Achieving universal health coverage in low-income settings

Abstract

The goal of universal health coverage is deeply embedded in politics, ethics, and international law. Article 25 of the 1948 Universal Declaration of Human Rights states that everyone has the right to a standard of living adequate for health, including medical care, and the right to security in the event of sickness or disability. 1 UN General AssemblyUniversal Declaration of Human Rights, 10 December 1948, 217 A (III). http://www.unhcr.org/refworld/docid/3ae6b3712c.html Google Scholar Motherhood and childhood are to be afforded special care and assistance. In the same year, the Constitution of the World Health Organization came into force, declaring that “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” 2 WHO. Constitution of the World Health Organization as adopted by the International Health Conference, New York, June 19–July 22, 1946. Google Scholar The struggle for universal health coverageCertain concepts resonate so naturally with the innate sense of dignity and justice within the hearts of men and women that they seem an insuppressible right. That health care should be accessible to all is surely one such concept. Yet in the past, this notion has struggled against barriers of self-interest and poor understanding. Building on several previous Lancet Series that have examined health and health systems in Mexico, China, India, southeast Asia, Brazil, and Japan, today we try to challenge those barriers with a collection of papers that make the ethical, political, economic, and health arguments in favour of universal health coverage (UHC), and which will be presented in New York on Sept 26, to coincide with the UN General Assembly. Full-Text PDF Universal health coverage: the third global health transition?As the world's nations gather for the UN meetings in September, 2012, real momentum on achievement of universal health coverage—aimed at giving everyone the health services they need without causing financial hardship—is no longer a distant dream. The 25 wealthiest nations all now have some form of universal coverage (apart from the USA, where political opposition remains strong, despite a recent supportive Supreme Court decision).1 Several middle-income countries, including Brazil, Mexico, and Thailand do as well. Full-Text PDF Universal health coverage: good health, good economicsUnderpinning the trends examined in The Lancet's Series on universal health coverage are several points that deserve deeper appreciation. Call them EPIC—a fitting acronym, in view of the epic transition now underway as the world moves towards universal coverage. Full-Text PDF Universal health coverage is a development issueThe recent Rio+20 United Nations Conference on Sustainable Development, in Rio de Janeiro, Brazil, took place 20 years after the first global conference on the environment and development and 10 years after the World Summit on Sustainable Development. Although much of the discussion focused on the environment, poverty reduction, and sustaining economic growth, the resultant resolution contained an important paragraph for the global health community: Full-Text PDF User fees in universal health systemsThe Lancet's Series on universal health coverage (UHC) offers a timely and comprehensive overview of the implementation and effect of this policy globally. Despite gains, many people still need to pay a high proportion of total health expenditure out of pocket (Sept 8, p 944).1 Patients' costs must be reduced to further improve health and provide financial protection in health systems with UHC. Full-Text PDF