19 February 2013 GENEVA – Top officials from health and finance ministries from 27 countries joined other high-level health and development stakeholders at a two-day meeting this week in Geneva to discuss ways that countries are progressing towards universal health coverage. The meeting was convened jointly by the World Health Organization (WHO) and the World Bank and took place just weeks after the United Nations General Assembly adopted a resolution supporting universal health coverage.
Delegates at the Geneva meeting expressed strong support for the ideas underlying universal health coverage: that everyone, irrespective of their ability to pay, should have access to the health services they need, without putting their families at financial risk.
Many speakers stressed the importance of getting political commitment to universal health coverage at the highest level. Some countries described how they are focusing their limited resources initially on providing coverage to the poor and vulnerable, while others have taken a more universal approach from the start. The use of general revenues to provide such coverage was a recurrent theme; but there was also some discussion about using earmarked revenues such as ‘sin taxes’.
Participants agreed that human resource shortages posed a challenge, but also pointed to the need for more focus on the distribution of health workers —between rural and urban areas, and between poor and more affluent areas. Some speakers indicated that more could be achieved using existing resources. The meeting also discussed strategies to ensure an adequate supply of good quality and affordable essential medicines and technologies, noting the value of using financial incentives to promote efficiency and quality of health services.
The participants agreed on the importance of improving information systems and holding governments and health care providers more accountable for delivering results. Several speakers raised the challenge many faced of how to balance ensuring people receive the care they need at a cost the government can afford.
The importance of monitoring progress towards universal health coverage was also a recurrent theme, as was the important role played by of researchers, civil society, and international agencies. Several delegates expressed the hope that universal health coverage would feature in the post-2015 development goals.
The WHO and the World Bank are working together at global, regional and country levels, and stand by ready to help countries confront the numerous challenges that the meeting highlighted in accelerating progress toward universal health coverage. In response to country demand, the WHO and the World Bank are already developing a monitoring framework that will help countries track their countries’ progress toward universal health coverage in a way that explicitly captures the potential importance of universal health coverage in achieving better health and higher living standards for everyone. The framework will be available for consultation with countries and other partners later this year.
The UN General Assembly resolution urges Member States to develop health systems that avoid significant direct payments at the point of care. It further encourages them to establish mechanisms for pooling risks to avoid catastrophic health expenditures that drive households into poverty.