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December 17, 2012

Universal Health Coverage (UHC) in the Post-2015 Development Agenda

The approach of the 2015 deadline has stimulated reflection on the usefulness and effectiveness of the MDGs and deliberations on what should succeed them. What can be learnt from the experience of the MDGs at global and country levels? Should the post 2015 goals emphasize issues that are missing in the MDG framework, such as inequality, empowerment, climate change, and sustainability? And where does health fit within this emerging agenda

A frequent criticism of the current MDGs is their preoccupation with aggregate achievement in the face of a growing body of evidence of the importance of the multidimensional aspects of increasing equity (in terms of opportunity, access and outcome). With about three-fourths of the world's poorest people now living in middle income countries, the issue is no longer confined to a debate about development aid (although aid will remain important for some countries). Rather it is about social justice and its realization in all countries rich and poor. Social policy developments in major emerging economies such as Brazil, Mexico, India, China and South Africa increasingly highlight the importance of Universal Health Coverage (UHC) as a means of linking equitable social and economic development.

The potential for using UHC in the post-2015 agenda as a way of addressing the wide range of global health concerns is justified as follows:

- The goal of achieving UHC has two inter-related components coverage with needed health services (prevention, promotion, treatment and rehabilitation) and coverage with financial risk protection, for everyone.

- Universal Health Coverage is not about a fixed minimum package, it is about making progress on several fronts: the range of services that are available to people; the proportion of the costs of those services that are covered; and the proportion of the population that are covered.

- Moving towards universal coverage requires a strong, efficient health system that can deliver quality services on a broad range of country health priorities. This requires health financing systems that raise sufficient funds for health, access to essential medicines, good governance and health information, people-centered services, and a well-trained, motivated workforce, for example.

- Access to needed services improves or maintains health, allowing people to earn incomes, and children to learn providing them with a means to escape from poverty. At the same time, financial risk protection prevents people from being pushed into poverty because of out-of-pocket payments for health. UHC is thus a critical component of sustainable development and poverty reduction.

UHC is, by definition, a practical expression of the concern for health equity and the right to health. Moreover, access to services when needed and financial protection are valued for their own sake.


AbouZahr C. Identifying goals, indicators and targets: key questions. June 2012.

UNAIDS, UNICEF, UNFPA, WHO. Health in the post-2015 UN development agenda. UN Thematic Think Piece on Health. May 2012.

WHO discussion paper. Positioning Health in the Post-2015 Development Agenda. October 2012