Great Blog Adam, on how the HLP report dropped the ball on health.
Whereas it is appropriate to aim for an overall goal relating to improved health outcomes, this should have been accompanied by an ambitious goal that will hold the health sector to account for achieving this goal. In which case, Universal Health Coverage (UHC) fits the bill perfectly.
Everyone understands that the health sector contributes to health, primarily through people consuming effective health services. Therefore a goal which measures coverage of a broad range of preventive, curative, rehabilitative and palliative services would be appropriate. Unfortunately the HLP’s revamped MDG list isn’t adequate. Furthermore, from the US to the poorest countries in Africa, people recognise that one of the greatest barriers inhibiting coverage (and a major cause of poverty) is inadequate financial protection from health care costs. This should be reflected in the health system goal too.
UHC combines these two policy objectives very efficiently and across the world populations and politicians intuitively understand the concept of UHC. This is shown by people taking to the streets to protest specifically for UHC, either in terms of improved health services or better financial protection or frequently both. Just in the last month improved health coverage has been one of the main demands of protestors in Brazil, Spain and Indonesia. On the contrary you don’t see people taking to the streets demanding a 10% increase in healthy life expectancy.
Whereas the HLP report has disappointed many, for being so unambitious and not addressing health coverage, the good news is that other post-2015 processes are recognizing its relevance and importance. So for example, recently, the UN Global Compact, which represents the views of big international businesses chose UHC as its recommendation for a global health goal post 2015: http://www.unglobalcompact.org/docs/news_events/9.1_news_archives/2013_06_18/UNGC_Post2015_Report.pdf (see pages 14 and 15) Similarly the Leadership Council Report of the Sustainable Development Solutions Network has a strong emphasis on achieving UHC http://unsdsn.org/files/2013/06/130613-SDSN-An-Action-Agenda-for-Sustainable-Development-FINAL.pdf (see page 29). Finally, only last week, at the post-2015 Open Working Group meetings, many speakers , especially those from UN member states, identified UHC as an appropriate goal. This can be seen in this summary statement from the chairs: http://sustainabledevelopment.un.org/content/documents/3693cochairsconcluding.pdf
Establishing UHC as a development priority also reflects the policy objectives of some of the major agencies involved in health, not least WHO and the World Bank. For example when the President of the World Bank concluded his speech to the World Health Assembly in May he said:
“WE MUST BE the generation that delivers universal health coverage”
Many feel, this is a much more inspiring and relevant health goal for the generation steering development beyond 2015.