In September, the United Nations will convene the 2nd High-Level Meeting on Universal Health Coverage (UHC), at which member states will come together to discuss progress on the 2019 political declaration “Universal health coverage: moving together to build a healthier world” which sets out a high-level framework for the development and implementation of national UHC plans with the engagement of civil society organisations and other stakeholders.

In the wake of the wide-ranging health, and social and economic impact of the COVID-19 pandemic, it is not surprising that since 2019, progress on UHC has stalled. Now more than ever, it is essential to prioritise action. As the climate crisis deepens, armed conflicts worsen, health emergencies become more common, and economies more volatile, inequality widens as a result. Countries with resilient health systems will be better able to prepare for and respond to shocks, protect and increase UHC.

Around 90% of essential health services can be delivered through primary care in communities and local clinics by doctors, nurses, and healthcare workers

A key means to achieve UHC and increased health system resilience is by strengthening primary health care. Understood to be the most inclusive, equitable, cost-effective, and climate friendly approach.  According to Dr Tedros Ghebreyesus, WHO Director-General, around 90% of essential health services can be delivered through primary care in communities and local clinics by doctors, nurses, and healthcare workers.

This progress requires governments to make sustainable investments in their health systems. In  Ready for the Next Crisis. Investing in Health System Resilience, the OECD has calculated that even in high income countries, an increased annual investment of 1.4% of GDP relative to a 2019 baseline is needed to deliver health system resilience to be able to withstand another major health threat the scale of COVID-19.

A key area for investment in this context is to properly resource the health care workforce. Currently significant shortages of health care workers where they are needed most and their challenging work environment and conditions, threaten the achievement of UHC. This may be further exacerbated by mobility and migration from low- and middle-income countries (LMICs) to rich countries and from rural to urban areas.

The relationship between population health and the sustainability and resilience of health systems is reciprocal and intertwined. A healthy population places less strain on resources, lowers health care costs, and bolsters systems sustainability. Yet health systems remain overwhelmingly reactive and focused on acute care rather than investing in illness prevention, health promotion, and continuity of care. 

Each year, about 70 million people are pushed into extreme poverty after paying the cost of essential health care out of their own pocket

While many countries seek to reduce barriers to health care, inequality for vulnerable and disadvantaged groups, including women, youth, elderly, refugees, migrant/displaced persons, and other marginalised populations has increased during COVID-19. At least half of the world's population lacks access to essential health services, and, each year, about 70 million people are pushed into extreme poverty after paying the cost of essential health care out of their own limited resources.

These persistent and deepening socioeconomic inequalities are a significant problem and merit inclusion of all stakeholders around solutions that drive UHC. Creating an action plan to address social determinants of health including improving measurement of health-related inequalities, setting objectives, and encouraging cross-sectoral collaboration will help reduce health inequalities.

The pandemic provides compelling arguments to prioritise health investments now: the costs are small compared with the economic costs of not acting. The pandemic has shown that the choice is not between health security and UHC: strong health systems, grounded in primary health care, are needed for both.

For populations to be better protected in the future, governments must create space for communities to participate actively in shaping more equitable health systems. Strong civil society, public and private sector voices have a vital role in driving health systems that protect everyone.

SESSION SCENARIO

14:30    Welcome and moderation

• Pamela Druckerman, Journalist, Emmy-winning Documentary Producer and Author

14:35-16:00   Panel Discussion

• Mark Pearson, Deputy-Director, Employment, Labour and Social Affairs Directorate, OECD
• Gabriela Cuevas Barron, Co-Chair of the UHC2030 Steering Committee, currently the Honorary President of the Inter-Parliamentary Union (IPU)
• Manan Shah, Vice-President, Global Health Equity & Partnerships, Bristol Myers Squibb
• Lasha Goguadze, Senior Health Officer, International Federation of Red Cross, and Red Crescent Societies

16:00    Closing

• Pamela Druckerman, Journalist, Emmy-winning Documentary Producer and Author