Universal Health Coverage: Finding a Path to Health for All

Poverty should no longer mean poor health, nor should ill health lead to poverty. That is the promise of UHC. It is widely recognized that good health reduces poverty, improves educational performance, increases productivity, and as a result, stimulates economic growth.
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The affordability of health care is an issue familiar to most of us, whether we live in affluent nations, emerging economies or low-income countries. Now, imagine a world in which everyone has equitable access to high quality health services and where maintaining good health no longer carries the risk of financial ruin -- the core tenets of universal health coverage (UHC). On December 12, 2012, a unanimous UN assembly did just that, declaring their commitment to take steps toward achieving health for all, a decision we mark today during the first official observance of UHC Day.

Each year, more than 150 million people experience catastrophic financial loss as a result of health care costs and more than a billion people lack adequate access to needed health services. Universal health coverage not only protects people from experiencing catastrophic financial loss as a result of high out-of-pocket costs, but also promotes better quality of services and greater health equity.

Poverty should no longer mean poor health, nor should ill health lead to poverty. That is the promise of UHC. It is widely recognized that good health reduces poverty, improves educational performance, increases productivity, and as a result, stimulates economic growth. Every dollar invested in health care may produce between $9 and $20 worth of economic growth by 2035. As UN Member States negotiate the new Sustainable Development Goals (SDGs), health-related targets, (currently considered under Goal 3 'Ensure healthy lives and promote well-being for all at all ages') should be viewed through the UHC lens. Doing so has the potential to transform populations' health -- especially of the world's poor -- for the better, enabling a better environment for economic development.

But to make the promise of UHC a reality, much more needs to be done. Health systems must be strengthened so that they extend to underserved and hard-to-reach populations, are more resilient to health emergencies and are re-designed to provide integrated care and services. Achieving this will require a number of critical changes, such as a dramatic increase in the number and density of health workers, particularly in Africa. There must also be a greater focus on prevention, early detection and treatment for both chronic and infectious diseases. In particular, countries should place greater emphasis on tackling noncommunicable diseases (NCDs) such as cancer, cardiovascular disease, upper respiratory infections and diabetes. These conditions affect people during their most productive working years and are placing increasing financial burden on both the families of NCD patients and the health care systems that serve them. Doing so will pay dividends over time in the form of economic savings and, most importantly, longer, healthier lives.

None of this is simple. Indeed, all countries will grapple with the challenges of making UHC a reality, each in its own way. While early adopters such as Mexico have made great strides toward reaching UHC, there is still a long road ahead. The path to universal health coverage will vary for each country, depending on its unique mix of demographic, epidemiological, economic, social and political factors. Achieving this target within the context of the SDGs will require strong leadership and accountability from government with "whole-of-society" support from civil society, the private sector and academe, among others. Creative approaches for innovative financing and care delivery, bolstering health infrastructures, as well as preventing, diagnosing and treating disease will require multisectoral collaboration and greater engagement from the private sector.

The health-related industry represents a major sector of the economy. Globally, health-related goods and services constitute 10 percent of the world economic product, around $6.5 trillion. This "health economy" includes stakeholders who are engaged in the production and consumption of health and health care. People in many low-and middle-income countries already depend on the private sector to meet their health needs. Aside from developing novel therapies to treat disease and creating new medical devices and diagnostic technologies, health-related businesses contribute to UHC in a multitude of ways, including clinical social franchises, private clinics and hospitals and insurance companies. There also exist a number of transportation, shipping, technology and manufacturing businesses that provide ancillary services and products to support the delivery of health care products and services.

Unfortunately, in many countries the aspiration for universal health coverage is not matched by requisite political commitment needed to stimulate strong public-private partnerships for mobilizing and ensuring efficient use of resources, catalyzing novel solutions, promoting improved delivery systems and developing local business models. There should be greater emphasis on the role of the private sector as a driver of good health and enabler of UHC around the world, and a willingness to experiment with new mixed approaches that will help us achieve better health for all. The question is not whether to work with the private sector to achieve UHC, but how.

On this historic day, let's work together in helping to make ill health -- and the poverty it causes -- history.

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