Nigeria: Adeniran, 54 years old, receives regular care at a medical center in Lekki, Lagos. WHO/Andrew Esiebo

Why the UN Is Making the Case for Universal Health Coverage

Amid a global pandemic, achieving universal health coverage may seem like an ambition for a later time. But in a new report released today, UN Secretary-General Antonio Guterres argues that universal health coverage would accelerate the end of the pandemic, get our economies up and running again and prevent a pandemic of this scale and impact from occurring again in the future.

The report, which is the latest in a series of policy briefs the Secretary-General has published since spring in response to the pandemic, defines universal health coverage as “a situation where all individuals and communities receive the health services they need without undue financial hardship.” It is a critical tool for guaranteeing that everyone’s fundamental human right to health is being respected. But even before the pandemic, at least half of the global population didn’t have full coverage of essential health services, according to the report, and more than 800 million people spend at least 10 percent of their household budget on health care.

This means that every year, more than 100 million people are pushed into extreme poverty just by paying for health services, according to 2017 estimates by the World Bank and World Health Organization (WHO).

Now the pandemic has exposed the inadequacies and inequalities of health systems around the world, as people – especially those whose incomes have been affected – have had less access to health services at a time when they’ve needed it the most. It’s also “reinforced existing evidence” that while investing in health has immense long-term benefits, not investing enough can have “devastating” social and economic impacts on the world that can last for years. Since the pandemic broke out, it has cost the global economy 500 million jobs and $375 billion a month, according to the UN, and for the first time since 1990, human development has regressed.

“The world has been really ill-prepared to cope with a global pandemic of this scale,” a senior UN official said in a press briefing Tuesday.

However, if every country has universal health coverage, the report says that they could “more effectively and efficiently address” how not only the virus itself is causing illness and death, but also how the socioeconomic fallout and the disruption of essential health services are doing so as well. Specifically, universal health coverage means that COVID-19 testing, isolating, contact tracing and care would be available to everyone, and they shouldn’t have to worry about the fees.

It also means fully funding efforts like the Access to COVID-19 Tools (ACT) Accelerator, which is a global collaboration to speed up the development and production of COVID-19 tests, treatments and vaccines and make them available to everyone everywhere affordably. This is the “fastest way to end the pandemic,” according to the senior UN official. The ACT-Accelerator still needs $35 billion.

Additionally, everyone should still have affordable access to essential health services during the pandemic to make sure that other issues like malaria, maternal mortality and child wasting do not become compound crises. Mental health services are particularly important right now and should be considered essential. One study of hospital patients in Wuhan, China, found that more than 34 percent of people experienced symptoms of anxiety, while 28 percent experienced symptoms of depression.

Of course, implementing pandemic preparedness measures, like a standardized outbreak alert system, is a critical component to the global response that cannot be overlooked. But the report says that the approach must be inclusive and collaborative, bringing together national governments, local communities, affected and vulnerable populations, civil society, the private sector and global investments in order to strengthen national health systems and achieve universal health coverage.

Pre-COVID-19, the UN estimated that just achieving universal primary health coverage would cost an additional $200 billion annually – and would save 60 million lives. If coverage includes broader, more comprehensive services like mental health, it would require another $170 billion annually. Again, those estimates are from before the pandemic. Now, those figures are likely higher.

National governments may shudder at those estimates, especially since most universal health coverage efforts will rely on domestic resources, but “this type of investment pales in comparison to what the pandemic is costing the global economy,” the UN official said. Since COVID-19 has made it clear that an unhealthy society cannot run a productive economy, national leaders shouldn’t look at investments in universal health coverage as a cost, but rather as “critical enablers to getting the economy back up and running,” she said.