Strebel, Network Medicus Mundi Switzerlandmartin.firstname.lastname@example.org