Determinanti globali della salute e (in)sostenibilità dell'obiettivo di copertura sanitaria universale

Abstract

Agenda 2030 has highlighted 17 Sustainable Development Goals (SDGs) and several targets to be achieved by each one of them. SDG3 includes target 3.8, among others, whose aim is to achieve «universal health coverage, with protection of financial risks, access to quality health services and safe, effective, affordable and good quality access to medical drugs as well as vaccination for all». The Agenda’s proposal of a «sustainable, inclusive and sustained growth» is contraddictory, and in fact since the 1970s the Club of Rome reported the «growth limitations» within a finite ecosystem. The aim of a universal health coverage is, at least in part, the synthesis of the health systems objectives, however, its feasibility and sustainability are strongly dependent on transnational determinants. The paper concentrates on the global determinants (such as climate changes, technological innovations, etc.) which impact on the functions typical of health systems (government, resource generation, funding and supply of services) and it analyses their impact. The analysis provides suggestions on the identification of new pathways allowing guarantees of an effective sustainability of SDG3 and a universal access to care.