The Right(s) Road to Universal Health Coverage

Abstract

The political momentum around universal health coverage (UHC) provides a welcome opportunity to scale up efforts to dismantle barriers to accessing health services and to create enabling environments for people to thrive and be healthy. However, UHC lacks sufficient clarity, both conceptually and operationally, to generate the societal transformation required to ensure its successful implementation in countries. This article argues that both the messaging and the monitoring and implementation guidance around UHC are ambiguous and flawed from a human rights perspective. To leverage the reforms necessary to achieve UHC, human rights norms and principles need to signpost the direction ahead, and human rights mechanisms need to be involved to enhance the accountability of those United Nations member states that choose to "take a wrong turn." The article argues that a human rights-based approach to programming offers a practical methodological framework for designing and implementing UHC at the national level. It concludes by illustrating five key areas in which it is critical to invoke human rights as the foundation for UHC and for which consistent, authoritative, and practical guidance is needed to support countries in getting onto the right(s) road to UHC.

Figure 1

Normative scope and content of the right to health Source: Office of the United Nations High Commissioner for Human Rights and World Health Organization, The right to health: Fact sheet no. 31 (June 2008). Available at http://www.ohchr.org/Documents/Publications/Factsheet31.pdf.

Figure 2

The three dimensions (policy choices) of UHC Source: World Health Organization, Universal coverage: Three dimensions. Available at http://www.who.int/health_financing/strategy/dimensions/en.