WHO Director-General addresses ministerial forum on universal health coverage

Dr Margaret Chan
Director-General of the World Health Organization

Welcoming remarks at a High-level Ministerial Forum on Sustainable and Equitable Growth through Universal Health Coverage
Tokyo, Japan

6 December 2013

Excellencies, distinguished ministers, representatives of development partners and civil society, ladies and gentlemen,

Welcome to this high-level ministerial forum on universal health coverage (UHC). We are looking at UHC as an instrument for sustainable and equitable economic growth.

Mounting evidence tells us that investments in health, especially when they aim for universal access to quality services, contribute to poverty alleviation and shared prosperity among nations.

I thank the Government of Japan and the World Bank for organizing this event. It is an outgrowth of a unique and fruitful collaboration, the Japan-World Bank Partnership for Universal Health Coverage.

The partnership has supported case studies of health reforms in several countries, emphasizing health financing, human resources for health, and the links between health and the wider economy.

Yesterday, you heard about experiences in ten of these countries, representing a wide diversity of settings. Today, we will focus on extracting lessons from those experiences.

There is no universal route to UHC. But experiences from one country can be highly instructive for others facing similar challenges with similar ambitions. Country experiences also yield an impressive range of policy options, reinforcing evidence and arguments set out in the 2010 "World health report" on health system financing.

You will hear about the work and views of development partners and civil society, another vocal and articulate partner in supporting UHC. I thank civil society organizations for their recent and compelling call to action on UHC.

Japan is likely the best possible host for this event. Japan was an early achiever. This country established an effective guarantee of universal service coverage, with financial protection, in 1961, giving virtually everyone access to preventive, curative, and rehabilitative services at an affordable cost.

That achievement was part of a deliberate effort to foster social cohesion and human security. In Japan, everyone is required by law to have health insurance, and fees are strictly regulated by the government to keep them affordable.

UHC is not cheap, but it is affordable when the right policies are in place. Again, Japan provides an excellent example. Government per capita spending on health in Japan is lower than average among OECD countries and about half of what the US spends.

At a time when health costs are soaring in many countries, Japan’s tight regulation of the health industry has kept costs in check. A recent study summarized Japan’s health system well: “good health at low cost with equity”. This is a truly commendable achievement

I thank His Excellency, Prime Minister Shinzo Abe, for his Lancet commentary with its strong support for UHC as a post-2015 strategy. His articulation of three global health challenges that can be met through UHC makes compelling good sense. This is the kind of high-level commitment that can lead the world in the right direction.

The World Bank is an equally valued partner, also for WHO. We are working hand-in-hand and shoulder-to-shoulder to extend technical and financial advice to the growing number of countries that have made UHC the goal for health system reforms. We have jointly held consultations with ministries of health and finance, and we have jointly conducted training courses in countries.

This close partnership between WHO and the World Bank sends a strong signal that UHC is financially feasible and makes good economic sense. Health officials are always encouraged to know we are working together, and I suspect this collaboration gives weight to arguments when they approach their ministers of finance.

We have good reason to anticipate that UHC will have a firm place on the post-2015 development agenda. Today, you will hear a status report on what WHO and the World Bank are doing to establish a framework and indicators for measuring progress towards UHC.

Monitoring progress towards UHC means monitoring social equity and fairness in the distribution of benefits. In fact, UHC is the ultimate expression of fairness. People who cannot afford to pay for health care are not left to stay sick or die.

Again, a very warm welcome to all of you. The outcome of this unique Japan-World Bank partnership, and the diversity of experiences within countries, will help guide the way forward as we move towards the post-2015 development agenda.

Thank you.