The pandemic has highlighted the importance of leadership and a multi-sectoral approach – two of the key strengths L4UHC is fostering. But will governments heed the lessons and accelerate UHC’s roll-out?

“COVID-19 reinforces the importance of global health – diseases don’t respect frontiers – so we have to work together, even from a self-interested perspective,” says Professor Sophie Witter, Professor of International Health Financing and Health Systems at the Institute for Global Health and Development at Queen Margaret University in Edinburgh. “It also forces us to think about UHC in a broader way, in terms of the package of services. UHC is not just about personal curative care, although that is of course important, but also emergency preparedness, prevention, surveillance, vaccine and testing development and other public goods, including social protection’. 

“However, these are not always well financed by markets so states have to step in and organise and finance these goods. That was already known but COVID-19 brings this message home very directly.”

As an opinion piece in the British Medical Journal noted, “Those countries with effective universal health coverage, such as South Korea and Singapore, have performed better during the COVID-19 pandemic.”

Professor Ilona Kickbusch, of the Global Health Centre at the Graduate Institute for International and Development Studies, and Dr. Githinji Gitahi, Global CEO, AMREF Health Africa, added in a recent blog for the World Bank: “UHC and health crisis management are two sides of the same coin. We are not alone in this view. In recent years, G7 and G20 leaders have also promoted strong and resilient health systems as vital to making progress toward UHC and ensuring effective health crisis management.”

That clearly hasn’t happened in many countries, as the pandemic has demonstrated. But will COVID-19 provide the shock that is needed for governments to turn their words, and public commitments to UHC, into action?

 Viviane Hasselmann, Health Advisor at Switzerland’s Federal Department of Foreign Affairs, one of L4UHC’s core funders, is hopeful yet uncertain. “COVID-19 has highlighted the necessity to push for UHC, but I’m not sure governments will walk the talk,” she says. “UHC is a systemic endeavour for all health conditions and for all people but there’s a risk that they’ll reallocate budgets from other parts of the system for COVID-19, rather than reinforcing the entire system. 

“There’s also a risk that governments will respond very specifically, addressing only COVID-19 health consequences, rather than taking a multi-sectoral approach, which is needed. You have of course to respond to the immediate health emergency at the beginning, but in the medium and long term a coordinated, multi-sectoral approach is required. And that’s true of UHC in general, not just in terms of managing the virus. 

“Although the coronavirus can cause serious and even fatal illness in humans, it’s shown how public health crises like this one can have massive repercussions on other sectors. It’s highlighted how determinants of health outside the health system, such as nutrition, pollution and education, can influence our ability to respond effectively to health crises and to develop sustainably. And vice versa.

“There are signs that sectors are regrouping and working together, but will it last?  I hope so. It won’t avoid a new virus but it might reduce its negative impacts and its probability of transmission.

“There seems to be greater momentum behind UHC now,” she adds, “But we still have to work and push heavily for it.”

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