Health for All on UHC Day 2016 - the UK’s role in promoting UHC in the SDGs era

Universal health coverage (UHC) has been high on the global and political agenda this year – with recent wins for the measurement of UHC in the SDG global indicator framework and growing country commitments to support the IHP for UHC2030. On the third ever UHC Day the call to ‘Act with Ambition’ has never been more timely.In celebration of UHC Day, Action for Global Health last week convened a panel of experts to hear how the UK can act ambitiously for UHC. Held in UK Parliament, guests from WHO, Chatham House, government, civil society and academia joined to discuss what role the UK can play in promoting UHC in the SDGs era.

The panel chair, Channel 4 News’ Health and Social Care Correspondent Victoria Macdonald, opened the discussion with an overview of the importance of UHC to reaching the Sustainable Development Goals (SDGs), in particular SDG 3.

Julia Watson, Senior Health and Economic Adviser in the Department for International Development’s (DFID) Health Services Team, described the UK government’s commitment to support developing countries to reach UHC equitably – in a way which puts the poorest and most excluded people first. This translates into DFID’s vision to continue strengthening health systems, through investments in the core systems building blocks.

Lord Crisp, Co-Chair of the APPG on Global Health, emphasised the need to support local leadership approaches towards achieving UHC. Whether focused on service provision (South Africa) or taking a poor-first approach (Rwanda), the many different routes countries follow to achieving UHC need technical and financial support.

Rob Yates, Project Director of the UHC Policy Forum, Chatham House, highlighted that this is particularly the case in fragile or post-conflict settings, and something the UK has direct historic experience of. The creation of the NHS in post-WWII Britain was enabled by external financial support from the US. The UK now has the technical capacity to become a major player in supporting developing countries to move towards UHC.

Rob argued that there is also great political capital in supporting UHC, especially in settings of fragility or political turmoil. Political champions of UHC have the potential to become ‘national heroes’ and can galvanise reform.

The World Health Organisation’s (WHO) Director for Health Systems, Governance and Financing, Dr Agnès Soucat, drew closer attention to the continued importance of domestic financing in developing countries in moving towards the $80 billion/year needed to reach UHC. Progress towards pooled, taxation-based funding however is essential to address the persistent gap in health financing currently being met by out of pocket expenditure.

David Olayemi, Special Adviser on External Relations to the Senior Management Team of Save the Children Nigeria, illustrated the negative impacts of this gap, where out of pocket payments at 69-71% are pushing many into poverty. Despite progress in the passing of Nigeria’s National Health Act 2014, health coverage has stalled at only 4%. The need for reform is greatest at primary healthcare level, and investments in the health workforce will also be critical for progress.

Throughout the panel discussion, it became clear that there is great potential for the UK to play a significant role in supporting the achievement of UHC. As part of this event, Action for Global Health produced a 2 page UHC briefing with key recommendations for UK government on how they might support developing countries to do this.