Dear Colleagues! This is Asrar Qureshi’s Blog Post #1197 for Pharma Veterans. Pharma Veterans Blogs are published by Asrar Qureshi on its dedicated site https://pharmaveterans.com. Please email to pharmaveterans2017@gmail.com for publishing your contributions here.
Preamble
This 2-part blog post is based on WHO report on Universal Health Coverage (UHC) 2025. To access full report, use this link. https://www.who.int/publications/i/item/9789240117815
Part II – “What Must Happen Now: Translating UHC Commitments into Resilient, Equitable Health Systems”
The findings of the 2025 UHC monitoring report sound a clear alarm. For advocates, policymakers, global health bodies, and national governments; urgent action is required. But the challenge is not just technical or financial: it demands vision, strategy, and sustained political commitment.
Here’s a roadmap, informed by the report’s insights, for how to move from aspiration to action, and how to build health systems capable of achieving true universal health coverage.
Redefine UHC for the 21st Century: Beyond Infectious Diseases
The era of global health shaped predominantly by infectious diseases and maternal–child mortality is evolving. Non-communicable diseases (NCDs), mental health issues, injuries, and chronic conditions now contribute the largest share of morbidity and mortality, even in LMICs.
What needs to shift: UHC must expand its definition. Essential services should include:
- NCD screening and management (hypertension, diabetes, cardiovascular, cancer)
- Mental health care and substance-abuse treatment
- Rehabilitation, disability support, pain management, palliative care
- Health promotion, prevention, and chronic disease management — not only acute care
- Access to diagnostics, laboratory services, imaging, long-term medications, and follow-up care
This requires rethinking health-system design: workforce training, supply chains for chronic medications, long-term financing, and patient-centered care models.
Invest in Primary Health Care (PHC) as the Foundation of UHC
Strong primary health care (PHC) is critical. When PHC is well-resourced and accessible, it can manage a broad range of conditions — from infectious diseases to chronic conditions, maternal health to mental health — and serve as the backbone of universal access.
Key actions:
- Expand PHC infrastructure – build clinics, mobile health units, community health centers, especially in underserved rural or peri-urban regions.
- Train and deploy community health workers, nurses, general practitioners, and allied health staff, not just specialists concentrated in cities.
- Strengthen referral systems: ensure that PHC is linked with secondary and tertiary care for complex conditions, emergencies, or specialized treatments.
- Ensure PHC includes preventive services, screening, immunization, maternal–child health, chronic disease monitoring, counseling, mental health services, and health promotion.
By investing in PHC, countries can reduce inequities, lower long-term costs, and improve health outcomes across populations.
Ensure Financial Protection; Health Care Shouldn’t Cause Poverty
One of the core principles of UHC is that no one should suffer financial ruin because of health care. Yet the 2025 report shows many households, especially in low-income settings, still face catastrophic spending or forgo care entirely.
What is needed:
- Progressive public financing: governments should increase health budgets, prioritize equity, and subsidize care for the economically vulnerable.
- Prepayment and risk pooling: through national health insurance, social health insurance, community-based insurance, or other mechanisms, to spread cost, reduce out-of-pocket expenses, and protect households.
- Subsidies or free essential services/ medicines for the poor and marginalized, especially for chronic diseases, maternal health, and preventive care.
- Transparent, accountable supply chains for essential medicines, diagnostics, and equipment — to prevent stock-outs, price-gouging, corruption, and inequitable distribution.
Health care should be a right, not a luxury. Financial protection ensures that right is meaningful.
Prioritize Equity – Reaching the Marginalized, Vulnerable, and Underserved
National averages can mask deep inequalities. To realize UHC, health systems must close the gap, not just raise the average.
- Use disaggregated data (by income level, geography, gender, rural/urban, ethnicity, migrant status) to identify underserved groups.
- Target investments: build clinics, deploy community health workers, ensure transportation, outreach, and culturally appropriate services in rural, remote, or marginalized communities.
- Include mental health, chronic disease, disability, and rehabilitation services, which often disproportionately affect vulnerable populations.
- Engage communities: involve civil society, local leaders, patient groups in planning, monitoring, feedback to ensure services meet real needs and build trust.
Build Resilient, Climate-Aware, Crisis-Ready Health Systems
The 2025 report’s context, pandemic recovery, climate stress, economic instability, underscores that UHC systems must be resilient.
What resilience means:
- Surge capacity: health systems should be prepared for sudden shocks (pandemics, disasters), with flexible staffing, supply chain redundancy, emergency response plans.
- Environmental health integration: invest in clean water, sanitation, vector control, environmental surveillance — factors that impact disease burden, especially in climate-vulnerable regions.
- Digital health and telemedicine: leverage technology to reach remote populations, deliver preventive services, support chronic disease management, provide remote consultations — especially where physical infrastructure is weak.
- Data systems and monitoring: strong health information systems to capture service coverage, financial protection, health outcomes — enabling timely response, resource allocation, and accountability.
Invest in Human Resources for Health – The People Behind the Care
Health workers, from doctors to community health workers, are the heart of UHC. Without sufficient, well-trained, motivated staff, even the best infrastructure fails.
Needs include:
- Training and education: programs for generalists, nurses, mid-level providers, community health workers, allied health staff. Emphasis on multi-disciplinary, patient-centered care.
- Fair compensation, job security, career development, to attract and retain staff, especially in rural or underserved areas.
- Support, well-being, and safety, especially in crisis times (pandemics, disasters), and in regions facing high workload or risk.
- Policies to avoid “brain drain” from low- and middle-income countries to wealthier ones, through incentives, career trajectories, and improved working conditions domestically.
International Cooperation — UHC as a Global Commitment
Many low-income countries cannot achieve UHC alone; external support, global financing, technology transfer, supply-chain support, and global solidarity remain vital.
Global actions:
- Donor agencies, international financial institutions should prioritize health, funding PHC, infrastructure, capacity building, medicines, technology.
- Promote equitable licensing, manufacturing, and distribution of essential medicines, vaccines, diagnostics, especially for LMICs.
- Shared research on NCDs, global supply-chain resilience, climate-health interface, digital health innovations, to benefit all regions.
- Global frameworks to support universal access, especially for marginalized or conflict-affected populations.
Why This Matters for Policymakers, Civil Society, and Citizens
The 2025 UHC report is not just a technical assessment. It is a call to humanity, a reminder that health is not a commodity, but a basic human right.
For policymakers, it’s a document that demands attention beyond statistics. It asks: Are we building health systems that serve everyone, not just the wealthy, the urban, the visible?
For civil society: it is a tool to demand accountability, equity, transparency; to advocate for marginalized communities; to urge governments to commit resources, reform financing, and uphold the promise of access.
For citizens, it is a call to action; to care about public health beyond individual treatment; to support universal coverage, solidarity, and inclusive systems that safeguard collective well-being.
Sum Up
The 2025 global monitoring report confirms what many already suspected: we have made meaningful progress in universal health coverage, but we are far from where we need to be. The path ahead is steep, complex, and fraught with challenges, but also full of possibility.
Achieving UHC is no longer just about building more clinics or delivering more vaccines. It is about rethinking health systems for the modern world, inclusive of chronic disease, mental health, rehabilitation; resilient to crises and climate shocks; equitable and rights-based; grounded in strong primary care, financial protection, and social solidarity.
The next decade is critical. Without bold political will, sustained funding, and global cooperation, we risk leaving millions behind, reversing hard-won gains, and allowing inequities to deepen. But with committed action, we can move closer to the world envisioned when the UHC agenda was first set; a world where health is universal, not a privilege.
Concluded.
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