Health For All: What’s Next for a Movement Hitting its Stride?

If the events of 2016 have taught us anything, it’s that we cannot know for sure what tomorrow will bring. But change has a way of illuminating those things about which we are certain. As a new year dawns, my conviction that every country can and must accelerate progress toward universal health coverage has never been stronger.

We can because political momentum and grassroots demand for universal health coverage (UHC) is growing, finally catching up to the evidence that universal health coverage is a smart investment and achievable goal everywhere.

We must because health system gaps jeopardize the lives and finances of hundreds of millions of people. That is true everywhere—especially where conflict, climate shocks, and disease outbreaks persist.

This time last year, I asked you to keep an eye on three things that could shape the health for all movement in 2016: (1) Japan’s G7 presidency; (2) the Sustainable Development Goal indicators for universal health coverage; and (3) country leadership.

Encouragingly, we’ve seen victories and positive steps forward across all three fronts:

• Under Japan’s leadership, the G7 endorsed UHC for the first time in its history.
• The United Nations statistical agency ratified two robust indicators for coverage of health services and financial protection.
• At TICAD VI, African heads-of-state committed to accelerate progress toward UHC and adopted a new framework for action.

But that wasn’t all. The Elders—a group of influential leaders convened by Nelson Mandela—launched a UHC campaign. Dr. Margaret Chan, Director-General of the World Health Organization, formally announced the establishment of the International Health Partnership for UHC 2030, a new global mechanism to drive UHC coordination, advocacy, and accountability. The Rockefeller Foundation is proud to announce a new grant to this mechanism, to ensure that the vision of health for all is met with equally ambitious action.

And today, on the third annual Universal Health Coverage Day, a coalition of 864 organizations in 117 countries took up the rallying cry of ‘Act with Ambition’ to show the world that we’re just getting started. UHC Day 2016 has already broken records, with 80 events in 33 countries, and more than 120 million calls for ‘Health For All’ on Twitter.

These wins were not guaranteed. They were hard-fought and hard-won by health and development advocates who don’t know the meaning of complacency.

WHAT’S NEXT?

Having made the case for universal health coverage, the question is no longer “if” but “when.”

As countries roll up their sleeves and advance new policies to achieve universal health coverage, I can’t deny that the problems they face will become more tactical and complex, the nuances more important. Doubts that we can achieve our goal may even grow.

What can be done?

• Build Country Capacity: We’ve entered a new era of health and development where countries that were traditionally recipients of aid are creating their own paths toward universal health coverage. If we’re serious about achieving UHC and reducing out-of-pocket payments in the long run, we need to support countries at every income level to find ways to increase domestic public health budgets. An example of work at this level is the Joint Learning Network for UHC, which The Rockefeller Foundation helped establish, in which today 27 countries are working together in the hard work of building and strengthening their health systems to assist all of their citizens.  And more countries are joining each year.

• Focus on the Intersections: Universal health coverage is inherently cross-cutting—it impacts (and is impacted by) economic opportunity, the environment, gender equity and so much more. That’s why we need to place a greater emphasis on the intersections of UHC: how it builds resilience against climate threats, how the private sector can contribute, how overlapping efforts—like work to expand access to primary health care—can be harnessed to help us achieve our shared goal.

• Get Serious about Accountability: We’ve set the stage for meaningful UHC measurement by advocating for a strong SDG indicator 3.8.2 and the establishment of the International Health Partnership for UHC 2030. Now we need to execute. This starts by asking the tough questions: Are we truly reaching everyone, everywhere, with the quality, affordable health services they need and deserve? Are we keeping people healthy in the first place? If not, what can we do to change course? Strong measurement tools and communication across efforts will allow us to expand basic, essential health services to the 400 million people who currently lack them. We can and must do better.

We cannot know for sure what tomorrow brings. But we do know that money spent on health is an investment, not a cost. So let’s make good on our promise to the hundreds of millions of people who are depending on us to make health care accessible and affordable. Let us stand together and affirm that universal health coverage is achievable, that health is a human right, and that we can reach our goal of ‘Health for All’ if we continue to act with ambition, together.