L’état de l’engagement en faveur de la CSU

• Foundations are strong, but impact is uneven. Political commitment to prioritize UHC is strong in most countries. This is evidenced through national health policies and plans with measurable targets, the recognition of the right to health in constitutions, and the adoption of legislation to protect the working conditions and safety of health workers. However, progress on health financing – along with reductions in out-of-pocket spending and financial hardship – remains modest, insufficient and uneven. In particular, there are still large disparities between high- and low-income countries in terms of health spending per capita.
• Disparities and inequalities persist. Across countries, stark differences remain in service coverage, health benefit packages, health workforce density, and digital health strategies. Significant inequalities also persist within countries, particularly between richer and poorer households and between individuals living in urban or rural areas. Moreover, progress on gender equality in health has been limited. These gaps, combined with slow advances in inclusive and participatory governance, continue to undermine the goal of leaving no one behind.
• UHC builds resilience against health emergencies. The link between UHC and health security has never been clearer. As countries strengthen their ability to prevent, detect and respond to public health emergencies in line with International Health Regulations, many are also integrating health into their national climate strategies — recognizing that protecting people’s health and investing in equitable, resilient and sustainable health systems is central to protecting our collective future.
• Better data is essential. Data limitations to identify those being left behind remain a major constraint. The lack of disaggregated data on the use of health services (such as by gender and socio-economic stratifiers) hinders the design of equitable interventions and the monitoring of progress, making it difficult to ensure universal access for marginalized and vulnerable populations.

As we prepare for the next UN high-level meeting on UHC in 2027, we must remember that there is no single pathway to UHC. Each country must shape its approach to its specific context and population needs. Guaranteeing access to essential health services without financial hardship requires recognizing that UHC is not a destination, but a journey, evolving with changing demographics, population needs and disease burdens. Embedding equity and inclusion at the core of this journey is essential to realizing the global promise of health for all.

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