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Universal Health Coverage (UHC) is a concept that ensures everyone can access medical services without financial hardship. In this article, we will explore the meaning, current state, and challenges of Universal Health Coverage.

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Tragic Photos Related to COVID-19 in Africa

The COVID-19 virus has spread worldwide, but its severity varied significantly from country to country.

South Korea has a robust national health insurance system that provides extensive medical services to all citizens, which became a crucial asset in protecting the population from the virus's onslaught.

In contrast, the healthcare systems in developing countries, including Africa and South America, were utterly unprepared to halt the spread of the virus and treat patients. Millions died, and communities and economies suffered irreversible damage.

This stark contrast powerfully illustrates how deadly the absence of Universal Health Coverage can be.

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Q. What is Universal Health Coverage (UHC)?

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A. Universal Health Coverage (UHC) means ensuring that everyone can access the essential quality medical services they need, without discrimination.

Imagine our society as a large ship. Universal Health Coverage is like providing every passenger on this ship with life jackets and emergency medical kits.

Just as anyone who falls ill or gets injured during the voyage should be able to receive the necessary medical services, regardless of their deck, UHC guarantees that everyone can access medical services when needed.

UHC goes beyond just access to healthcare; it encompasses disease prevention, treatment, rehabilitation, and health promotion.

It is a comprehensive concept that is one of the main global health goals emphasized by the World Health Organization (WHO) and the United Nations (UN), aiming to ensure the health of all and prevent financial ruin.

When everyone is healthy, the whole society can thrive more stably and prosperously! Thus, Universal Health Coverage plays a vital role in maintaining the health and safety of the entire society. 

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Q: What does Universal Health Coverage guarantee?

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A: The World Health Organization (WHO) aligns Universal Health Coverage (UHC) with the United Nations' Sustainable Development Goals (SDGs), specifically targeting Goal 3: "Ensure healthy lives and promote well-being for all at all ages." To achieve this, WHO proposes specific objectives including:

■ Provision of essential quality health services:

▪ Preventive services: Immunizations, maternal health check-ups, disease prevention campaigns, etc.

▪ Treatment services: Emergency care, surgeries, cancer treatments, etc.

▪ Rehabilitation services: Physical therapy, occupational rehabilitation, etc.

▪ Health promotion: Nutritional counseling, exercise programs, mental health services, etc.

■ Reduction of financial hardship in accessing health care:

▪ Healthcare cost burden: Household expenditure on health, protection against costly healthcare.

▪ Insurance benefits: Coverage of health insurance, support for premiums, public health assistance, etc.

■ Ensuring healthcare services for everyone:

▪ Protection for vulnerable groups: Ensuring medical accessibility for low-income families, people with disabilities, rural residents, and other socially vulnerable groups.

▪ Regional balance: Balancing the quality and accessibility of healthcare services between urban and rural areas, as well as among different regions.

■ Providing high-quality healthcare services:

▪ Improving patient satisfaction: Surveys on patients' experiences and satisfaction.

▪ Enhancing service efficiency and effectiveness: Rates of disease treatment, effectiveness of preventive services, medical error rates, etc.

This framework is part of the broader goal to reduce global health inequalities and promote a healthier life and well-being for all.

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Q: What is the global status of Universal Health Coverage?

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A: According to the 2023 UHC Global Monitoring Report published by the World Health Organization (WHO) and the World Bank, significant improvements have been made in global health services since 2000 (refer to Figure 3a). However, recent years have seen a halt in progress (refer to Figure 3b).

As of 2021, nearly half of the world's population, approximately 4.5 billion people, are unable to access essential health services. In 2019, around 2 billion people faced financial hardship due to out-of-pocket medical expenses, with 340 million of these individuals falling into extreme poverty.

The countries shaded in darker colors on the map below are those that have seen significant increases in their health service scores. The improvement varies from country to country, with some not improving at all and others increasing by as much as 39 points. Most countries (85 in total) have seen improvements of about 20-29 points compared to the year 2000.

However, since the launch of the United Nations Sustainable Development Goals in 2015, the global index has only increased by 3 points, with few countries experiencing significant improvements (refer to Figure 3b). This indicates a clear need for further action.

The graph below shows a cluster of points in the bottom right corner, representing countries that made progress in UHC between 2000 and 2015.

Yet, the top left corner, representing the change in health coverage between 2016 and 2021, is almost empty of points, signifying little to no progress in UHC advancement during this period.

This graph clearly demonstrates the urgent need for increased efforts and support for global Universal Health Coverage.

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Lessons Learned from the COVID-19 Pandemic

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The COVID-19 pandemic has caused a global health and social crisis, highlighting the critical need for Universal Health Coverage (UHC) more than ever.

Furthermore, the pandemic has underscored the importance of international cooperation in addressing global health crises. This is because viruses know no borders. Even high-income countries cannot be safe if any part of the world is vulnerable to an outbreak.

If universal health services were established for everyone around the globe, humanity could respond more effectively to new pandemics.

Just as life jackets must be provided to everyone on board a ship without discrimination, when essential health services are equitably provided to every global citizen, we all can enjoy a safer and happier life. 

"Universal health coverage is a political choice. It takes vision, courage, and long-term thinking. But the payoff is a safer, fairer, and healthier world for everyone."

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General

Written by: Yeon Je Choi