Universal Health Coverage, A brief overview.

The World Health Organization defines Universal Health Coverage (UHC) by its main objective of guaranteeing that “all people have access to the full range of quality health services they need, when and where they need them without financial hardship. It covers the full continuum of health services, from health promotion to prevention, treatment, rehabilitation and palliative care”.  Although not explicitly named, the concept of UHC dates back to the WHO Constitution of 1948, declaring health a fundamental human right, and the Alma-At a Declaration of 1978. However, it was at the 58th World Health Assembly (WHA) in 2005, through a resolution urging countries to embed UHC in their health systems, that the concept received greater attention. The 2010 World Health report represents another milestone in the history of UHC, linking its achievement to increased health financing. In 2017, the movement toward UHC gained further momentum with resolution endorsed by the United Nations General Assembly proclaiming December 12th as UHC Day. The international UHC movement culminated with the UN High-Level Meeting on UHC in 2019 and the Political Declaration through which countries committed to the ambitious goals of achieving UHC by 2030 and to “progressively cover one billion additional people by 2023 with quality essential health services and quality, safe, effective, affordable and essential medicines, vaccines, diagnostics and health technologies, with a view to cover all people by 2030.” Countries further stated their commitment to reducing or eliminating catastrophic out-of-pocket health expenditures by 2030.  Health financing and access to quality essential healthservices for everyone, everywhere are therefore two key UHC principles.

 The three dimensions of UHC are summarized in the WHO UHC cube, published in the 2010 World Health Report (Figure 1). 

Three essential components of UHC are the types of services covered, the proportion of direct costs individuals incur for health services and what is covered (Services, direct costs and population).

Figure 2 summarizes the timeline and progress in making UHC a priority in the global agenda. 

To advance health-related Sustainable Development Goals (SDGs), the UHC2030 multi-stakeholderpartnership was launched in September 2016, with the aim of bringing together diverse voices and perspectives for the common goal of achieving UHC. The UHC 2030 is the most prominent global initiative bringing together governments of 81 countries and territories, 17 multilateral organizations and global health initiatives, including the World Bank and WHO, four philanthropic organizations and a long list of nongovernmental organizations active in different health domains. Other initiatives are also contributing to the global movement toward UHC. For example, the Universal Health Coverage Coalition unites a number of health and development organizations under the common goal of health for all. A number of initiatives are now available at the global level, dedicated to UHC, driven by the SDGs and particularly SDG 3.8 on achieving UHC, including financial risk protection, access to quality essential health care services and access to safe, effective, quality and affordableessential medicines and vaccines for all.