By Daniel Mora-Brito
Universal health coverage (UHC) is based on the principle that individuals and communities have the right to access comprehensive and good quality health services without experiencing financial hardship. Given the rights-based approach that lies at the core of this concept, UHC has become pivotal to achieving the ambitious Sustainable Development Goals (SDGs) agenda. It calls for partnerships among multiple stakeholders in a concerted and coordinated approach—a call to work together despite potentially conflicting governance structures, expertise, primary interests and resources—moved by the common value of making the world a healthier and safer place.
At this year’s 10th Anniversary World Health Summit (WHS) in Berlin, topics covered antimicrobial resistance, digital health, health systems strengthening, and access to essential medicines, all coalescing around the theme of UHC. This year’s summit also overlapped with a parallel convening, the Grand Challenges Annual Meeting hosted by the Bill & Melinda Gates Foundation, which aimed at accelerating the transition of innovation to impact in addressing many of the world’s most pressing global health and development issues.
Innovative tools to meet the challenges of global health: At the Grand Challenges Annual Meeting there was a great sense of optimism with the presentation of new tools to tackle public health challenges through the potential development of personalized medicines.
Innovations in the way healthcare and services are delivered to reach those who need them most: Technology has the power to change the way health services and care are delivered with higher efficiencies and reduced costs, greater access (like closing the rural-urban divide with clinical expertise through telemedicine), and improved quality of care (for example, through smart algorithms to guide clinicians or frontline community health workers with recommended courses of action based on patient risk factors). Innovations to bring healthcare and services closer to those who need it will accelerate UHC.
Innovation in the way the international community works together: Several partners attending the WHS came together to commit to new ways of working, including through the launch of the Principles of Donor Alignment for Digital Health. The principles outline ten commitments of donors to align their investments to country digital health strategies that support national health plans, thereby encouraging integration and reducing duplication and redundancies. While many stakeholders agreed on the need to support health systems through greater digital health investments, uncoordinated interventions brought about a high degree of fragmentation and lack of operational interoperability. These principles, then, provide a framework for more coherent and harmonized action.
The WHS also saw the launch of a new commitment by health-focused multilateral organizations, the Global Action Plan for Healthy Lives and Wellbeing for All. This collective endeavor, also known as the SDG 3 Action Plan, gathers GAVI, the Global Financing Facility, The Global Fund, UNDP, UNFPA, UNICEF, UNITAD, UNWomen, the World Bank, and WHO (with many other organizations continuing to join) to align financing and resource mobilization, enhance shared accountability, and bring together resources, expertise and reach on cross-cutting issues, both in development and fragile environments.
Both the Principles of Donor Alignment for Digital Health and the Global Action Plan for Healthy Lives and Wellbeing represent solid steps toward greater coordination and integration for the successful achievement of UHC. And while complete integration is not the goal, the convergence of foundations, governments, the private sector, multilateral organizations and other international actors is paramount for achieving the SDGs and leaving no one behind.
When it comes to stronger partnerships and more coherent and effective ways of working, some of WHS discussions provided interesting insights on the tools and mechanisms that will be needed to successfully achieve UHC. As per the reflections of many guests, transitioning from an aspirational to an actionable stage could be accomplished by, for example, by doing the following:
- pooling resources, harnessing the power of multi-donor trust funds, mobilizing domestic resources, and exploring innovative financing tools;
- achieving more efficiency in health service provision by connecting public and private actors (insurance companies, the pharmaceutical industry, diagnostics technologies/labs, suppliers, clinics, hospitals and governments) through better data, more streamlined governance structures, and a greater commitment to quality;
- building health systems that focus on prevention;
- prioritizing health in political and electoral agendas as the foundation of productive societies;
- focusing multi-sectoral partnerships on vulnerable populations and a health service continuum, and not diseases; and
- promoting a structured marketplace that ensures profitability for private initiatives—including innovation—while providing access to health services and products.
As Peter Sands, Executive Director of The Global Fund to Fight AIDS, Tuberculosis and Malaria, would argue, the world needs to advance the universal health agenda with a true and honest sense of global solidarity. The arguments that favor an international health agenda solely based on fragmented or vertical service delivery models, Sands said, are not only ignoring numerous system-wide interdependencies, but also supporting the misleading premise that unilateral action can drive real solutions forward. This is the context—fragmented, with powerful forces pushing and pulling in all directions—in which trust and coherent action becomes the intangible but indispensable ingredient that global health needs to thrive.
The global health community must act with urgency to operationalize partnerships that render concrete, measurable and impactful results based on the shared conviction that collaboration is key to any effective collective endeavors. As WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, and business leader and philanthropist, Bill Gates expressed in the joint keynote session of the Summit and Grand Challenges Annual Meeting, the international community must reflect deeply on how to reduce the gap between innovative products and access to users. The litmus test is, then, the ability of all stakeholders to sit around the table and collaborate under a “coopetition” framework that generates mutually beneficial results and serves as a catalyst for the achievement of truly universal health coverage.
The World Health Summit takes place in Berlin each year, bringing together policy- and decision-makers, multilateral organizations, civil society representatives, scholars and business leaders from around the world to catalyze open dialogue and collaboration around issues of critical importance to the future of global health.