Picture of Kirsten PatrickKirsten Patrick is Deputy Editor at CMAJ


Today, 12/12/14, sees 533 partners in 103 countries participating in events to mark the first ever World Universal Health Coverage Day.

Supported by a grant from the Rockefeller Foundation,  12/12 marks the anniversary of the unanimous UN resolution, 2 years ago, that endorsed Universal Health Coverage as a priority for sustainable development.

The aim is to highlight the need to improve the effectiveness and accessibility of heath care worldwide. Why? As this (slightly UK-focused) video from the London School of Hygiene and Tropical Medicine elegantly illustrates, unequal access to health care between and within countries is associated with stark variations in life expectancy and health outcomes.

While some headway has been made on important health indicators with initiatives like the Millennium Development Goals (MDGs), it has become clearer that many health care disparities can’t be addressed properly without universal access to basic health care. Health care holes that are filled by donor funding or aid programs are inherently unstable and usually not sustainable. Countries really need help with developing the infrastructure needed for the delivery of health care to all, which includes training of sufficient qualified health care staff. Problems with weak health system infrastructure have been at the root of difficulties in three West African countries struggling to deal with the Ebola outbreak.

The barriers to building health care infrastructure in countries with weak, fragmented or two-tier health systems are many, and some research groups are doing great work to identify what it takes to fund and deliver universal health care coverage sustainably. The reality is that health is often too far down the agenda when a government decides on its priorities. Ministries of health often lack power at the negotiating table and can’t rally the sort of political will that is needed to get behind health-system-strengthening initiatives that everyone fears will come at a high cost (and not just a one-off cost).

The idea that everyone on the planet should enjoy access to adequate health care (without having to decline into poverty to pay for it) is at last gaining real traction. There are ‘poster countries’ (Rwanda and Thailand for example) that have achieved it at relatively low cost and have given hope to others. We live in a global village. Increasingly, the health of one affects the health of all. It’s time.