Today, 21 September 2023, at the United Nations (UN) General Assembly High-Level Meeting, world leaders have approved a new Political Declaration on “Universal Health Coverage (UHC): expanding our ambition for health and well-being in a post-COVID world”.  

The declaration is hailed as a vital catalyst for the international community to take big and bold actions and mobilize the necessary political commitments and financial investments to attain the UHC target of the Sustainable Development Goals (SDGs) by 2030.

The UHC target measures the ability of countries to ensure that everyone receives the health care they need, when and where they need it, without facing financial hardship. It covers the full continuum of key services from health promotion to prevention, protection, treatment, rehabilitation and palliative care. Alarmingly, global progress towards UHC has been largely stagnating since 2015, before stalling in 2019.

The urgency of the declaration is evident in the staggering statistics. At least 4.5 billion people—more than half of the world’s population—were not fully covered by essential health services in 2021. Two billion people experienced financial hardship, with over 1.3 billion being pushed or further pushed into poverty just trying to access basic health care – a stark reality of widening health inequities.

“Ultimately, universal health coverage is a choice–a political choice,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “The political declaration countries approved today is a strong signal that they are making that choice. But the choice is not just made on paper. It’s made in budget decisions and policy decisions. Most of all, it’s made by investing in primary health care, which is the most inclusive, equitable, and efficient path to universal health coverage.”

Turning point for course-correction

In the Political Declaration, Heads of State and world leaders committed to take key national actions, make essential investments, strengthen international cooperation and global solidarity at the highest political level to accelerate progress towards UHC by 2030, using a primary health care (PHC) approach.

For health care to be truly universal, it requires a shift from health systems designed around diseases to systems designed for people. PHC, an approach to strengthening health systems centred on people’s needs, is one of the most effective areas for investment to accelerate progress towards UHC.

Countries that have taken a PHC approach have better ability to rapidly build stronger, more resilient health systems to reach the most vulnerable and achieve a higher return on health investments. Most importantly, they ensure that more people are covered with essential health services and are empowered to participate in making the decisions that affect their health and well-being.

It is estimated that an additional US$ 200–328 billion investment per year is needed to scale-up a PHC approach in low- and middle-income countries (e.g. up to approximately 3.3% of national gross domestic product). This could help health systems deliver up to 90% of essential health services, save at least 60 million lives and increase average life expectancy by 3.7 years by 2030.

WHO, through its network of more than 150 country offices and six regional offices, provides technical support to accelerate the radical reorientation of health systems through PHC focused approaches, and ensures robust normative guidance to track progress for accountability and impact.

WHO commends Member States for approving the second UN High-Level Meeting Political Declaration on UHC, which was developed through a broad consultative process. WHO is fully committed to working with Member States and partners to ramp up policy actions for UHC to expand service coverage, ensure financial protection and shape the financing architecture to invest more and better in health.

Once adopted by the UN General Assembly, the Political Declaration will be regularly monitored for implementation to identify gaps and solutions to accelerate progress, and discussed at the next dedicated UN High-Level Meeting in 2027.