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Submitted by F. Upham on

I attended that inter-governmental meeting a civil society (DGH). My 'inside' view of the meeting is very very different from the report I read. There were no consensus by Member States on 'targetting' as proposed by the organizers. Many countries identified that they did not want 'poor health care for the poor'. Senegal said the poor would reject care if it was not comprehensive. Many countries object to 'packages of minimal care', with vouchers (replacing user fees but in a similar mindset)
Many countries also stressed that good health output in their countries were reached by strong public health care systems. Public health care allowed for citizens to have access to primary health care and also hospital care. The private sector contributes but hangs on the strength of the public system. France-Germany health specialists favor universal social security insurance system while the UK favors a charity based model. The debates were strong even if the tone is always very diplomatic. And the sound system is meant to allow delegates to discuss the issues among themselves while listening to the speakers without disturbing others. I have attended the World Health Assembly for over 20 years, and what is a pity is that the reports from these are always bland, spiceless, while many governement are in fact often enough showing courage.
In a lunch time meeting with the Bank and WHO DG Dr Chan this past Friday (during the WHA in Geneva), we heard Nils Daulaire (US rep.) speak of the Right to Health, and stress it was the first time ever that the USA spoke that language. This is progress.
In a nutshell I would say the underlying debate is really whether countries can undertake to achieve "Quality Health Services for All" (after all even very poor Cuba achieved that, besides Sri Lanka, France, Brazil, Thailand, Costa Rica etc etc. El Salvador and Ecuador are making great progress... And many differ from Dr Margaret Chan when she said this Friday : While many British "hold dearly to their NHS...UHC is all services for all people? NO!". Some of us, basing ourselves on evidence of countries such as Brazil strongly believe we should all strive for that. We say "YES we could." Of course it cannot be overnight, but the question is not money, the question is political will. And true enough it demands a proper approach in economics, a notion of developmental State. In 2011 China adopted a continental European social protection system, including health, retirement etc., if the BRICS countries pull the chariot of UHC, then we might get somewhere.