Why Universal Health Coverage Remains a New Year’s Resolution for Global Health

Last updated December 11, 2023

Written by: Camden Malone, Global Health Policy Associate, United Nations Foundation

Over half of the world’s population lives without access to essential health services.  Each year on December 12, Universal Health Coverage (UHC) Day recognizes the urgent need to address this unacceptable inequality. UHC means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship. In 2023, UHC Day promotes the theme Health for All: Time for Action. Here is what you need to know about the status of UHC in 2023 and what’s ahead for this critical global health agenda.

Stocktaking in 2023

2023 was an action-packed year for UHC. It was the first full year since passing the midway point between the Sustainable Development Goals’ (SDGs) inception in 2015 and the deadline of 2030. UHC is a primary component of SDG3 on good health and wellbeing. Through SDG Target 3.8, countries have committed to “achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.”

UHC is a cornerstone for realizing broader progress in global health by improving access to essential health services through a primary care approach, which has potential to save 60 million lives and increase life expectancy by 3.7 years by 2030. Furthermore, Target 3.8 is key to unlocking action across the wider SDG agenda, especially for eradicating poverty (SDG1), achieving gender equality (SDG5), promoting economic growth (SDG8), and reducing inequalities (SDG10).

The 2023 Global Monitoring Report released by the World Health Organization (WHO) and the World Bank revealed troubling findings at halftime for the SDGs. Due to stagnating improvements to health service coverage since 2015 and increases in the proportion of the population that faced catastrophic levels of out-of-pocket (OOP) health spending, progress remains significantly off-track for achieving Target 3.8. In 2021, roughly 4.5 billion people – half the world’s population – were not fully covered by essential health services. COVID-19 certainly contributed to some UHC-related backsliding, although prior to the pandemic, the number of individuals incurring catastrophic OOP health spending had been continuously rising since 2000 and surpassed 1 billion globally in 2019.

Recent political traction

Recognizing that progress has fallen behind, there were several resurgences in political action on UHC in 2023. In September, countries gathered at a high-level meeting during  the UN General Assembly and adopted a Political Declaration on UHC. This outcome was an important milestone for catalyzing progress and addressing critical gaps since the previous declaration in 2019. The 2023 political declaration lays out new commitments to strengthen the healthcare workforce and reinforce primary health care (PHC) as the backbone of UHC. Commitments also cover policies toward sustainably financing UHC and promoting collaboration among relevant health and finance authorities to address unmet health needs and eliminate financial barriers to accessing services.

The UHC agenda was also advanced in the G7 and G20 forums. Japan assumed the presidency of the G7 at the year’s start and launched the “G7 Global Plan for UHC Action Agenda,” which featured concrete steps in eight action areas to achieve UHC. Action Item 6, to “move together towards universal health coverage,” held a specific commitment to increase global and public awareness and cooperation in events and activities to commemorate UHC Day on December 12 of every year. At the G20 Health Ministers Meeting hosted under India’s presidency, countries also committed to supporting digital health innovations and solutions to aid universal health coverage and improve healthcare service delivery. Moving forward, these powerful international forums will continue to be a space outside of the UN for countries to build coherence and strategy on the path to achieving UHC.

Sustainable financing powerfully dictates the execution of the UHC political agenda. In order for all countries, especially low-and middle-income, to achieve this goal, there is a need to a) align the allocation of external resources with national health plans and b) create pathways for increased and sustainable domestic financing. To address this specific need, the Future of Global Health Initiatives (FGHI) was established as a time-bound process of consultation and research throughout 2023 to reflect on how global health initiatives (GHIs) can be optimized to support national UHC-related priorities. Their final report published on December 12, Lusaka Agenda: Conclusions of the Future of Global Health Initiatives Process, highlights concrete steps for improving the effectiveness and efficiency of the global health financing ecosystem as an enabler of accountability.

Accelerating action in 2024

The commitments made to UHC in 2023 are only lofty ambitions unless they are matched by urgent, concrete action. For many UHC proponents, a major goal for 2024 is the active implementation of the recently adopted UN political declaration. Civil society and other relevant stakeholders – mobilized through UHC2030 – will be keen to ensure that those commitments go beyond words on paper and are promptly translated to action on the ground.

Other gains for the UHC movement are set in motion by the advocacy of its many champions. A champion can be anyone who stands for the fundamental right of everyone to receive equal and affordable access to treatment and care. Most champions effect change through public advocacy and awareness-building, such as joining social media campaigns to amplify the call for UHC. Others also engage with leaders at the local, national, and global level to promote the value of prioritizing health in decisions. It is the collective calls from these masses that help turn the wheels of policymaking.

UHC will not return to New York for another high-level meeting until 2027. This means that tremendous effort is required to carry momentum of 2023 forward and ensure that progress continues in that period. Before ringing in the New Year, UHC Day reminds us to do our part to make 2024 a step forward to delivering the promise of health for all.




About the Author

Camden Malone advances the global health agenda through engagement with UN Member States on a wide range of health policy issues, including universal health coverage, antimicrobial resistance, and pandemic preparedness, prevention, and response. Prior to the United Nations Foundation, Camden worked at the Permanent Mission of Costa Rica to the UN, covering intergovernmental negotiations related to health and human rights. Camden holds a master’s degree in International Affairs from the Colin Powell School for Civic and Global Leadership at the City College of New York; and a bachelor’s degree in History and Political Science from the College of Saint Rose. 

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