Universal health

Universal access to health and universal health coverage imply that all people and communities have access, without any kind of discrimination, to comprehensive, appropriate and timely, quality health services determined at the national level according to needs, as well as access to safe, effective, and affordable quality medicines, while ensuring that the use of such services does not expose users to financial difficulties, especially groups in conditions of vulnerability. Universal access to health and universal health coverage require determining and implementing policies and actions with a multisectoral approach to address the social determinants of health and promote a society-wide commitment to fostering health and well-being. The right to health is the core value of universal health coverage, to be promoted and protected without distinction of age, ethnic group, race, sex, gender, sexual orientation, language, religion, political or other opinions, national or social origin, economic position, birth, or any other status.

Key facts
  • In the Region of the Americas, millions of people lack access to comprehensive health services required to live a healthy life and to prevent disease, as well as, to receive the health services they need when they are sick, including palliative care in the terminal phase of disease.

  • The segmentation and fragmentation observed in the majority of health systems in the Region result in inequity and inefficiency that compromises universal access, quality, and financing.

  • In 11 countries of the Region, there is an absolute deficit of health workers (less than 25 physicians, nurses, and certified midwives per 10,000 population)

  • A lack of adequate financing and inefficient use of available resources are major challenges in moving towards universal access to health and universal health coverage. While the average public expenditure on health in the countries of the Organization for Economic Cooperation and Development (OECD) was 8% of GDP in 2011, public expenditure on health in Latin American and Caribbean countries stood at only 3.8% of GDP.

Fact sheet

Access to and rational use of safe, effective, quality medicines and other health technologies, as well as respect for traditional medicine, continue to present challenges for most of the countries of the Region, affecting quality of care. Supply problems, the underuse of quality generic drugs, weak regulatory systems, inadequate procurement and supply management systems, taxes on medicines, higher than expected drug prices, and the inappropriate and ineffective use of medicines and other health technologies are additional challenges to achieving universal health coverage. Regulatory capacity for medicines and health technologies, although improving Region-wide, remains a challenge, in particular for newer and more complex health technologies.

What PAHO does

Despite the advances made the Region remains one of the most inequitable in the world. The process of reducing health inequities is made more complex by the new epidemiological and demographic patterns that require different and innovative responses from health systems and services; and that problems of exclusion and lack of access to quality services persist for large sectors of the population in the Region, especially those groups in conditions of greatest vulnerability. Recognizing that there are many ways to achieve universal access to health and universal health coverage and that each country will need to establish its own action plan, taking into account its social, economic, political, legal, historical, and cultural context, as well as its priorities and current and future health challenges, the proposed strategic lines are intended for use by the Member States

  1. Expanding equitable access to comprehensive, quality, people- and community-centered health services.

  2. Strengthening stewardship and governance.

  3. Increasing and improving financing, with equity and efficiency, and advancing toward the elimination of direct payments that constitute a barrier to access at the point of service.

  4. Strengthening multisectoral coordination to address the social determinants of health that ensure the sustainability of universal coverage.

Mandates and strategies

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