No time to lose: Seize the renewal moment for the health-related SDGs

This year’s World Health Assembly comes at a pivotal time for global health. As some countries start to look beyond the COVID-19 pandemic, many still feel its effects. The pandemic has underscored the health, social, political, economic and environmental consequences of failing to invest adequately and efficiently in health. It has illuminated national and international inequities. Meanwhile we see yet again that war creates and deepens humanitarian, migration, economic and health crises. With progress on all Sustainable Development Goals (SDGs) at risk, world leaders must act urgently for health and well-being for all.

We congratulate Dr Tedros Adhanom Ghebreyesus on his reappointment as WHO Director-General and welcome his vision for the next five years. We especially welcome efforts to strengthen health systems with emphasis on primary health care (PHC). This is crucial for universal health coverage (UHC), health security and healthier populations everywhere – especially to meet the needs of vulnerable and marginalized people whose communities have been hit hard by the pandemic.

Accelerating progress on the road to 2030 demands solidarity and political will. In 2019, world leaders at the UN high-level meeting (HLM) on UHC committed to move towards a healthier, safer and fairer world. Many countries have made important UHC commitments and set national targets, including to prioritize equity and gender equality. Yet gaps persist between legislation, policy, implementation and results.

Looking ahead, the UN HLM on UHC in September 2023 will be a key moment for political leaders to review progress on UHC commitments and discuss how, at the mid-point of the SDGs, to accelerate action. There is no time to lose. If leaders at all levels of government and in parliaments act urgently, the HLM can be a moment to celebrate renewed progress rather than despair at stagnation:

1. Leaders at all levels should fully embrace the crucial renewal opportunity to accelerate progress on the health-related SDGs – especially to build stronger health systems, based on PHC, and make UHC, health security and health and well-being a reality for all. This should be part of a holistic effort linking with renewed efforts on all SDGs. 
2. We again call on all countries that have not already done so to institutionalize measurable national UHC targets, and redouble efforts to achieve them – for example, to prioritize health in public spending, with special emphasis on PHC and on gender equality, and take immediate steps to address the global shortfall of 15 million health workers and ensure decent working conditions. 
3. As well as nationally-led actions, we call for leaders to act together to address global inequities. Trade, intellectual property regimes and global supply chains must work better to ensure equitable access to essential medicines and health products and technologies for UHC. The new pandemic instrument is an opportunity for commitments on strengthening health systems and renewed global solidarity. 
4. We look forward to leaders’ contributions to an exciting, inclusive process for the HLM on UHC, that ensures voices of all stakeholders – especially civil society, communities, local and regional governments and representatives of under-served populations and groups, especially women and girls – are heard, and the HLM delivers meaningful accountability and actions that respond to their needs.

For our part we will unwaveringly support UHC2030 to mobilize a diverse UHC movement and make the HLM process truly inclusive. We will continue to demand that global leaders rise to the challenge. We hope you will join us.

Co-Chairs of Steering Committee, UHC2030

• Ms. Gabriela Cuevas Barron
• Dr. Justin Koonin

UHC Movement Political Advisory Panel, UHC2030

• Mr. Elhadj As Sy, Chair of the Board, Kofi Annan Foundation
• Ms. Emilia Saiz, Secretary General of the United Cities and Local Governments
• Prof. Keizo Takemi, Member of the House of Councillors, Japan
• Ms. María Fernanda Espinosa Garcés, President of the 73rd Session of the UN General Assembly
• Dr. Vytenis Povilas Andriukaitis, Former European Commissioner for Health and Food Safety
• Ms. Joy Phumaphi, Executive Secretary, the African Leaders Malaria Alliance
• Prof. Ilona Kickbusch, Chair, International Advisory Board, Global Health Centre, Graduate Institute for International and Development Studies Geneva

Progress towards universal health coverage

The latest statistics show progress is not on track, and the COVID-19 pandemic seems to bring the world further away from the 2023 targets set by the political declaration on UHC in the 2019 meeting:

• Progressively covering 1 billion additional people, with a view of covering all people by 2030
• Stop the rise and reverse the trend of catastrophic out-of-pocket health expenditure and eliminate impoverishment due to health-related expenses by 2030

Critical outcomes for the 2023 high-level meeting on UHC identified by UHC2030:

• Countries motivated to step up investment in resilient and equitable health systems and specific policy actions for UHC, through a primary health care approach
• “Renewed action on SDG 3”: Political declaration reinforces clear and measurable UHC commitments, with specific milestones/actions to accelerate equitable progress by 2030
• “Inclusive accountability”: Member states report progress towards 2019 UHC commitments in consultation with diverse country stakeholders of UHC2030
• “A path to 2030”: Comprehensive review of global health commitments linked strategically with SDG accountability processes
• In tandem with the pandemic treaty negotiations, countries commit to core minimum health systems capacities as the basis for UHC and health security