Applying a Health Systems Assessment in a fragile setting.
As we move towards the multi-stakeholder meeting on 29 April, and the UN HLM on 23 September, now is the time for us all to galvanise our efforts around a set of crucial political messages. With a set of Key Asks from the UHC Movement, we encourage all our partners to call on Heads of State and national governments, who have committed to UHC through the Sustainable Development Goals to take action and ensure faster progress towards UHC around the world.
Key Asks Summary
ASK 1: Ensure political leadership beyond health – Commit to achieve UHC for healthy lives and wellbeing for all at all stages, as a social contract.
ASK 2: Leave no one behind – Pursue equity in access to quality health services with financial protection.
ASK 3: Regulate and legislate – Create a strong, enabling regulatory and legal environment responsive to people’s needs
ASK 4: Uphold quality of care – Build quality health systems that people and communities trust.
ASK 5: Invest more, invest better – Sustain public financing and harmonize health investments.
ASK 6: Move together – Establish multi-stakeholder mechanisms for engaging the whole of society for a healthier world.
Launch of Key Asks
The Key Asks from the UHC Movement were launched on 1 April 2019 at an Informal Briefing of the Group of Friends of Universal Health Coverage and Global Health in New York.
H.E. Mr. Koro Bessho, Permanent Representative of Japan to the United Nations opened the meeting saying, “I thank UHC2030 for making the process of developing the Key Asks as inclusive as possible”.
UHC2030 co-chair Dr Githinji Gitahi presented the Key Asks and said, “I’m here speaking on behalf of all members of UHC2030 globally and those who are here with us. Thank you all members of UHC2030 who participated in the process, which has resulted in the high-level six key asks for the UN HLM. Please internalise these key asks and take them back to your country discussions and dialogues. They have very heavy backing from all constituency groups; the final declaration will be built from the bottom up.”
H.E. Mr. Kaha Imnadze, Permanent Representative of Georgia to the UN and Co-facilitator for the UN HLM said, “We need to internalize domestically what we have in the Key Asks so they become country priorities for everyone and this wonderful large Group of Friends who are countries that are likeminded, who really have a stake in UHC.”
H.E. Mr. Vitavas Srivihok, Permanent Representative of Thailand to the UN and Co-facilitator for the UN HLM: "The UHC2030 consultation was a meaningful process, it was indeed very promising and when I listened to the Key Asks today it is truly inspiring, informative, and educational. These Key Asks are very detailed, comprehensive and action oriented.”
Representatives from other UHC2030 partners and stakeholders gave their reflections and responses to the Key Asks from the UHC movement.
Ms. Wambui Munge, Senior Manager, Communications and Advocacy, Gavi, responded to Key Ask 1: Ensure Political Leadership Beyond Health. “We must reach those left furthest behind, the underserved, with public health “best buys,” with health systems strengthening and by addressing the social, environmental and commercial determinants of health,” she said.
Ms. Ariana Childs Graham, Director of the Primary Healthcare responded to Key Ask 1: Ensure Political Leadership Beyond Health and Key Ask 2: Leave No One Behind saying: “In order to achieve UHC, governments must address the compounding effects of poverty, gender inequalities, and discrimination based on ethnicity, disability, sexual orientation, gender identity. Non-discrimination is the key underpinning principle to achieve UHC” she said.
Dr. Benoit Kalasa, Director, Technical Division, UNFPA, responded to Key Ask 2: Leave No One Behind, saying, “We need to look at sexual and reproductive health and rights, there is no UHC without PHC and there is no PHC without SRH and rights.”
Mr. Simon Bland, Director, UNAIDS New York Liaison Office also responded to Key Ask 2: Leave No One Behind, “Human rights and gender equality must be at the heart of UHC. […] We must ensure the U in the UHC, make sure it is truly universal for all without any discrimination.”
Dr Tenu Avafia, UNDP, responded to Key Ask 3: Regulate and Legislate, saying, “It’s clearer now than ever has been that the responsibility of protecting and promoting people’s health is no longer in the sole remit of Ministries of Health. […] Enhancing coherence in regulatory and legal frameworks and removing barriers is central to UHC.”
Ms. Vanessa Candeias, Head, Shaping the Future of Health and Healthcare at the World Economic Forum responded to Ask 3: Regulate and Legislate, saying, "UHC is primarily the responsibility of governments but they need to work very closely with the private sector to achieve their goals and priorities, including by removing barriers for public and private cooperation.”
Mr.Ted Chaiban, Director, Programme Division, UNICEF, responded to Key Ask 4: Uphold Quality of Care. “Consideration of quality in the provision of health services should focus on those that are at risk of being left behind, those most likely NOT to get quality of care. First and foremost we must start with the most vulnerable rural and remote poor, the urban poor and mobile populations, people who are cut off from their usual social support networks.”
Dr. Magnus Lindelow, Practice Manager for Health, Nutrition and Population for Eastern and Southern Africa at the World Bank Group responded to Key Ask 5: Invest More, Invest Better. “It’s not just about spending more; spending better is equally important. That’s why the World Bank puts an emphasis on strengthening public financial management.”
Dr. Craig Burgess, Senior Technical Officer, JSI Research and Training Institute, responded to Key Ask 5: Invest More, Invest Better and Key Ask 6: Move Together “Countries must establish a social contract between citizens and governments, putting citizens and families as drivers at the heart of realizing UHC,” he said.
Look at our Twitter feed for more speakers and quotes from the meeting.
Advocacy materials to disseminate the Key Asks will follow soon
Background to the UN HLM and the Interactive Multi-Stakeholder Hearing
The UN HLM on UHC will take place on 23 September 2019 during the United Nations General Assembly (UNGA) high-level week. This is a great opportunity for all UHC champions and advocates to make their voice heard and help mobilise high-level political attention globally and in your countries.
The theme of the HLM-UHC is ‘Universal Health Coverage: Moving Together to Build a Healthier World.’ This UN HLM will be the last chance before 2023, the mid-point of the SDGs, to mobilise the highest political support to package the entire health agenda under the umbrella of UHC, and sustain health investments in a harmonised manner. To do this, it is critical to identify how the political declaration on UHC can add value to these efforts and set milestones towards achieving UHC by 2030.
UHC2030 has been asked to support the preparatory process for the UN HLM, particularly to share “evidence and good practices, challenges and lessons learned.”
Process: how were they Key Asks developed?
A series of multi-stakeholder face-to-face consultations and an open online consultation on the UHC2030 website took place in February and March 2019.
All stakeholders had the opportunity to comment, make suggestions and contribute to an initial set of draft Key Asks.
Following that, a team of experts analysed the contributions and redrafted the Key Asks based on everyone’s feedback.
The final set of Key Asks were reviewed and agreed by the UHC2030 Steering Committee on 28 March 2019.