International Universal Health Coverage Day: Health for All - Now More than Ever

Urgent Acceleration Needed for Universal Health Coverage

By Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia

On International Universal Health Coverage (UHC) Day, the United Nations, World Health Organization and its Member States in the South-East Asia Region highlight the urgent need to accelerate progress toward the achievement of Universal Health Coverage (“UHC”), with primary health care as its’ cornerstone. 

Eleven years ago today, with leadership from countries of our Region, the United Nations General Assembly (“UNGA”) endorsed a ground-breaking resolution urging all countries to accelerate progress towards UHC. Three years later, in 2015, UHC became the founding principle of the health-related Sustainable Development Goals. 

Seven years remain in the 2030 Agenda for Sustainable Development Globally, the expansion of service coverage has slowed prior to pre-2015 gains, with limited or no progress since 2019: currently 4.5 billion people are not fully covered by essential health services. Trends in financial protection are also worsening: with an estimated 2 billion people suffering financial hardship due to out-of-pocket expenditure. Reflecting their concern on the limited progress and investment in UHC, in September 2023 at the UNGA, Heads of State and Government committed to scaling up national and international efforts.

At the Regional level, the South-East Asia Region has prioritized UHC as a Flagship Priority since 2014. Over the last decade, very significant UHC-related reforms have and are currently in process of implementation across the Region. Important gains are already evident. Between, 2015 and 2021, the Region increased its UHC service coverage index from 54 to 62. Between 2014 and 2020, alongside an increase in share of public investment, out-of-pocket health spending as share of current health spending decreased from 42.8% to 37.9%. Moreover, while catastrophic health spending remains a key concern, the population impoverished and further impoverished due to out-of-pocket health spending declined from 30.5% in 2005 to 6.6% in 2019. 

However, progress to date remains insufficient to achieve the UHC SDG targets. Of particular concern, while noncommunicable diseases cause nearly two-thirds of all deaths in the Region, the regional average noncommunicable diseases sub-index has evidenced the slowest pace of improvement.

Acceleration towards Universal Health Coverage is needed in a time of significant global turbulence with escalating pressures and demands on health systems.  The Covid-19 pandemic, ongoing global conflicts, subsequent and associated economic challenges, epidemiological and demographic transitions, intensifying climate crises, increasing frequency of new and novel pathogens, rapid urbanization, need for integration of  historically siloed program and approaches, and increased population expectations are collectively demanding more from health systems across the Region.

Recognizing contemporary challenges and opportunities, Member countries of our Region are committed to accelerating progress towards UHC through strengthening the foundation of primary health care. Universal Health Coverage provides a key platform for all technical departments to integrate our support to countries.

Importantly, a little over a month ago, during the WHO SEA Region 76th Regional Committee Session Ministers of Health adopted the “Delhi Declaration on strengthening primary health care as a key element towards achieving universal health coverage” (SEA RC/76/R3). Through the Delhi Declaration, Health Ministers of Member countries committed to reorient health service delivery systems based on a life cycle approach, with people and communities at the center; to prioritize primary health care in health budgets; and to assure effective use of resources through strengthen systems for accountability and monitoring at national and sub-national levels. 

Health for all has been a desired goal for countries of the Region since the end of the colonial period. Despite the challenges facing us, never has it been closer in reach. Countries in our Region, through both political commitment and action, are showing the path forward for a healthier, more just, and more prosperous world.  As we proceed towards the goal of health for all, concerted focus on identifying and addressing health inequities with engagement of affected communities, must remain at the forefront. WHO is committed to providing its ongoing and unmitigated support, for a South-East Asia Region in which all people can access quality health services, when and where they need them, without financial hardship.

WHO’s South-East Asia Region comprises the following 11 Member States: Bangladesh, Bhutan, Democratic People’s Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste.