Solidarity Message from African Health Economics & Policy Association (AfHEA) on the occasion of Universal Health Coverage (UHC) Day, 12. 12. 2021

Every year on December 12, the world celebrates Universal Health Coverage (UHC) Day. The commemoration of the UHC Day is with the aim of raising awareness and reminding all of us about the need to work for stronger and resilient health systems and to ensure the provision of quality, affordable health services for all; ultimately without people facing financial hardships as a result.

In other words, the tenet behind UHC: ‘HealthForAll’, calls for access to equitable and quality health care services for all people irrespective of financial status, gender, environment and location. To achieve this agenda, we must work together to achieve viable investments in our health systems that will “Leave No One’s Health Behind”.  This is necessary because investment in health is the cornerstone for our collective progress towards achieving UHC. We must therefore endeavor to support the building of resilient health systems that are capable of meeting everyone’s needs.

The Covid-19 pandemic presents an even greater challenge to the world in its drive for UHC. Its impact on health and economies has been severe in the past 2 years and it threatens to further exacerbate existing inequalities. The pandemic has provided the litmus test of the resilience of our health systems and their ability to withstand shocks and offer populations the needed quality care without their experience of financial hardships. Obviously, many countries around the world are far from fully achieving UHC, yet the momentum for UHC must not be lost to the Covid-19 pandemic, irrespective of how daunting the challenge may be at the moment.

We at AfHEA have long committed to the UHC drive in Africa and have been at the forefront of promoting and supporting UHC activities, interventions and programs in the African continent. Our work around UHC pre-dates the sustainable development goals (SDGs) of which UHC is one of the major goals. Since 2012, AfHEA has supported the UHC drive in Africa through various programs and activities among which are:

• Training policy makers in both Francophone West Africa and Anglophone West Africa on the principles of UHC and implementation modalities
• Providing technical support to governments of Ghana and Nigeria on health insurance which are key components of the UHC agenda of these countries
• Providing technical support to the government of Ghana in the review of the National Health Insurance Scheme between 2015 and 2016
• Convening scientific conferences to stimulate debate and discussion on UHC and key global health topical issues.

AfHEA’s scientific conferences since 2011 have their themes centered on the global development goals and UHC, primary health care (PHC) and UHC as well as the Covid-19 pandemic and health systems resilience. Our conferences have become an important platform for stimulating debate and discussion around key global health topical issues. We have used this platform not only to stimulate debate and discussion around the key global health topical issues but also to promote the interaction between policy makers and researchers and increase the uptake of research findings into policies. Specifically, the themes for our scientific conference have been:

Our upcoming scientific conference, which will be the sixth, will take place virtually from 7 – 11 March 2022. The theme for this conference is “Towards Resilient Health Systems in Africa: The Role of Health Economics and Policy Research”. This of course, will once again provide the platform for researchers and policy makers to brainstorm and discuss ways to make our health systems resilient and equitable in support of the UHC agenda.

Since the Alma-Ata declaration in 1978, there has been global efforts to strive for access to equitable quality health services. Yet, the HealthForAll, goal is far from being achieved despite some significant progress. There have been improvements in access to, and the quality of, health-care services and these have resulted in improved health outcomes. For example, life expectancy increased globally from 62.19 years since the Alma-Ata Declaration of 1978 to 72.56 years in 2019. Despite the significant progress made in the HealthForAll agenda and for that matter UHC, equity financial barriers remain major challenges today. Evidence suggest that more than half of the world’s population lack full access to essential health services, because they are unaffordable, inadequate, inaccessible or unavailable to certain population groups.

Despite the improved health outcomes, there is increasing inequity around the world. Life expectancy in the poorest countries of the world is comparatively far lower than in the wealthiest countries, and living in areas shattered by poverty can mean a shorter life span and a lost hope. The inequities and disparities occur across and within countries, with the most vulnerable, marginalized communities being left behind in the HealthForAll agenda, which defeats the UHC principles that many countries around the world have committed to.

Making progress towards UHC means making progress towards equity, inclusion and social justice. Progress to UHC requires health care service delivery that is people-centered, human rights-based and community-led, as well as with a recognition of the need to address the social determinants of health, including relevant health reforms and policies. It requires the removal of all barriers to accessing needed care irrespective of gender, income, location or any other characteristics and requires significant investments in health. Progress towards UHC require efforts at reducing out-of-pocket (OOPs) health expenditures especially in countries where OOPs exceed the acceptable threshold. Given the impoverishing effects of OOPs, public health expenditure remains the only viable option for countries to make meaningful progress towards achieving their UHC targets.

AfHEA therefore, wishes to call on governments across the world to rise up and mobilize public resources towards funding UHC for all their populations. This way the true meaning of HealthForAll and “Leave No One’s Health Behind” would be fully realized. There is no better time than now.

12. 12. 2021

African Health Economics & Policy Association (AfHEA)