Countries can build on experiences and lessons learned since 1978
Washington, D.C., 3 March 2014 (PAHO/WHO) — The evolution of the concept of universal health coverage (UHC) since the 1978 call for "Health for all in the year 2000" was the subject of the third in a series of seminars on UHC sponsored by the Pan American Health Organization/World Health Organization (PAHO/WHO).
"Since that historic global health milestone until now, we have consolidated the idea of health as a right and primary care as a strategy for transforming health systems," said PAHO Assistant Director Francisco Becerra. "But our region presents its own characteristics and challenges that must be taken into account when we decide to advance toward universal coverage."
Like the Alma Ata call for "health for all" in 1978, the push for UHC today is fundamentally an ethical imperative rooted in the view of health as a human right.
"It is in essence a declaration of permanent ethical commitment of health systems to people's rights," said Jorge Jimenez de la Jara, Professor of Public Health at Pontifical Catholic University in Chile and former Minister of Health. He added that UHC represents "an opportunity to reactivate and relaunch knowledge gained and lessons learned" from countries' experiences in expanding access to care.
But unlike the Alma Ata target of health for all by the year 2000, UHC is "more a process than a goal," said Jordi Garces, holder of the Principe de Asturias Chair at Georgetown University. "We have to identify ways to make people's lives better."
Countries in the Americas have gained valuable experience in expanding access to health services for their populations since the late 1970s, said José Romero Teruel, Adjunct Professor of International Health at Georgetown University. Sharing those experiences and identifying key principles and effective practices can help countries advance toward sustainable universal coverage.
William McGreevey, Associate Professor in Georgetown University's Department of International Health, said that both Alma Ata and the Millennium Development Goals (MDGs) had set high expectations that had been partially though not completely met, with maternal mortality reductions being the most important unmet goal. He said governments of both low- and middle-income countries will have to find ways of increasing resources to support greater inclusiveness in health and that substantial external assistance will be needed for basic health care in many developing countries as they aim for universal coverage.
Panelists noted other major challenges to achieving universal health coverage including aging populations with growing needs for health care, and shortages of primary care doctors in nearly all countries. Overcoming these will require changes in medical education as well as innovation in the organization, management and financing of health systems, including the incorporation of new health technologies and integrated models of care.