View Point Public health, universal health coverage, and Sustainable Development Goals: can they coexist?

Harald Schmidt, Lawrence O Gostin, Ezekiel J Emanuel

The Lancet, S0140-6736(15)60244-6
Published online: 29 June 2015


In her 2012 reconfirmation speech as WHO Director-General, Dr Margaret Chan asserted: “universal coverage is the single most powerful concept that public health has to offer. It is our ticket to greater efficiency and better quality. It is our saviour from the crushing weight of chronic noncommunicable diseases that now engulf the globe”. The UN General  Assembly is currently considering proposals for Sustainable Development Goals (SDGs), succeeding the Millennium Development Goals. SDG 3, focusing on health, specifically includes universal health coverage (UHC) among its targets. Unquestionably, UHC is timely and fundamentally important.3–5 However, its promotion also entails substantial risks. A narrow focus on UHC could emphasise expansion of access to health-care services over equitable improvement of health outcomes through action across all relevant sectors—especially public health interventions, needed to effectively address non-communicable diseases (NCDs). WHO first endorsed UHC in its 2005 resolution on sustainable health financing, calling on states to provide “access to [necessary] promotive, preventive, curative and rehabilitative health interventions for all at an affordable cost”. The resolution and its UHC concept firmly and narrowly centre on health insurance packages financed through pre-payment. This narrow understanding is echoed in major recent reviews of 65 empirical studies on UHC progress…

KeywordsPalabras clave:

Sustainable Development Goals; Universal Health Coverage; Public Health; Global Health.

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