By Herb Riband
Interim Director, Access Accelerated
Last month’s endorsement of the second UN political declaration on Universal Health Coverage (UHC) at the 2023 UN High-Level meeting (UN HLM) on UHC comes at a pivotal moment. This political declaration, coupled with the stark findings of the 2023 Universal Health Coverage (UHC) Global Monitoring Report by the World Health Organization (WHO) and the World Bank, converged to send a clear and compelling message: global progress towards UHC has stagnated over the past years, and UHC is not advancing as it should, including in low- and middle-income countries (LMICs).
Aging populations, COVID-19 and its aftermath, and a succession of global crises have resulted in stalled service coverage and a decline in financial protection for people seeking essential, life-saving care. At the center of these challenges is the continuing surge in noncommunicable diseases (NCDs), which can no longer be overlooked as a critical component of achieving UHC.
The state of Universal Health Coverage
Launched ahead of the UN HLM on UHC, the 2023 Universal Health Coverage (UHC) Global Monitoring Report presents a sobering overview of the faltering global progress in health service coverage (SDG 3.8.1) and financial protection (SDG 3.8.2). In 2021, over 4.5 billion people – more than half the world’s population – lacked full coverage for essential health services. People living with NCDs remain underserved, with almost negligible increases (1% or less) in NCD service coverage prior to 2015, and little or no improvements observed from 2019 to 2021.
At the same time, around 1 billion people experienced catastrophic out-of-pocket health expenses, with low-income families most vulnerable to being pushed into poverty as a result. When people are denied the right to quality, essential health services, we harm the health of individuals, destabilize communities, and impede economic development. The need for global and local leadership and meaningful change has never been clearer.
Renewed commitment to UHC
The second UN political declaration, “Universal Health coverage: expanding our ambition for health and well-being in a post-COVID world”, acknowledges the inadequacies and challenges faced so far, including the shortfall in health financing and the scant progress towards addressing NCDs. To regain lost momentum, this declaration sets out several renewed commitments to achieve health for all by 2030, including primary healthcare strengthening and ensuring sufficient, sustainable investments for better health.
Unlocking financing to build resilient health systems and protect individuals from increased out-of-pocket spending is critical. Last month’s round-table discussion on the margins of the UN General Assembly (UNGA) hosted by Access Accelerated, the NCD Alliance, World Bank, and the World Diabetes Foundation, in cooperation with the WHO, served as a vital platform to share examples of best practices and learnings. The discussions confirmed a collective resolve among participating policy makers, companies, and civil society organizations: stepping up financing for NCDs is indispensable for making headway toward achieving UHC.
A strategic partnership catalyzing health financing
Collective action by governments, development partners, funders, healthcare professionals, patient advocacy groups and private sector organizations has never been more important. Since 2017, Access Accelerated has partnered with the World Bank and other strategic partners to support countries and their ministries of health and finance to address ways to improve access to quality NCD care.
Our approach is centered on catalyzing additional investments in NCD care, as part of UHC. From 2020 to 2022, Access Accelerated worked with strategic partners to leverage an additional USD3.7 billion in investments into NCD programs and projects, including 30 UHC-focused projects. We have been pleased to see that this type of approach creates positive “ripple effects” that benefit entire health systems, and ultimately the communities and individuals they serve.
The path forward
Looking ahead to the second WHO global dialogue on financing national NCD responses in summer 2024, and the fourth UN High Level Meeting on the Prevention and Control of NCDs in September 2025, we have a window of opportunity to translate recent commitments into impactful action on NCD and UHC financing. Our collective ability to act decisively and invest now will improve the health and economic future of billions of people. There is much work to be done, but the imperative to build quality NCD care as part of UHC is clear. The need for action and investment is now.