It’s time for action on universal health coverage

Juliet Milgate, September 2019

Half the world lacks access to essential health care services, and every year 100 million people are pushed into extreme poverty because of health expenses, according to World Health Organization figures.

At current levels of progress, a third of the world’s population will still have no access to health services by 2030.

For so many people, the current and future situation regarding accessing quality health care is abysmal. Each year in low and middle income countries, an estimated eight million people die of conditions that should be treatable. This is unacceptable.

It is why commitment to universal health coverage (UHC) – that all people have access, without discrimination, to quality health services without experiencing financial hardship – is more relevant than ever, and why recognising that investment in health systems, particularly at the primary health care level, is essential to making genuine progress.

Strengthening health systems to deliver UHC, and ensuring better health outcomes for everyone, are critical development issues. The UN’s Sustainable Development Goals (SDGs) recognise the relevance of ensuring UHC to broader development progress. Goal 3, which aims to ensure healthy lives and promote wellbeing for all at all ages, includes target 3.8, which is explicitly focused on progressing UHC by 2030 and is recognised as the key pathway for achieving SDG3 by the World Health Organization.

This deep connection between health and achieving sustainable development has led to the UN system focusing on UHC for the first time, with a High-Level Meeting on universal health coverage taking place during the UN General Assembly this month.

The meeting and, crucially, the accompanying Political Declaration, have the potential to drive the transformative change that is required.

At Sightsavers, we – along with many of our partners and wider civil society – have engaged in this process throughout 2019 and welcome the declaration. It recognises the importance of strengthening health systems by such things as investment in infrastructure and of addressing the huge shortage of health workers in low and middle-income countries.

The declaration also recognises the rights of people with disabilities. This is crucial, and key to the principle of leaving no one behind set out in the SDGs. Development progress that excludes some of the poorest and most marginalised people cannot be considered effective. This is particularly relevant for people with disabilities, who – due to widespread and systemic discrimination – are often among the poorest in a community and can face multiple barriers accessing the health care they need.  

A surgeon in Mali stands next to his female patient following her eye surgery. Both are smiling.

Our approach to inclusive health

Sightsavers promotes inclusive health because we believe that everyone, wherever they live, should be able to receive quality, affordable health care.

About our health work
Mahamed Hafiz from Barakoh in Pakistan.

Muhammed’s story

Muhammed Hafiz is paralysed from the waist down following a workplace accident 14 years ago. When we met him at an eye health outreach camp in Barakoh, Pakistan, he told us a familiar story. “I did not go to the hospital or any other health facility because it is difficult, there is no one to accompany me. And when I go there I need some help because it’s difficult for me to move around. The health facilities are not accessible for me. They give you different appointments for other visits, so it’s difficult for me to go there again and again.”

The principle of equity within UHC is critical, and is why it’s essential to ensure that the rights of people with disabilities are realised in practice. The High-Level Meeting and Political Declaration must drive action, and real change. Progress hinges on all stakeholders, governments, civil society and the private sector, taking concrete actions to realise the commitments outlined in the declaration – this includes consideration around disability disaggregated data, ensuring investments in health system infrastructure are accessible to everyone, addressing stigma and discrimination faced by people by people with disabilities through integrated training for healthcare workers, increasing domestic resources allocated to health and ensuring that people with disabilities are explicitly considered in financial protection measures.

Without concrete action, there is a risk the commitments outlined this month will remain stuck to the pages of the Political Declaration. We need the international community to work together to ensure the commitments are brought to life, and – most importantly – the lives of people across the world are immeasurably improved by finally being able to access the quality health care that all people have a right to, and deserve.

Muhammed has his eyes tested by a health worker.
Muhammed is paralysed from the waist down, and struggles to access health facilities.



Juliet Milgate
Juliet is director of policy and advocacy at Sightsavers

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