UNITED NATIONS (AN) — The U.N. General Assembly adopted a landmark political declaration on Monday that calls on all nations to work towards enabling everyone to have affordable, quality health services by 2030.
The globally adopted political declaration on universal health coverage, or UHC, reaffirmed "the right of every human being to the enjoyment of the highest attainable standard of physical and mental health, without distinction of any kind."
It was adopted by acclamation at a high-level meeting at the start of the 193-nation assembly of world leaders, diplomats and officials held each year at U.N. headquarters in New York.
"The political declaration in front of us is the most comprehensive agreement ever reached on global health — a vision for universal health coverage by 2030," U.N. Secretary-General António Guterres told the meeting.
Guterres called it a "significant achievement" that will drive progress over the next decade on primary health care systems to handle communicable diseases, including HIV/AIDS, tuberculosis and malaria, along with other, non-communicable diseases, or NCDs, and antimicrobial resistance.
NCDs — mainly cancer, cardiovascular disease, chronic respiratory diseases, and diabetes — are the most common causes of death and disability worldwide. Low and middle income countries and the poorest and most vulnerable populations are the ones that are the hardest hit, according to the NCD Alliance, a Geneva-based network of 2,000 organizations in 170 nations.
Guterres emphasized that the political declaration also calls for universal access to sexual and reproductive health care services and reproductive rights, which he said are "essential to protect the wellbeing and dignity of women and girls" worldwide.
"Many countries are on the path towards achieving health for all by 2030. Others will need to accelerate their efforts so that no country, community or person is left behind," he said. "Let us all be champions of health for all."
The @UN declaration on universal health coverage #UHC represents a landmark for global health & development. The world has 11 years left to make good on its @GlobalGoalsUN. UHC is key to ensuring that happens. It's time for #HealthForAll! https://t.co/MYvJ2V5Bzo
— Tedros Adhanom Ghebreyesus (@DrTedros) September 23, 2019
Reducing financial hardship
Some 50 million people worldwide suffer from what the World Health Organization calls “catastrophic spending” on health costs due to user fees and other direct payments. A third of global health spending is out-of-pocket payments. More than 80 nations lack enough health professionals to treat everyone.
The World Bank reported in 2017 that only 76 countries, with 62% of the world’s population, had some form of UHC. Of those, 44 were wealthy nations; 23 were low to middle income; and nine were poor. Just 22 nations had “comparatively high rates of service coverage and financial protection" that are the aim of UHC, the report said, noting out-of-pocket costs often caused financial hardship.
As a result, all 193 U.N. member nations supported establishing UHC worldwide as part of the U.N.’s 17 Sustainable Development Goals for 2030 aimed at ending poverty and building resilience.
The U.N.’s third goal, titled “Good health and well-being,” says the spread of UHC — based on principles of equity, access and quality — will be “integral’ to its achievement, and to ending poverty and reducing inequalities.
Tedros Adhanom Ghebreyesus, head of the U.N. health agency, said the new political declaration represents "a landmark for global health and development." He noted that nations have just 11 years left to make good on their 2030 sustainable development goal for good health and well-being.
Among the key obstacles to success are adequate financing, systems strengthening and capacity building, according to the International Federation of Pharmaceutical Manufacturers & Associations, or IFPMA, based in Geneva.
The global trade federation has joined a chorus of international voices trying to persuade more governments, particularly leaders and finance ministries, that health spending is best viewed as a critical investment rather than a cost.
"IFPMA and its members welcome the declaration’s call to address healthcare in a holistic way and the elevation of health discussions beyond the ministries of health," the federation said in a statement. "UHC is a journey unique to each country’s needs and priorities, and there is no one-size-fits-all approach."
Though financing is a main obstacle, the political declaration included no detailed commitments other than WHO's recommendation that nations spend at least 1% of GDP on health. It also cited WHO estimates that spending US$3.9 trillion more on health globally by 2030 could prevent 97 million premature deaths and add several years or more of life expectancy in poorer countries.
The Paris-based Organization for Economic Cooperation and Development, or OECD, has said that a 10% increase in health spending per person could bring a gain of 3.5 months of life expectancy among its 36 member nations.
