G20 2024: A chance to take bold action towards equitable and resilient health systems for universal health coverage

On February 22, the G20 will gather for the first health working group meeting under the Brazilian G20 presidency. This year, members will focus on resilient health systems to promote access to health for all and reduce inequalities. We commend the Brazilian government for highlighting universal health coverage (UHC) as part of this year’s G20 theme and call on all G20 leaders to take bold action towards UHC. 

Urgent action is needed to translate political commitments into action, taking forward the Political Declaration adopted by Member States at the UN high-level meeting on UHC in September 2023. 4.5 billion people – more than half of the world's population – lack access to essential health services, and 2 billion individuals face financial hardship when paying for health services. These figures illustrate the daily hardships endured by billions worldwide who are deprived of their right to health, well-being and dignity. This includes women and girls, for whom health is often still treated as a privilege rather than a human right. 

UHC is the basis for progressing on all health-related issues. UHC, based on a primary health care approach, is central to achieving health equity and ensuring that no one is left behind. Primary health care can deliver nearly 90% of essential health services and is the most inclusive, equitable, cost-effective and efficient approach to enhancing health. Leveraging digital health innovations can help to further expand access to essential health services, such as to people living in remote areas. UHC based on resilient and equitable health systems is also key to ensuring that countries are fit to address emerging pandemics. If countries have strong health systems equipped with enough trained health workers, lab capacities and well-functioning basic services, they can rapidly respond to these threats. Furthermore, UHC is crucial for addressing climate change-related extreme weather events and disease outbreaks. The health impacts of climate change can only be addressed through equitable and resilient health systems that withstand climate change while delivering essential health services and protecting populations, particularly vulnerable groups at risk for adverse health outcomes. 

This year's focus of the G20 health track on resilient health systems is a unique chance to  make progress towards UHC and health for all. The G20 represents not only the world's largest economies but, with the inclusion of the African Union, an even larger and more diverse group of people. We call on G20 leaders to leverage this opportunity to collectively take bold action on UHC. The G20 should: 

• Invest in UHC. Prioritise primary health care to strengthen health systems and scale up services to leave no one behind. Work towards health equity by strengthening financial protection to ensure that everyone can access the health services they need while minimizing out-of-pocket payments throughout their life course. 
• Connect UHC and health security. Recognize that UHC and global health security are intertwined goals anchored in the health systems of every country. Foster resilience through integrated approaches that connect UHC and health security to ensure the capacity to address health threats such as climate change and disease outbreaks while continuing service delivery. 
• Embed social participation in decision-making. Build on the ongoing work on a WHA resolution on social participation to ensure people have a say in the laws and policies that affect their health and well-being, as this is the best way to ensure their needs are addressed and to build trust in public action. 

As Members of the G20 Working Group on Health convene to define the health agenda for this year, we reiterate our call to take bold action to achieve UHC and health equity. We are running out of time left to ensure that by 2030, health is no longer a privilege for a few but a right for all. 

-Ms Gabriela Cuevas Barron and Dr Justin Koonin, Co-Chairs of the UHC2030 Steering Committee 

Photo: © WHO / Panos / Eduardo Martino