Universal Health Coverage: A Movement Gains Steam


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Ministerial meetings aren’t known for their dynamism. As Adam Wagstaff wrote in a recent blog post, these formal interactions sometimes lack the energy—and follow-through—that such high-level gatherings should inspire.
However, this wasn’t the case in late February, when the World Bank and the World Health Organization (WHO) met with 27 finance and health ministers, international partners and civil society organizations in Geneva to discuss countries’ progress toward universal health coverage (UHC). The topic energized attendees, who vowed to continue following the path towards UHC in their countries.
The topic, itself, is of great interest worldwide: More than 30 middle-income countries are implementing programs that lead them down the road to UHC—and many more low- and middle-income countries are considering embarking on this journey.
UHC working across globe
The jury is in on these UHC initiatives: They’re helping countries achieve better health and development outcomes, preventing people from falling into poverty due to illness, narrowing gaps in use of needed services, and giving people the opportunity to lead healthier, more productive lives.
Just before the Geneva meeting, the Bank released more than 20 country studies, which examine in depth the programs that have expanded coverage, starting with the poor and vulnerable. The countries’ stories speak for themselves.
Mexico has insured 52 million people, thanks to its Seguro Popular program. On the other side of the world, Indonesia is covering more than 76 million people and India, 300 million. In Kenya, nearly 3,000 health facilities are expanding care to the poor. In the Kyrgyz Republic, out-of-pocket expenditures for the poorest 40% have dropped thanks to UHC. And in the Middle East, Tunisia is calling for a new social contract to include greater health care coverage.
The Bank has supported these countries and many others as they move toward UHC. Whatever path countries take, the Bank aims to help countries build healthier, more equitable societies, as well as improve their fiscal performance and country competitiveness—all toward the goals of ending extreme poverty and boosting shared prosperity.
Looking beyond 2015
The global movement is gaining momentum, with the United Nations General Assembly recently calling for countries to “urgently and significantly scale up efforts to accelerate the transition towards universal access to affordable and quality health care services.”
The Bank-WHO meeting helped answer that call. The meeting reenergized the Bank’s commitment to work closely with WHO and country and development partners, as the world moves toward articulating the post-2015 development framework.
During the meeting, ministers emphasized that the next round of development goals should reflect the key elements of UHC: universalism, equity, financial protection, and timely and good-quality health care. They also said that “coverage” is less an end in itself and more a means to an end. In fact, two ends: better health outcomes and higher living standards, both of which are key elements of the Millennium Development Goals.
In response to country demand, the Bank and WHO are developing a monitoring framework that will help countries track their countries’ progress toward universal health coverage in a way that explicitly captures the potential importance of UHC in achieving better health and higher living standards for everyone. The framework will be available for consultation with countries and partners later this year.


Nicole Klingen

Practice Manager, Strategy and Operations Health, Nutrition, and Population Global Practice World Bank Group

Join the Conversation

March 05, 2013

I dunno what to say.. In theory everything sounds great but still.. there are many countries where people cannot have access to decent health care if they can't pay. In some places you can't buy decent healthcare because there is none! Too bad..

Sharam Kohan
April 14, 2013

Universal health care systems vary according to the degree of government involvement in providing care and/or health insurance. In some countries, such as the UK, Spain, Italy, Australia and the Nordic countries, the government has a high degree of involvement in the commissioning or delivery of health care services and access is based on residence rights not on the purchase of insurance. Others have a much more pluralistic delivery system based on obligatory health with contributory insurance rates related to salaries or income, and usually funded by employers and beneficiaries jointly. Sometimes the health funds are derived from a mixture of insurance premiums, salary related mandatory contributions by employees and/or employers to regulated sickness funds, and by government taxes. These insurance based systems tend to reimburse private or public medical providers, often at heavily regulated rates, through mutual or publicly owned medical insurers. A few countries such as the Netherlands and Switzerland operate via privately owned but heavily regulated private insurers that are not allowed to make a profit from the mandatory element of insurance but can profit by selling supplemental insurance.
At some point in future the Universal Health Coverage will be implemented in the United States. It is just a matter of time.