Assessing the universal health coverage target in the Sustainable Development Goals from a human rights perspective

Abstract

BackgroundThe UN’s Sustainable Development Goals (SDGs), adopted in September 2015, include a comprehensive health goal, “to ensure healthy lives and promote well-being at all ages.” The health goal (SDG 3) has nine substantive targets and four additional targets which are identified as a means of implementation. One of these commitments, to achieve universal health coverage (UHC), has been acknowledged as central to the achievement of all of the other health targets. As defined in the SDGs, UHC includes financial risk protection, access to quality essential health-care services, and access to safe, effective, quality and affordable essential medicines and vaccines for all.DiscussionThis article evaluates the extent to which the UHC target in the SDGs conforms with the requirements of the right to health enumerated in the International Covenant on Economic, Social and Cultural Rights, the Convention on the Rights of the Child, and other international human rights instruments and interpreted by international human rights bodies. It does so as a means to identify strengths and weaknesses in the framing of the UHC target that are likely to affect its implementation.SummaryWhile UHC as defined in the SDGs overlaps with human rights standards, there are important human rights omissions that will likely weaken the implementation and reduce the potential benefits of the UHC target. The most important of these is the failure to confer priority to providing access to health services to poor and disadvantaged communities in the process of expanding health coverage and in determining which health services to provide. Unless the furthest behind are given priority and strategies adopted to secure their participation in the development of national health plans, the SDGs, like the MDGs, are likely to leave the most disadvantaged and vulnerable communities behind.

Socio-anthropological methods to study the feasibility and acceptability of the minimally invasive autopsy from the perspective of local communities: lessons learnt from a large multi-centre study

“…The dearth of reliable information on causes of death (CoD) in low-income countries hinders the adequate planning and resource allocation required to achieve the specific Sustainable Development Goal 3 (Ensure healthy lives and promote well-being for all at all ages) that primarily aims to halve child and maternal morbi-mortality caused by preventable infectious diseases [1,2].…”

Sustainable Development Goal Integration, Interdependence, and Implementation: the Environment–Economic–Health Nexus and Universal Health Coverage

“…[7] Global health transitions include public health improvements (e.g., basic sewage and sanitation), the epidemiological transition (that reduced the burden of communicable diseases), [8] and potentially UHC. [11] Health services also encompass curative care (for individuals) and health promotion (for communities) [12] which alleviate the burden on healthcare service delivery. [9] Health expenses should be charged according to socioeconomic status to ensure that poor households are not disproportionately burdened relative to wealthier households.…”

“…[10] Therefore, basic health services (at least) should be free for poor citizens with less indigent citizens heavily subsidized. [11] Health services also encompass curative care (for individuals) and health promotion (for communities) [12] which alleviate the burden on healthcare service delivery. Thus, the return on investment in health delivers healthier citizens with increased life expectancy, economic activity, and productivity [13] (due to healthier economically active populations) with less burden on health service delivery due to fewer patients.…”

International comparisons of disparities in access to care for people with mental health conditions

“…The international aspiration to ensure universal health coverage (which is understood to encompass access, equity, and quality components) comes with a commitment that “no one will be left behind.” To monitor this aim, however, it is necessary to disaggregate measures of access by population groups . Population characteristics commonly used as disaggregation groups for measures of health system performance include income, educational level, sex, age, rurality, ethnicity, migrant status, and disability status .…”