Universal health Coverage Report 2023: A buzzword or world buzz?

This article was exclusively written for The European Sting by Mr. Ibrahim Dafallah, a fourth-year medical student studying at Alzaiem Alazhari University in Sudan. He is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

In light of the release of the Universal health Coverage (UHC) report 2023 and the Universal health Coverage High Level Meeting held this year expectations on the progress of Universal Health Coverage were high. The declaration of Astana in 2018 focused on political commitment and action to achieve UHC but is that enough? 

Universal health coverage (UHC) is a concept which refers to all people receiving the quality health services without incurring a financial burden. This health systems ideal which was born out of the Sustainable Development Goals and the ‘health for all’ agenda has been at the forefront of health systems discussions and lauded as the ‘grail’ of major health systems challenges.

The report however holds within concerning results. Catastrophic out- of-pocket health spending (over 40% of household income spent on healthcare) has increased globally by almost 1% percent and reaching milestone of 1 billion people affected by catastrophic health spending. This comes at the expense of only about 1% increase in health service coverage over the same period (2016-2019). This is prior to COVID-19.

National statistics of a sample country showed an increase in catastrophic health spending after the pandemic by about 3 percent. The next batch of global statistics are yet to track progress following 2019.

Universal health coverage received a lot of attention from the global community, before and after the pandemic. Noting increased commitment and implementation from developing countries in adopting UHC targets, developed countries have worked on refining their approaches.

It can be imagined health systems are made to be tested through continually evolving viral strains, human behavior changes, wars and other shifting events. In a rapidly transforming world faced with these planetary and global challenges and atop that ambitious goals- sustainable development is necessary.

UHC as powerful a concept the greater the care and capacity in execution is required. Leaving no one behind in health will continue to evolve in and we must too. The healthcare sector has been slow in the uptake of technology, eco-friendly operation, community participation and considerations of increasingly diverse populations such as refugees and migrants. Unsustainable universal health coverage will be costly to people and the planet, increasing inequalities. Most importantly it will be a imbedded error which will be expensive to fix. The world cannot afford to miss sustainable implementation of UHC, much so after a pandemic which ‘baffled’ and reset health systems worldwide.

To this end, research and feasibility studies of sustainable health systems interventions must be coordinated and supported by international and national organizations. The role of relevant United Nations agencies in proactively providing technical support to governments is central to drive the political commitment to right direction. A focus on evidence based approaches (most notably primary health care) and case studies of national and sub-national experiences will allow a positive course towards implementation of UHC.

About the author

Ibrahim Dafallah is a fourth-year medical student studying at Alzaiem Alazhari University in Sudan and currently serving as the IFMSA Standing Committee on Public Health (SCOPH) Regional Assistant for Africa. His interests include universal health coverage, neglected tropical diseases, and research. He looks forward to improving health outcomes as a future doctor.

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