Lancet: Universal Health Coverage – Editorial, Commrent, Series

The Lancet  
Sep 08, 2012  Volume 380  Number 9845  p859 – 948
http://www.thelancet.com/journals/lancet/issue/current

Editorial
The struggle for universal health coverage
The Lancet
Preview
Certain concepts resonate so naturally with the innate sense of dignity and justice within the hearts of men and women that they seem an insuppressible right. That health care should be accessible to all is surely one such concept. Yet in the past, this notion has struggled against barriers of self-interest and poor understanding. Building on several previous Lancet Series that have examined health and health systems in Mexico, China, India, southeast Asia, Brazil, and Japan, today we try to challenge those barriers with a collection of papers that make the ethical, political, economic, and health arguments in favour of universal health coverage (UHC), and which will be presented in New York on Sept 26, to coincide with the UN General Assembly.

Comment
Universal health coverage: the third global health transition?
Judith Rodin, David de Ferranti

Universal health coverage: good health, good economics
Julio Frenk, David de Ferranti

Universal health coverage is a development issue
David B Evans, Robert Marten, Carissa Etienne

Profile
Margaret Chan: committed to universal health coverage
David Holmes
Extract
Margaret Chan is a woman who needs little introduction. As WHO Director-General, her face is a fixture on news bulletins whenever there is a serious disease outbreak, drug safety issue, or food scare. But it was the less sensational—although some would argue more important—work that Chan and WHO are doing to promote universal health coverage that she was keen to talk about when she spoke to The Lancet.

Universal health coverage is, Chan says, “part of her DNA”, and has become an important part of WHO’s agenda under her stewardship. After her appointment for a second 5-year term as Director-General in May this year, Chan used her speech to the World Health Assembly to issue a stern rebuke to those “bitter observers” who say that the financial crisis “derailed the best chance ever to alleviate poverty and give this lopsided world greater fairness and balance”. Instead, Chan argued that “the best days for health are ahead of us, not behind us”, in large part because of the critical momentum that has built behind the move towards universal health coverage.

The launch in 2010 of WHO’s Health Systems Financing: the Path to Universal Coverage led to “more than 60 middle-income and low-income countries requesting technical assistance and advice to move towards universal health coverage”, Chan told The Lancet. She points to the “amazing achievement” of Mexico as a measure of what progress can be made. Universal health coverage is, Chan says, “the most powerful unifying single concept that public health has to offer, because you can realise the dream and the aspiration of health for every person irrespective of what class you belong to, whether you are a woman, or whether you are poor”.

Chan’s commitment to universal health coverage has been shaped by personal experience. Born in 1947 and brought up in Hong Kong under British rule, Chan says she “benefited from a similar system to the National Health Service in the UK”. Her mother, she says, was very “liberal minded”, and always told her to “follow her heart”, but it was following her “childhood sweetheart” (now her husband, David) that led her into medicine. After working as a teacher, Chan followed David to Canada and the University of Western Ontario in the early 1970s, where he was to study medicine. There, Chan was delighted to win a place to train in a Canadian health system already on the last leg of its journey towards universal health coverage…

Series
Universal Health Coverage
Does progress towards universal health coverage improve population health?
Rodrigo Moreno-Serra, Peter C Smith
Preview |

Universal Health Coverage
Political and economic aspects of the transition to universal health coverage
William D Savedoff, David de Ferranti, Amy L Smith, Victoria Fan
Preview |

Universal Health Coverage
Moving towards universal health coverage: health insurance reforms in nine developing countries in Africa and Asia
Gina Lagomarsino, Alice Garabrant, Atikah Adyas, Richard Muga, Nathaniel Otoo
Preview |

Viewpoint
Achieving universal health coverage in low-income settings
Jeffrey D Sachs
Preview |
The goal of universal health coverage is deeply embedded in politics, ethics, and international law. Article 25 of the 1948 Universal Declaration of Human Rights states that everyone has the right to a standard of living adequate for health, including medical care, and the right to security in the event of sickness or disability.1 Motherhood and childhood are to be afforded special care and assistance. In the same year, the Constitution of the World Health Organization came into force, declaring that “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human