The Road to 2023: gaps, challenges and opportunities to accelerate progress on UHC

More than 240 people from around the world participated in an online event, ‘The Road to 2023: Kickoff to the High-level Meeting on Universal Health Coverage’, on 30 September. The event was co-hosted by the Co-chairs of the Group of Friends of Universal Health Coverage and Global Health (Permanent Missions of Georgia, Japan and Thailand to the United Nations), the World Health Organization and UHC2030, on the margins of the 76^th Session of the UN General Assembly.

Recognizing that investments in health systems can have far-reaching impacts, UN leaders, ministers, UHC champions and other high-level speakers came together to take stock of the progress, gaps and challenges faced during COVID-19 and to recommit to the implementation of the 2019 Political Declaration on UHC. The event highlighted the need for stronger primary health care, integration of emergency preparedness, community empowerment and increased collaboration and coordination across sectors to support resilient and equitable health systems that protect everyone.

The speakers also emphasized the need to translate policy into action, recognizing that “when health is at risk, everything is at risk” (Dr. Tedros Adhanom Ghebreyesus, WHO Director-General). To quote Ms. Gabriela Cuevas Barron, UHC2030 Steering Committee Co-chair, “The next UN high-level meeting will be a significant opportunity to take stock of our progress and setbacks during the pandemic and set into motion concrete actions to invest in more resilient and equitable health systems that leave no one’s health behind in peacetime and emergency situations.”

Other highlights include video messages from principals of the Global Action Plan for Healthy Lives and Well-being for All and the Coalition of Partnerships for UHC and Global Health, which recently published its first op-ed: No healthy life without universal health coverage. UHC2030’s Civil Society Engagement Mechanism (CSEM) also shared a brand new Health for All Advocacy Toolkit in the event.

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High-level Opening Segment: The event started with opening remarks of co-hosts, who focused on and provided examples of concrete actions to accelerate UHC goals, promote resilient health systems and respond to and recover from the COVID-19 pandemic.

H.E. Ms. María Fernanda Espinosa, member of the UHC Movement Political Advisory Panel, UHC2030  and President of the 73rd Session of the UN General Assembly, moderated and introduced the meeting by challenging participants to use the pandemic to build back stronger, saying “The 2019 Political Declaration is a great blueprint, but now we must strengthen it further. We must leave ourselves better prepared for the next crisis. The upcoming High-level Meeting in 2023 is an opportune moment to align efforts and translate political commitment into action. I invite today’s panelists to join me in this dialogue to pave the way to 2023.  Together we can make this moment impactful.”

H.E. Mr. Don Pramudwinai, Deputy Prime Minister and Minister of Foreign Affairs, Kingdom of Thailand, called attention to three key areas that are essential to realizing UHC: “First, we must do more to promote equitable, affordable, timely and universal access to vaccines and medicines… Second, we need to tackle the problem of underinvestment in healthcare infrastructures and services… Third, UHC must be highlighted as part of post COVID-19 response strategies,” concluding with the poignant reminder that “apathy is not, and must not be, an option.”

H.E. Mr. Toshimitsu Motegi, Minister of Foreign Affairs, Japan, emphasized the need for partnership and collaboration, stating that “in order to prepare for future pandemics, we need to share lessons learned among stakeholders and strengthen health systems through partnership. In the post-COVID era, we will need to achieve a resilient universal health coverage that contributes to global health security. Moreover, we need to work through broader, multi-disciplinary partnerships not limited to the health sector alone.”

Ms. Tamar Gabunia, First Deputy Minister of Internally Displaced Persons from the Occupied Territories, Labour, Health & Social Affairs, Georgia, focused on the interconnection between health security and UHC policies and interventions, stating that “the pandemic shows us again how important it is to make health systems fully resilient to health emergencies by investing in public health infrastructure and strengthening health security programmes.”

Ms. Amina Mohammed, Deputy Secretary-General of the UN, recalled that “even before the COVID-19 pandemic, we were not on track to achieve the UHC targets for 2030.” Calling for national action and multilateral collaboration, she stated that “Accelerating joint action on Universal Health Coverage, climate change and transforming food systems must be essential elements of all COVID-19 recovery plans. This will help to build stronger, more resilient communities and societies, and is central to preventing and dealing with future pandemics.”

Dr. Tedros Adhanom Ghebreyesus, Director-General, WHO, called on leaders to “end the pandemic, and the disruption it is causing to systems, societies and economies… strengthen the global health architecture… [and] support all countries to invest in strengthening the foundations of their health systems, and especially primary health care,” reminding participants that “the task of supporting countries to progress towards UHC is more urgent than ever – and more possible than ever.”

Ministerial Segment: Co-sponsors shared their experiences, priorities and efforts towards achieving UHC. They also called for international, multilateral collaborations and global leadership to build effective health systems that can deliver affordable and quality health care.

H.E. Dr. Frank Anthony, Minister of Health, Cooperative Republic of Guyana, spoke about the intergovernmental role to promote UHC and translate it into national policy, stating that “COVID-19 has demonstrated forcefully that health systems do not exist in a vacuum. Our global goals require political commitment, national implementation and international coordination to ensure good health for all, and ultimately, global health security.”

H.E. Mr. Alexey Tsoy, Minister of Healthcare, Republic of Kazakhstan, called attention to the importance of primary health care, describing it as “a pillar of UHC in emergencies, ensuring the continuum of care and the provision of essential health services in line with humanitarian principles” and “one of the key pandemic response measures.”

H.E. Dr. Hanan Mohamed Al Kuwari, Minister of Public Health, State of Qatar, emphasized the importance of health security and UHC in local policies and international collaborations, reminding participants that “COVID-19 is not just a health crisis, for it has revealed many socio-economic issues inherent to this era, and created many challenges and obstacles to achieving the Sustainable Development Goals. It has also become clear that this crisis represents a major threat to the maintenance of international peace and security, for it increases social unrests and violence, which, in turn, would significantly undermine our ability to fight the pandemic.”

H.E. Dr. Faisal Sultan, Special Assistant to Prime Minister, Ministry of National Health Services, Regulations and Coordination, Pakistan, focused on how to translate the political vision of UHC into practical steps, calling for more ambitious and fast-paced implementation and highlighting “the need for national action and multilateral collaboration through the SDG Action Platform. This platform serves as a very important opportunity to share knowledge and experiences and to identify regional trends and share best practices and lessons learned for sustainable development in health to ensure healthy lives and the well-being of our citizens.”

H.E. Ms. Wendy Morton, Minister for European Neighbourhood and the Americas at the Foreign, Commonwealth and Development Office, United Kingdom, called for “high-quality essential health services to support better mental and physical health for everyone, everywhere, without fear of financial hardship. We need health systems with strong, integrated public health functions, that combat all forms of malnutrition, deliver effective water, sanitation and hygiene services, and help prevent, detect and respond to local and global health threats – in the now, and in the future.”

Partner Contributions: Two video messages from SDG3-related initiatives were played to showcase a horizontal approach to health. A video of the SDG3 Global Action Plan Principals Group highlighted the collaborative work the 13 agencies are doing to enhance efforts toward UHC. The Coalition of Partnerships for UHC and Global Health shared its principal group’s vision on the better alignment in advocacy and accountability activities between the UHC and disease-specific agendas. The Coalition also shared its op-ed, ‘No healthy life without universal health coverage’, which was recently published in the British Medical Journal.

Interactive Panel Discussion: The panel discussion presented perspectives from partners and UHC champions. The panelists invoked a sense of urgency and emphasized the need for gender equality and investment in strong health systems, calling for meaningful structural shifts.

Ms. Gabriela Cuevas Barron, Co-chair of the UHC2030 Steering Committee, focused on equity and resilience, stating that “we are in the middle of a pivotal moment, and we have an opportunity and a responsibility to invest efficiently in strong health systems that protect everyone. We can do so by ensuring action on two ‘systems shifts’: investment and integration. This means ensuring more and better-aligned resources for health systems, based on a primary health care approach that reinforces health service delivery, essential public health functions and emergency risk management, while considering the system as a whole”.

Ms. Emilia Saiz, Secretary-General of United Cities & Local Governments, focused on the determinants of health and the role of local government, saying “This is an all of government, all of society effort. And at the core of that all-of-society effort, you find local governments, local investments, local public service delivery. The international community needs to support this vision. And healthcare and the roles that local governments play in health care need to be understood beyond emergencies.”

Ms. Anamaria Bejar, Civil Society Engagement Mechanism (CSEM) Advisory Group Member of UHC2030, spoke about the role of civil society in holding government accountable for their UHC commitments, emphasizing the need to ensure UHC is truly universal and stating that “strong health systems need transparent and accountable governance, which must include communities and civil society in every step of the decision-making. Not as an add-on, but from the beginning.”

Interventions from the floor emphasized the need for inclusive and universal health services.

Dr. Emmanuel Ankara Odame, Director of Policy Planning Monitoring and Evaluation, Ministry of Health, Ghana, highlighted the need for agile and responsive health systems and for strong health architecture, and Ms. Florine Clomegah, Deputy Regional Director for Africa, IFRC, emphasized the key role of national society and of community health-based workers and volunteers in achieving UHC, engaging in health ministries and strengthening health services. Dr. Poonam Dhavan, Senior Migration Health Policy Advisor, IOM, also intervened to remind participants of the importance of addressing the particular needs of migrants, refugees and internally displaced persons and of including these groups in decision-making, and Dr. Cesar Nunez, Director, UNAIDS NY Office, similarly underscored the need to address the social and structural determinants of health, to build stronger health systems that place people at the centre and take a human-rights based approach, and to ensure the critical role of communities in health and social systems.

A recorded video of the event is available here (UHC2030 YouTube Channel).

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Useful Resources

• Scope, modalities, format and organization of the high-level meeting on universal health coverage (A/RES/75/315)
• UHC Commitments (UHC Day Campaign Microsite)
• Collaborating for an equitable recovery towards the health-related Sustainable Development Goals (SDG3 GAP video, WHO YouTube Channel)
• UHC Leaves No One Behind: Let's work together towards good health & wellbeing for all (The Coalition video, UHC2030 YouTube Channel)
• No healthy life without universal health coverage (The Coalition op-ed, the BMJ Opinion)
• Tell the real story of universal health coverage (Submission Deadline: 31 October 2021, UHC2030)
• Health for All Advocacy Toolkit (CSEM)
• Parliamentarian Guide: 6 Action Steps to Achieve Universal Health Coverage (EPF/FPA & UHC2030)