Making universal health coverage a realit

COVID-19 has dramatically exposed global weaknesses in healthcare systems, catalysing renewed calls to work and invest together to create a healthier – and truly equal – world for all

The most basic function of any society is to care for the well-being of its people – and the most fundamental aspect of every person’s life is their health. Without health, economic and social progress is simply not possible – for people and countries alike.

We need look no further than COVID-19 to see a living example of the clear link between the health of people and the health of countries and economies. The pandemic and the unprecedented measures to contain it vividly demonstrate how health challenges can quickly and dramatically affect nearly every aspect of a country’s socio-economic well-being.

The pandemic also exposes the world’s inability to provide basic health care to millions of people. It reveals the gulf between people who have ready access to health care – and to the many determinants of good health and disease prevention, such as sanitation, clean water and good nutrition – and those who do not.

When the G20 met last year in Osaka, UNICEF called on leaders to encourage all countries to invest in, finance and deliver quality, community-based, primary health care capable of reaching all people. We underscored the need to gather other partners around this critical need – businesses, healthcare providers, innovators, scientists and policymakers.

In 2020, we renew this global call.

The need is urgent. The barriers of poverty, inequality, distance, discrimination and humanitarian emergencies such as conflicts and natural disasters continue to deny millions access to even the most basic levels of health care.

This denial of primary health care – universally – is especially tragic when it affects the most vulnerable people of all: children.

Despite progress in child survival over the last two decades, every five seconds – the time it takes to read this sentence – one child or young adolescent died in 2019. Most of these deaths (85%) occurred in the first five years of life. Half occurred in the first month.

Most of these deaths are preventable. They occur because children lack proper nutrition or a vaccination. Because their mothers do not receive the care they need during childbirth, or give birth in unsanitary conditions where clean water is scarce.

Poverty kills

Most of all, these deaths occur due to poverty, inequality and under-development. Unequal distribution of power, money and resources condemns millions of people around the world to poor health and to low-quality – or non-existent – health services. In sub-Saharan Africa, one in 13 children dies before their fifth birthday. That’s 15 times higher than in high-income countries where the ratio is one in 199.

In short, millions of children die each year because health care is financially out of reach for their families, or because there are no systems to deliver these life-saving services where they live. Without universal access to quality health care for all people, any vision of a truly equal society will remain unrealised.

Now is the time to reimagine health care for every person and design systems that reach them, no matter where they live.

Now is the time to make our dream of universal health coverage a reality for every person.

In 2018, the Astana Declaration called on all countries to deliver on our promise of universal health coverage through better, more accessible community-based primary health care.

In our work with governments and civil society partners, UNICEF is working to build stronger primary health systems that can reliably deliver community-based services in all contexts, especially for the most vulnerable. In 2019, we invested more than 80% of our resources and staff in countries with the highest mortality and disease burdens to help governments improve delivery of vital healthcare services to every community.

Emergency contexts are particularly important – not only to reach people in their time of need, but also to help countries build health systems over the long term. In Afghanistan, many rural communities have no access to basic services such as vaccinations, sick-child care and antenatal screening. With the support of Japan and Korea, UNICEF is now strengthening primary care for more than one million women, children and newborns, through 70 mobile health teams linked to – and supplied by – local community health services.

Throughout, we remain focused on the many determinants of health and bringing together our programming to deliver a number of key interventions in one place, at the same time.

In Ethiopia, Nigeria and Burkina Faso, we are integrating screening for severe acute malnutrition into routine medical visits.

We are delivering packages of information on early childhood development and interventions such as nutrition screening and learning kits in health facilities where parents bring their children for routine vaccinations and check-ups.

And we are working with partners and governments to strengthen all of the systems that support good health – water, sanitation, hygiene, food, nutrition and social protections.

Bold investments required

Again, COVID-19 dramatically exposes weaknesses around the world. Communities without water and sanitation are critically disadvantaged when handwashing and sanitation are essential weapons in fighting the virus.

At a time when all health and health-related systems are stretched to breaking point because of COVID-19, UNICEF calls on world leaders to make bold investments in accessible health systems and the many systems that support them – to help defeat the pandemic in the short term, and to build the effective and accessible health systems that every community needs and deserves over the long term.

Help us give health the prominence and profile it deserves on the global agenda, not just in the halls of power and government, but in boardrooms and financial institutions. With media outlets. With digital information and communications technology companies. With scientists and innovators. And with industries and corporations, small and big. We need everybody to join us to make universal health coverage a reality in every country and every community.

By working together – and, most importantly, investing together – we can help ensure that all people, no matter who they are or where they live, have access to good quality and affordable health care.

Let’s work together for communities in need and take one more step towards a healthier and truly equal world for all.