Blog: How the Commonwealth can seize momentum to achieve Universal Health Coverage

26 September 2023
Blog: How the Commonwealth can seize momentum to achieve UHC

Last week’s UN High Level Meeting on Universal Health Coverage (UHC) provided an opportunity for leaders to rekindle their political commitments to achieving UHC, with a view to scaling up global efforts. But what does this mean for the Commonwealth, and where should efforts be prioritised?

Blog by Emily Gilmour, Health Officer, and Janneth Mghamba, Adviser - Health, Commonwealth Secretariat

Commonwealth progress so far

The Commonwealth continues to play a key role in advocating for UHC, in line with the Commonwealth Charter’s principles of promoting access to affordable health and removing wide disparities and unequal living standards.

Since 2014, Commonwealth Health Ministers have focused on various aspects of UHC, including ageing and good health (2015); health security (2016); sustainable financing and global security (2017); non-communicable diseases (NCDs) in the context of resource mobilisation for UHC (2018); UHC in the context of equitable access to vaccines and building resilience for health systems and emergencies (2021); and, UHC and Global Health Security as complementary agendas in the Commonwealth (2022). Likewise, at the Commonwealth Heads of Government level, UHC has remained a key priority.

Prior to the COVID-19 pandemic, progress had been made on achieving UHC, both globally and within the Commonwealth. The UHC service coverage index (SDG indicator 3.8.1) increased from 45 in 2000 to 67 in 2019, with the fastest gains in the African Region. However, the COVID-19 pandemic pushed already burdened health systems past their breaking point and as a result, the progress towards achieving UHC is at standstill.

As of 2023, the Commonwealth remains far short of reaching the SDG target of 3.8 to achieve UHC. Deep inequities in access to quality health services and products remains a fundamental challenge for UHC, with aggregated data masking within-country inequities in service coverage.

The increased vulnerabilities and limitations of many health systems has underscored the need for strengthening health system resilience to make and sustain progress toward Universal Health Coverage, global health security and healthier populations in tandem.

To reinvigorate the Commonwealth’s commitment to UHC, Commonwealth Health Ministers convened in Geneva in May 2023, under the theme: Getting UHC in the Commonwealth on track for 2030. A key discussion during the meeting was re-orientating health systems towards primary health care (PHC) as a driver for achieving UHC.

Recognising PHC as the critical pillar of UHC

The World Health Organization (WHO) has  acknowledged that 90 percent of these essential interventions are able to be delivered through PHC, reinvigorating the role of PHC in the global health agenda in recent years. The 2018 Astana Declaration on Primary Health Care positions PHC as the cornerstone of sustainable health systems, emphasising the importance of working towards the SDGs and achieving equity within and between countries.

Recognising that UHC can be advanced more effectively and efficiently with a fully functional and well-delivered PHC system, Commonwealth health ministers agreed in May 2023 to work collectively to monitor progress, share best practices and expertise on strengthening primary health care for UHC. Some of the priorities include:

  • A need to increase investment for the transformation of PHC services:
    With one in six dollars being spent on PHC – even in high-income countries – it is important that PHC services receives the financing it needs to ensure sufficient coverage.
  • Utilising digital health to enhance the provision of PHC services:
    With accessibility, affordability and quality of health services being fundamental to PHC, the safe and equitable use of digital health technologies can complement and enhance health system functionality.
  • Investing in PHC-orientated resilient health systems: Often, PHC and pandemic preparedness are siloed, but in recognising these two efforts are intertwined, health systems can become more resilient. This includes ensuring that external and internal shocks and stressors and patient-centred care are managed by robust and integrated health infrastructure.
  • Recognising the fundamental role of heath and care workers:
    With the increasing global shortfall of health workers, it is important that countries invest in training, developing, recruiting and retaining a skilled health workforce.

Seizing the momentum on UHC

The UN’s Political Declaration on UHC, as well as the Commonwealth’s commitments, are important steps forward in achieving our collective UHC goals. The newly-adopted declaration recognises equity at the core of UHC, and the need for bilateral, regional and multilateral coordination and cooperation to expand health coverage to all.

The Commonwealth Secretariat is on hand to support countries in achieving these global targets, including through these milestones and initiatives:

  1. The upcoming Commonwealth Heads of Government Meeting, to be chaired by Samoa in 2024, offers an opportunity for UHC to continue to be elevated and retain vital political support. The Commonwealth can continue to act as a leader in making substantial commitments towards further investment towards UHC.
  2. The Commonwealth Secretariat is working to support countries in assessing maturity of digital health systems and providing technical assistance to address gaps through its Technical Country Support Programme on Enhancing Digital Health Maturity, a joint programme with WHO. With this initiative and the recently launched Commonwealth Artificial Intelligence Consortium, the Commonwealth can leverage these initiatives for sustainable development and improve efficiency in hospitals and health systems.
  3. Under the Technical Country Support Programme on Building Health System Resilience, the Commonwealth, working jointly with WHO, will tailor a technical package of support for countries on enhancing emergency preparedness and other essential public health functions.

With 2030 fast approaching, it is important that accelerated action needs to be taken, backed by sustainable and significant investments, to ensure our efforts our realised.

Media contact

  • Josephine Latu-Sanft  Senior Communications Officer, Communications Division, Commonwealth Secretariat
  • +44 20 7747 6476  |  E-mail