17 May 2019: The zero draft of a political declaration on universal health coverage is under consideration by UN Member States. The text highlights health as a right and stresses the importance of health for “all the goals and targets” of the 2030 Agenda. The draft was expected to be presented to governments on 21 May, discussed at informal consultations on 28 May, and considered further through informal consultations in June and early July.

The UN General Assembly (UNGA) will hold a high-level meeting on UHC on 23 September 2019, mandated to result in a political declaration. The Permanent Representatives of Georgia and Thailand circulated a zero draft of the declaration on 17 May, titled ‘Universal Health Coverage: Moving together to build a healthier world.’ At nine pages long and 66 paragraphs, the text sets out 13 areas for action. The action areas include: accelerate high-impact interventions; health financing; strengthen primary health care (PHC); quality and affordable access to medicines, vaccines, diagnostics and health technologies; governance and participatory approach; strong health and social workforce; promoting the use of technologies, innovation and data; mainstreaming gender, equity and human rights; and UHC in fragile situations and health security.

The text notes that this meeting will mark the first time that heads of state and government assemble at the UN with “a dedicated focus” on universal health coverage. By the text, leaders would reaffirm that health is both “a precondition for and an outcome and indicator of” all three dimensions of sustainable development and the implementation of the 2030 Agenda for Sustainable Development.

Leaders would commit to stopping the rise of catastrophic out-of-pocket health spending by providing financial risk protection.

The text defines UHC as a state in which “all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose individuals and families to financial hardship.” It describes UHC as an “overarching umbrella” for the achievement of healthy lives and wellbeing for all, and it notes that the level of progress and investment to date is insufficient to meet SDG target 3.8, which is to “achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.”

Among the commitments to be made by heads of state and government are:

• Stop the rise of catastrophic out-of-pocket health spending by providing financial risk protection and reverse the trend by 2030, and
• Progressively cover one billion additional people with quality essential health services and quality, essential, affordable and effective medicines, vaccines and technologies for all by 2023, and an additional two billion people by 2030; and
• Recognize the fundamental importance of equity, social cohesion and social protection mechanisms to ensure access to health without financial hardship for all people particularly for those who are vulnerable or marginalized.

The declaration links UHC to the SDGs, not only those related to health but also to ending poverty (SDG 1), ensuring quality education (SDG 4), achieving gender equality (SDG 5), providing decent work and economic growth (SDG 8), reducing inequalities (SDG 10), ensuring just, peaceful and inclusive societies (SDG 16) and building and fostering partnerships (SDG 17). Likewise, it says, reaching the goals and targets included throughout the 2030 Agenda is critical for the attainment of healthy lives and wellbeing for all at all ages.

The text also links UHC to climate change, environmental degradation, and protecting vulnerable people and communities, including those in small island developing States (SIDS) and people in fragile settings.

The round of informal consultations on the draft is scheduled for 7, 13, 18 and 28 June, and 3 July. [Zero draft of political declaration on UHC]