What UHC is, what it is not

At least 400 million people have no access to essential health services, and 40% of the world’s population lack social protection, resulting in financial catastrophe for many. Around the world, at least 100 million people are pushed into poverty by paying for health care out of their own pockets. In response, world leaders committed to attain Universal Health Coverage (UHC) by 2030 as part of the health-related Sustainable Development Goals (SDG).

The World Health Organization (WHO) outlined what UHC is and what it is not. Knowing what UHC is would help in the overall strategy to achieve the goal and expected outcomes. On the other hand, understanding what UHC is not will aid in leveling expectations of what it could deliver to individuals, communities, and the country.

UHC means access to quality health services for all without suffering financial hardship. The WHO said it addresses the entire continuum of care from health promotion, prevention, treatment, rehabilitation, and palliative care. UHC also considers priority health concerns, and ensures the quality of services so that outcomes can be measured, such as more people not getting sick, diseases not progressing, and people living longer. Towards this end, it means promoting health and confronting diseases at the primary level to prevent hospital visits and long-term care.

UHC is also about protecting people from paying for the majority of health services resulting in financial catastrophe. A good social insurance program limits the risk of individuals being pushed into poverty due to unexpected illnesses, compelling them to use up any savings that would have otherwise been spent on food and the education of their children.

Moreover, UHC helps ensure that health-related targets in the SDGs are achieved, namely, reducing maternal and child mortality, lowering premature deaths caused by non-communicable diseases, and ending epidemics of infectious diseases.

The WHO, on the other hand, explained that UHC is not about making all possible health interventions free as no health system can provide all services without charge on a sustainable basis. It is not about a minimum package but a progressive expansion of coverage of health services and financial protection.

However, UHC is not just about health financing. It is holistic and considers all the building blocks of a resilient health system such as service delivery, human resources, facilities, health technologies, information systems, and governance.

UHC is also not just about individual treatment services but provides for population-based services, including a public health advocacy centering on the prevention of diseases and mitigation of risk factors.

Finally, the WHO said that UHC is not just about health. It is about progress towards “equity, development priorities, and social inclusion and cohesion.”

After all, health is linked to the global aspirations of sustainable development. Children in good health are able to attend school and focus more on learning. Adults who are healthy need not be absent from work, thus taking home more food for the family. Communities that are healthy are more productive, triggering long-term social developments and inclusive economic growth.

Medicine Cabinet is a column of the Pharmaceutical and Healthcare Association of the Philippines (PHAP), representing the research-based medicines and vaccines sector in the country. The author is the executive director of PHAP. E-mail the author at medicinecabinet@phap.org.ph.