Last week’s UN High Level Meeting on Universal Health Coverage (UHC) provided an opportunity for leaders to reiterate their political commitments to achieve UHC, with the aim of scaling up global efforts. But what does this mean for the Commonwealth, and where should efforts be prioritized?
The development of the Commonwealth so far
The Commonwealth continues to play a key role in promoting UHC, in line with the Commonwealth Charter’s principles of promoting access to affordable health and eliminating wide disparities and unequal living standards.
Since 2014, Commonwealth Health Ministers have focused on various aspects of UHC, including aging and good health (2015); health security (2016); sustainable financing and global security (2017); non-communicable diseases (NCDs) in the context of resource mobilization for UHC (2018); UHC in the context of equitable access to vaccines and building resilience for health and emergency systems (2021); and, UHC and Global Health Security as complementary Commonwealth agendas (2022). Likewise, at the Commonwealth Heads of Government level, UHC remains a key priority.
Before the COVID-19 pandemic, progress was made in achieving UHC, both globally and within the Commonwealth. The UHC service coverage index (SDG indicator 3.8.1) increased from 45 in 2000 to 67 in 2019, with the fastest gains in the African Region. However, the COVID-19 pandemic has pushed already overburdened health systems to their breaking point and as a result, progress towards achieving UHC has stalled.
Until 2023, the Commonwealth remains far from meeting the SDG target of 3.8 to achieve UHC. Deep inequities in access to quality health services and products remain a fundamental challenge for UHC, with aggregated data masking inequities within countries in service coverage.
The increasing vulnerabilities and limitations of many health systems highlight the need to strengthen health system resilience to enable and sustain progress towards Universal Health Coverage, global health security and a healthier population. together
To reinvigorate the Commonwealth’s commitment to UHC, Commonwealth Health Ministers met in Geneva in May 2023, under the theme: Getting Commonwealth UHC on track for 2030. An important discussion during the meeting is to re-orient health systems towards primary health care (PHC) as a driver to achieve UHC.
Recognizing PHC as a critical pillar of UHC
The World Health Organization (WHO) has recognized that 90 percent of essential interventions can be delivered through PHC, which will revitalize the role of PHC in the global health agenda in recent years. The 2018 Astana Declaration on Primary Health Care places PHC as the foundation of a sustainable health system, emphasizing the importance of working towards the SDGs and achieving equity within and between countries.
Recognizing that UHC can progress more effectively and efficiently with a fully functional and well-delivered PHC system, Commonwealth health ministers agreed in May 2023 to work together to monitor progress, share best practices practices and skills to strengthen primary health care for UHC. Some of the priorities include:
- A need to increase investment for the transformation of PHC services:
With one in six dollars spent on PHC – even in high-income countries – it is important that PHC services receive the financing they need to ensure adequate coverage.
- Using digital health to improve the delivery of PHC services:
With the accessibility, affordability and quality of health services fundamental to PHC, the safe and equitable use of digital health technologies can increase and improve the functionality of the health system.
- Investing in PHC-oriented resilient health systems: Often, PHC and pandemic preparedness are blamed, but by recognizing that these two efforts are interconnected, health systems can become more resilient. This includes ensuring that external and internal shocks and stressors and Patient-centered care is managed by a strong and integrated health infrastructure.
- Identify the basic roles of heath and care workers:
With the growing global shortage of health workers, it is important that countries invest in training, developing, recruiting and retaining a skilled health workforce.
Seizing the UHC momentum
The UN Political Declaration on UHC, as well as the Commonwealth’s commitments, are important steps forward in achieving our collective UHC goals. The newly adopted declaration recognizes equity at the core of UHC, and the need for bilateral, regional and multilateral coordination and cooperation to expand health coverage to all.
The Commonwealth Secretariat is on hand to support countries in achieving these global targets, including through these milestones and initiatives:
- The upcoming Commonwealth Heads of Government Meeting, to be chaired by Samoa in 2024, offers an opportunity for UHC to continue to raise and retain significant political support. The Commonwealth can continue to act as a leader in making significant commitments for further investment in UHC.
- The Commonwealth Secretariat is working to support countries in assessing the maturity of digital health systems and providing technical assistance to address gaps through its Technical Country Support Program on Enhancing Digital Health Maturity, a joint program of WHO. With this initiative and the recently launched Commonwealth Artificial Intelligence Consortium, the Commonwealth can use these initiatives for sustainable development and improve the efficiency of hospitals and health systems.
- Under the Technical Country Support Program on Building Health System Resilience, the Commonwealth, working in partnership with the WHO, will tailor a technical support package for countries to improve emergency preparedness and other key health functions in public.
With 2030 fast approaching, it is imperative that swift action be taken, backed by sustainable and significant investments, to ensure that our efforts are realized.