Faced by the COVID-19 crisis, it is crucial that world leaders remember their universal health coverage commitments

Around the world, the COVID-19 pandemic is having a huge impact on health systems, economies and the lives, livelihoods and wellbeing of people and communities.

This global crisis is a sharp reminder that everyone, everywhere should have access to quality and affordable health services. Health is a fundamental human right and the foundation of economic prosperity and security. In recent years G7 and G20 leaders promoted strong and resilient health systems as vital for both universal health coverage (UHC) and health crisis management, which are ‘two sides of the same coin’. (1)

In September 2019, at the United Nations High-Level Meeting (UN HLM) “Universal Health Coverage: Moving Together to Build a Healthier World”, world leaders endorsed the most ambitious and comprehensive political declaration on health in history. Faced by the COVID-19 crisis, it is crucial that leaders recognise the interconnectedness of UHC and health emergencies and remember their UHC commitments.

Prior to the UN HLM, the UHC movement (including governments, parliamentarians, civil society, private sector, international agencies, global health networks and academia) came together behind the UHC Key Asks, which fed into the key targets, commitments and actions in the political declaration. These UHC asks and actions are mutually reinforcing with the seven urgent actions to prepare the world for health emergencies issued by the Global Preparedness Monitoring Board in 2019.

The key asks and UN HLM commitments can help guide political leaders as they respond to COVID-19:

1. Ensure political leadership beyond health. COVID-19 requires bold political decisions and responsible leadership at the highest levels. Health crisis preparedness and response are public goods that are primarily the responsibility of governments. They are the first step towards UHC.
    
2. Leave no one behind. No one should face financial, geographical and cultural barriers that prevent access to appropriately prioritised testing or treatment. Safety nets are essential to ensure people can afford to isolate and minimize the spread of infection. These measures should especially recognise the needs of vulnerable people, older people, and those with underlying health conditions.  
    
3. Regulate and legislate. Health crises require bold emergency measures. Transparency, inclusiveness and accountability build trust. Parliaments and local and national governments must balance individual rights and collective responsibilities. Regulatory measures must ensure patient safety while enabling urgent innovative solutions.
    
4. Uphold quality of care. COVID-19 is placing huge strain on health systems and services. Governments must pay special attention to protect health workers and take urgent action so essential medicines and equipment are available where they are most needed. Context-specific guidance on triage and referral is essential to meet urgent needs while protecting health systems to the greatest extent possible. 
    
5. Invest more, invest better. COVID-19 highlights pre-existing needs to increase domestic investment, especially public financing (including social insurance contributions where relevant)* and reduce reliance on impoverishing out-of-pocket payments. Where countries require external support, this should be harmonized to reduce fragmentation. Governments must also step up investment in innovation (including vaccines, diagnostics, medicines and digital solutions).
    
6. Move together. COVID-19 demonstrates that health is everyone’s business. Countries must come together, with the international community, to ensure coherent action. The G7, G20, G77 and regional inter-governmental organizations should lead by example. At all levels, social solidarity and public trust are essential: governments must meaningfully and transparently engage the whole of society in their responses.
    
7. Ensure gender-equitable responses. At times of crisis, the needs and rights of women and girls are often neglected. Early evidence suggests more COVID-19 deaths among men than women. Countries should publicly report sex-disaggregated data on testing, confirmed infections, and deaths – and be sensitive to gender throughout their actions.

COVID-19 will directly or indirectly affect everyone, everywhere. In reminding world leaders how their UHC commitments can guide action during this global emergency, the UHC movement stands in solidarity with the hardest-hit communities, brave political leaders, and health workers on the front line.

*Updated 20 April: clarified reference to social insurance contributions. See Financing for UHC: Dos and Don’ts (WHO) for key issues on UHC financing.

Statement by UHC2030 Co-Chairs, in consultation with the UHC Movement Political Advisory Panel of UHC2030.

UHC2030 Co-Chairs

Prof. Ilona Kickbusch, Chair, International Advisory Board, Global Health Centre, Graduate Institute for International and Development Studies Geneva 

Dr. Githinji Gitahi, Global CEO, AMREF Health Africa

UHC Movement Political Advisory Panel

Mr. Elhadj As Sy, Chair of the Board, Kofi Annan Foundation

Ms. Emilia Saiz, Secretary General of the United Cities and Local Governments

Ms. Gabriela Cuevas Barron, President of the Inter-Parliamentary Union

Dr. Gro Harlem Brundtland, Board Member of The Elders

Prof. Keizo Takemi, Member of the House of Councillors, Japan

Ms. María Fernanda Espinosa Garcés, President of the 73rd Session of the UN General Assembly

Dr. Vytenis Povilas Andriukaitis, Former European Commissioner

UHC2030 is a movement to accelerate progress towards UHC by providing a multi-stakeholder platform that promotes collaboration on health systems strengthening.

Download PDF file format UHC2030 COVID-19 and UHC political messages

FRENCH
Face à la crise du COVID-19, les dirigeants mondiaux doivent impérativement être fidèles à leurs engagements en faveur de la couverture santé universelle

Déclaration des coprésidents de la CSU2030, en consultation avec le Panel consultatif politique du Mouvement de la CSU pour la CSU2030: Face à la crise du COVID-19, les dirigeants mondiaux doivent impérativement être fidèles à leurs engagements en faveur de la couverture santé universelle

UHC2030 COVID-19 and UHC political messages FR

SPANISH
Frente a la crisis de la COVID-19, es crucial que los líderes mundiales recuerden sus compromisos en materia de cobertura sanitaria universal

Declaración de los copresidentes de la CSU2030, en consulta con el grupo consultivo político del movimiento para la cobertura sanitaria universal: Frente a la crisis de la COVID-19, es crucial que los líderes mundiales recuerden sus compromisos en materia de cobertura sanitaria universal

UHC2030 COVID-19 and UHC political messages ES

GERMAN
Universeller Zugang zu Gesundheitsdiensten (UHC) und COVID-19

ERKLÄRUNG DER KO-VORSITZENDEN UHC2030: UNIVERSELLER ZUGANG ZU GESUNDHEITSDIENSTEN (UHC) UND COVID-19

https://www.worldfuturecouncil.org/de/universeller-zugang-zu-gesundheitsdiensten-und-covid-19/

JAPANESE
新型コロナウイルス感染症（COVID-19）の危機に直面し、 世界の指導者はユニバーサル・ヘルス・カバレッジ（UHC）のコミットメントを 心に留めておくことが極めて重要

UHCムーブメント政治委員会の助言に基づくUHC2030共同議長声明: 新型コロナウイルス感染症（COVID-19）の危機に直面し、世界の指導者はユニバーサル・ヘルス・カバレッジ（UHC）のコミットメントを心に留めておくことが極めて重要

COVID-19に関するUHC2030共同議長声明_仮訳

(1) See G7 Ise-Shima Leaders’ Declaration (2016),  G7 Ise-Shima Vision for Global Health (2016),  G20 Leaders´ Declaration Shaping an interconnected world (2017), Berlin Declaration of the G20 Health Ministers: Together Today for a Healthy Tomorrow (2017)

More resources

Living with COVID-19: Time to get our act together on health emergencies and UHC 
UHC2030 Discussion Paper 

Beyond COVID-19 (coronavirus): What will be the new normal for health systems and universal health coverage?
Blog by Agnes Soucat, Francesca Colombo and Feng Zhao 

Categories: Ensure political leadership beyond health, Leave no one behind, Regulate and legislate, Uphold quality of care, Invest more, invest better, Move together, Gender