WHO Director-General addresses conference on universal health coverage
Dr Margaret Chan
Director-General of the World Health Organization
Professor Takemi, distinguished participants and guests, ladies and gentlemen,
I thank the Japanese government for hosting this event. Japan is a most appropriate venue. This country has long promoted universal health coverage as part of its strategy for global health diplomacy. The strategy will again receive prominence when Japan hosts next year’s G7 summit and the sixth Tokyo International conference on African development.
As the year comes to an end, we face an important moment in history. After decades of neglect, the world is finally focused on the need for equitable, inclusive, and resilient health systems that can withstand shocks, whether these are caused by a changing climate, a natural disaster, or a runaway virus.
I thank Prime Minister Abe for his 12 December Lancet commentary, which underscored the importance of health for human security and a peaceful world.
The Ebola outbreak in West Africa dramatically demonstrated what can happen when a lethal virus gains a foothold in countries with fragile health systems. The absence of a sensitive surveillance system, with laboratory support, allowed the virus to circulate, undetected, off every radar screen, for three months.
The failure to provide basic health services fed public preference for care from traditional healers, which contributed to the exponential increase in cases.
The first core capacity set out in the International Health Regulations is an ability “to detect events involving disease or death above levels for the particular time and place in all areas within the territory”.
Guinea, Liberia, and Sierra Leone had programmes for HIV, tuberculosis, malaria, maternal and child health, and the neglected tropical diseases, but they did not have this core capacity to prevent, detect, and respond to an unusual disease event.
In a Lancet commentary in 2013, Prime Minister Abe referred to what he called the “glorious” era of the MDGs, but added an important warning. As he wrote, “If the world follows the existing disease-focused vertical pathway for development assistance in the coming years, the disparity between resource allocation and actual disease burdens will widen.”
Fortunately, the world changed course.
The inclusion of universal health coverage as a target under the health goal for sustainable development expresses the very spirit of the new agenda, with its emphasis on poverty alleviation, equity, and social inclusion that leaves no one behind.
UHC, based on primary health care, serves the health goal well as a unifying concept, a platform for the integrated delivery of health services, and one of the most powerful social equalizers among all policy options. It is the ultimate expression of fairness. People who cannot pay for health care are not left to stay sick, get sicker, or die of a preventable or treatable condition.
It contributes to efficiency. Schemes for financial protection encourage people to seek care early, when the prospects of successful treatment are greater and the costs much lower.
UHC is a desirable outcome in its own right, a foundation for reaching other health goals, and a reliable measure of how well sustainable development is progressing. On that, let me welcome the Bill and Melinda Gates initiative on Vital signs performance indicators, which has stimulated discussion on data systems and primary health care.
In short, UHC is a pro-poor strategy for sustainable development that has great and growing appeal.
Since 2010, more than 100 countries have approached WHO seeking support in moving their health systems towards UHC. This likewise tells us that UHC is the most powerful concept that public health has to offer.
Ladies and gentlemen,
The challenge now before us is implementation, as you will be exploring during this conference. UHC cannot provide access to all health services. Resources in every country fall short of what is required to meet all needs, especially as the costs of new medicines and technologies continue to rise. In other words, priorities must be set and choices must be made.
Making fair choices is challenging, but fully worth the effort. The evidence is now overwhelming. Providing quality health services free at the point of delivery helps end poverty, boosts economic growth, and saves lives.
I wish you every success during a conference that is certain to be uplifting. The political will to achieve UHC is there. It is our job to illuminate the pathway to that goal.