Universal Health Coverage Day 2015: Accountability for UHC to Leave No One Behind

Lara Brearley

Universal Health Coverage Consultant, Management Sciences for Health

This blog post originally appeared on Management Sciences for Health's Global Health Impact Blog.

December 12 marks the second annual global Universal Health Coverage (UHC) Day, and what a year it has been.

Through legal reform and new programs, many countries—like Burkina Faso and Iran—have made important progress on the path to UHC. The Sustainable Development Goals (SDGs) announced in September reinforced the world's commitment to UHC; the third SDG calls for "good health and well-being" and includes a target of achieving universal health coverage.

Now that goals and targets have been set, indicators to track progress are being agreed upon, and we must focus on the implementation, monitoring and accountability of these goals. Accountability—encompassing the interconnected functions of monitoring, review, and remedial action—is imperative to guiding implementation and accelerating progress across the SDGs.

Today we are launching a public consultation on accountability for UHC, calling for feedback on an options paper with proposals for key components of an accountability framework. We welcome your expertise, experience, and ideas to develop this thinking.

UHC is fundamental to the right to health, which governments are obliged to fulfill. It is an inherently political agenda, pertaining to the redistribution of resources in society. And it is countries' policy choices made along the path to UHC that will determine whether those most in need will benefit first from efforts to expand coverage.

While there is no blueprint for how countries should progress towards UHC, implementation should be consistent with guiding principles—such as progressive universalism, shared responsibility, and participatory decision-making—in order to advance the right to health and fulfill the promise to leave no one behind. Accountability mechanisms throughout implementation are crucial to ensuring adherence to these principles and to prompt course correction when necessary.

UHC can also provide a more integrated and coherent framework for accountability across the health goal, encouraging integrated, people-centred approaches. This is why Management Sciences for Health is working to strengthen accountability mechanisms for UHC at local, national, regional and global levels, with the support of the Rockefeller Foundation.

In recent months, we have been conducting informal consultations on the topic of accountability for UHC. We organized a brainstorming meeting with key stakeholders in New York during the UN General Assembly, co-hosted by the Rockefeller Foundation, WHO, the World Bank, USAID, the government of Japan, and Save the Children. Meeting participants agreed on next steps, which included the development of an options paper for wider consideration. We have also facilitated discussions at related events, including at a WHO and World Bank meeting on the measurement of UHC, and at a meeting to discuss harmonizing civil society advocacy on health systems strengthening and the health goal in the SDGs.

Let's work together to prevent UHC from becoming yet another silo and a failed promise to the world's most vulnerable populations. With strong systems for accountability, we hope to celebrate equitable and accelerated progress next UHC Day and in the years to come.