The recent OECD Forum Virtual event, Developing Resilient and Equitable Health Systems, focused on Universal Health Coverage (UHC) ahead of a number of health-focused meetings taking place at the United Nations General Assembly in New York from 20-21 September on pandemic prevention, preparedness, and response; UHC; and tuberculosis.

These health issues are now a key priority for the UN, as most health-related targets in the Sustainable Development Goals (SDGs), have been thrown off track and inequalities have widened following the COVID-19 pandemic. Increased conflicts and climate change threats have left countries and vulnerable populations at even greater risk in the face of emerging health challenges.

Gabriela Cuevas Barron, Co-Chair of the UHC2030 Steering Committee, and currently the Honorary President of the Inter-Parliamentary Union (IPU), mentioned the stark reality that we are far from achieving UHC, with half of the world's population lacking access to essential health care services, and women and girls facing the gravest vulnerability.

Mark Pearson, OECD Deputy Director, Employment, Labour, and Social Affairs, explained that the OECD works closely with the World Bank and the WHO as part of the UHC 2030 Secretariat. He highlighted that lack of access to UHC is the case in poorer countries, but there are also lots of people in richer OECD countries who are not getting access to health care when they need it.

The first Political Declaration on UHC was made in 2019. This second UN High-Level Meeting on UHC reviewed the progress made and issued a new resolution to double down efforts to meet the goal of UHC by 2030, reaffirming that the way forward to making progress towards UHC needs to be based on a people-centred primary health care approach. But according to Gabriela, another declaration is not enough, the focus needs to be on how we are going to translate this resolution into tangible, concrete results for people, and how we are going to strengthen health systems everywhere.

And despite the difficult lessons we all should have learned from the pandemic, there continues to be underinvestment in healthcare, despite its essential role in supporting a well-functioning economy. Mark Pearson mentioned that during the pandemic those countries that had better healthcare coverage, had lower mortality, and thus lower costs to the economy. UHC is foundational to both economic and social systems, extending beyond citizen rights to a crucial economic necessity.

While some progress has been made in sharing health-related data post-pandemic, critical areas, such as health spending and standardised monitoring worldwide, still lag behind. The best defence against future pandemics and epidemics is strong primary healthcare and fostering community trust in the healthcare system.

Lasha Goguadze, Senior Health Officer, International Federation of Red Cross, and Red Crescent Societies, explained that while the first objective of the IFRC has always been to improve the health of the most vulnerable who suffered from conflict, the IFRC’s work extends beyond conflict and other emergencies, and addresses health and vulnerability. It spans 191 National Red Cross and Red Crescent Societies working worldwide with around 15 million staff and volunteers, making sure that health and social services are provided to those who do not have access and are falling outside of the formal health sector.

Lasha mentioned that at every stage of every health problem, whether this is an emergency or not, it is essential to build trust in the public health system, and to build this it is essential to engage local people, and patients who speak from experience.

Manan Shah, Vice President, Global Health Equity & Policy Partnerships, Bristol Myers Squibb, also highlighted that a key element in BMS’ approach is to engage directly with patients, communities, and health care providers to understand real-world, practical concerns, and needs. BMS regularly convenes a Health Equity Commitments Advisory Board, which is comprised of experts addressing health equity challenges in a variety of communities bringing their insights to BMS staff on what could be done differently. He highlighted the key importance that BMS attaches to bringing “the outside-in.”

Gabriela Cuevas Barron also found that politicians need to understand better by engaging more directly with communities how key access to healthcare is for them. If politicians understood this better, there might be more focus at the highest political level to invest, and to use health as one of the possible bridges to renew public trust.

Gender gaps persist in the health sector, with women comprising 70% of the global health workforce yet facing issues of unpaid labour, underpayment, overwork, and precarious job situations. 

Mark Pearson referred to recent OECD research, Risks That Matter, surveying the pulse of 27,000 working-age respondents in 27 OECD countries, who prioritised increased government spending on health. Mark confirmed as well that the OECD is focusing on Patient-Reported Indicator Surveys to assess the outcomes and experiences of patients managed in primary care across countries. The PaRIS survey aims to fill a critical gap in the evaluation of healthcare effectiveness, by asking about aspects like access to healthcare and waiting times, as well as the quality of life, pain, physical functioning & psychological well-being which provides a patient-centred perspective; quite distinct from that of health care professionals who focus more on whether an operation or treatment was successful.

Gabriela Cuevas Barron also drew attention to the fact that gender gaps persist in the health sector, with women comprising 70% of the global health workforce yet facing issues of unpaid labour, underpayment, overwork, and precarious job situations. The underrepresentation of women in leadership positions also contributes to shortcomings in addressing women-specific health issues.

Mark Pearson agreed and highlighted that the health workforce that has lived through the pandemic has had a tough time, suffered burn-out, and is now confronted with pay falling behind due to inflation. It is essential to make healthcare careers more attractive, ensuring career mobility and recognition of skills.

Manan Shah brought an optimistic note, citing a significant increase in students pursuing public health degrees between 2001 and 2020, indicating a positive shift in the field's attention. And although we may not see the impact of this today or tomorrow, as we are talking about the need to have a well-staffed and supported infrastructure for public health workers around the globe, this news should be acknowledged and celebrated.