Investing in Health Systems Strengthening for Universal Health...
UHC is more than just three letters. Universal health coverage is based on the conviction that health is a human right, not a privilege. Achieving UHC is both a moral imperative to reach all individuals with health care, and a strategic objective to build healthier societies. It is the best investment for a safer, fairer and healthier world.
Opening high-level panel session
These are some of the strong messages from the opening high-level panel session of world leaders for universal health coverage, held on Monday 18 September in New York at the UN General Assembly.
The event was co-hosted by Japan, Senegal, UK, South Africa, Thailand, France, Germany, World Health Organization, World Bank Group, UNICEF, United Nations Development Programme, the Rockefeller Foundation, UHC Coalition, UHC2030 and the Partnership for Maternal, Child and Newborn health.
World leaders spoke auspiciously of UHC, highlighting the broad impact that achieving UHC has on all of the SDGs and that it has far-reaching social and economic benefits. It is achievable with vision, will and action and Dr.Tedros, the WHO Director General, made an important Call for Action.
Shinzo Abe, Prime Minister of Japan opened the meeting with a speech urging the global community to face the challenges ahead. “Our journey towards UHC has just begun. There are tremendous challenges ahead of us. It will be by no means an easy path to expand the number of skilled doctors, nurses and community health workers, establish pharmaceutical supply and management systems, and introduce financial systems that ensure affordable access to basic health for all.”
Amina J. Mohammed, UN Deputy Secretary-General stressed the significance of UHC in relation to all the other SDGs, saying, “Health is at the core of the SDGs; it is a precondition, an outcome and an indicator of progress. UHC is a key that can help unlock the full ambition of the SDGs.”
Macky Sall, President of Senegal spoke about the reach that can be achieved when striving for UHC. “In Senegal, as we launched our plan from 2014, we sought to underscore human capital, social protection and sustainable development. We’ve gone from 20% coverage to more than 47% coverage, that is a considerable achievement and we are proud of it.”
Achim Steiner, Administrator of UNDP underscored the effects brought about by UHC in meeting the ambitious range of the SDGs. “The goals give us a demonstration of multiple benefits because with actions around UHC we can address so many different targets and indicators […] It not only makes sense, it also translates into an extraordinary economic rationale.”
Angel Gurria, Secretary General at OECD also emphasized the economic benefits of UHC. “Health is an investment, not a financial burden. Around one quarter of the economic growth in low- and middle-income countries between 2000-2011 resulted from improved health. The SDG clock is ticking. Collectively we must start working now.”
Shinichi Kitaoka, President of JICA, supported the notion of economic benefits and shared Japan’s perspective. “The historical experience of Japan which achieved universal health insurance in 1961 shows that UHC not only frees people from fear of disease, but also contributes to the stabilization of society and sustained economic growth. We can vouch for the validity of UHC from this experience.”
Dr Tedros, Director General of WHO encouraged everyone to have the political will to take action saying, “Universal health coverage is based on the conviction that health is a human right, not a privilege. […] The good news is that UHC is achievable. In July, we presented the evidence showing that 85% of the costs of meeting the SDG health targets can be met with domestic resources. All countries at all income levels can do more with the resources they have, and can take action now to improve the health of their populations.”
Anthony Lake, Executive Director of UNICEF argued that achieving UHC is a moral imperative and a strategic necessity essential to the economic and political health of every nation as well as the health and human security of its individual citizens. He also posed the question, whether to emphasise a top-down approach designing health systems that first reach the most advantaged, easy-to-reach populations or to adopt a bottom up approach using as a starting point the hardest to reach? “Of course we must do both. It simply makes sense that achieving UHC means giving priority to systems that address the needs of the most disadvantaged. This is not only fair but it is the most effective pathway forwards. In 2010 a UNICEF analysis found that while it cost more to reach the hardest to reach, those additional costs are dramatically outweighed by the results.”
Kristalina I. Georgieva, Chief Executive Officer, the World Bank made a persuasive plea to reach women and girls through UHC. “Let me speak as a woman, a mother, and as a grand mother. We owe it to all but we particularly owe it to women and girls. How is it that we can send people to space but we can still have women dying in childbirth and children being lost?”
Rajiv Shah, President of the Rockefeller Foundation requested that we take concrete action and empower citizens. “I hope all of us will continue to link our words to concrete actions that make a difference, that are grounded in evidence and together allow us to usher in more coverage for more communities. It’s about more than just three letters. It’s about empowering citizens around the right to health, so they can demand better and more affordable services.”
Elizabeth Cousens, Deputy CEO of the UN Foundation and the event moderator captured the spirit of the meeting when she said, “With leadership like this and with actions from everybody in the room, we will be able to be on the cusp of a transformative change.”
Panel session: How do countries make meaningful progress?
Zain Verjee, Co-founder and CEO of Akoma Media posed important questions to another panel of national and international health leaders. “There are technical, financial and political hurdles that every single country faces. So how can a country make meaningful progress in its own unique way?”
High-level county representatives responded with the need to finance and build stronger health systems, work in partnerships, and improve coordination between different health stakeholders.
Don Pramudwinai, the Foreign Minister of Thailand stressed the need for diverse income sources and partnership. “We needed to make UHC truly universal and sustainable by diversification of sources of finance to support the system. We stepped up our health care infrastructure in rural areas and utilization of the health workforce in partnership with the local government and private sector, civil society and all other sectors. It is a question of partnership.”
Aaron Motsoaledi, Health Minister of South Africa argued for using UHC to change South Africa’s existing two-tier health system into one system. “Our method is to strengthen the healthcare system. We believe that for UHC to be affordable and sustainable we need a comprehensive health care system where prevention is the order of the day, and health promotion is everyone’s business.” He added, “The heartbeat of the system must be primary health care.”
Laurent Bili, Director General for Global Affairs, Culture, Education and International Development, Ministry for Europe and Foreign Affairs, France said, “Continuity is at the core to our development policies; health stabilization and development are all one. If you don’t have health, you don’t have much. If you don’t have a proper health system you are on shaky ground.”
Tobias Bergner, the Coordinator for the Foreign Policy Dimension of Global Health Issues, the German Ministry for Foreign Affairs said, “We have to join forces. This is the first step that we make sure that we know what each others agendas are and that we work on a common and joint agenda […] Political commitment is important, leadership is important, and improving coordination between different actors and stakeholders is important, which has grown over the last years.”
Ciarán Cannon, Minister of State for Diaspora and International Development, pointed out, “UHC is a challenge for both developed and developing countries” and he announced Ireland’s support to WHO for country-level progress towards UHC through the UHC Partnership.
Panel session: How can everyone play a role in keeping the UHC movement strong?
With incredible support globally for UHC, the question is how do we keep momentum going? Panelists emphasised the role of all stakeholders including the private sector, the importance of primary health care as a foundation, and how we must align and work together as we go forward.
Professsor Kiyoshi Kurokawa, Representative Director of Global Health Innovative Technology (GHIT) said,“To promote UHC, investment research and development is a very important issue but sometimes the free market may not be compatible with other partners. So this is a very innovative financing mechanism by a Japanese initiative in a public private partnership.”
Chris Elias, President Global Development, at the Bill and Melinda Gates Foundation said, “We’ve prioritized primary health care (PHC) as the cornerstone for achieving UHC […] Strong PHC sees fewer children die before their fifth birthday and people live longer and healthier lives. There will be no UHC without strong PHC.”
Marijke Wijnroks, Interim Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria argued for a coherent and multi-stakeholder response to UHC. “We are firmly in the SDGs: you can look at it as simple messages about the universality of the agenda and the interconnectedness of our world, the need for integrated responses in multi-stakeholder partnerships to deal with all these global challenges and the principle of leaving no one behind.”
Seth Berkley, CEO, Gavi agreed with the interconnectedness of the movement. “Immunisation is as close to a universal health intervention as we get and this is a platform for other interventions in the public health system. It is about all of us being aligned and brining all these wonderful parts of the health system to everybody.”
Suzanne Ehlers, CEO & President of Population Action International also argued for primary health care to support access to health care for women and children. “High functioning systems drive lasting change and we are committed to driving primary health care and systems to achieve UHC.” She emphasized the importance of strong civil society engagement to build a broad and inclusive movement for UHC.
Marie Hauerslev, Vice-President for External Affairs, International Federation of Medial Students’ Association said that collectively, as young and future healthcare workers, they are impatient for change. “UHC is about taking social responsibility, about the right the health.”
Finally, Ellen Chilemba on behalf of UHC Coalition and Global Citizen called on everyone to continue the movement. “If you leave today’s event I call on you to take the conversations beyond the UN walls and engage with citizens to talk about the right to health.” She also announced the petition – “Tell world leaders health is a right not a privilege” – please sign up if you support UHC.
The event marked a significant moment for the UHC movement with so many world leaders demonstrating their commitment for vision, action and working in unison.
If you missed the event, you can watch it here on UNTV.
See all of the resources associated with the event below.