The second High-Level Meeting on Universal Health Coverage will take place in New York on 21 September. By 2015, governments have agreed to ensure that everyone has access to the full range of quality health services they need, when and where they need them, without financial hardship. Médecins du Monde will be present at the meeting and is calling on world leaders to agree on bold steps to achieve this goal.
By working directly with marginalized people who lack access to health services, MdM witnesses the social, economic and political determinants that shape people’s health. We see that the introduction of user fees and the privatization of the health sector often have detrimental effects on the accessibility of health services.
We also see that many marginalized communities are denied access to health care. This is the case even in countries that have formally declared UHC. The excluded groups vary, but often include poor and rural communities, women and girls, migrants and refugees, people who use drugs, and prisoners. Our teams often find a lack of primary health care and sexual and reproductive health care. Without full coverage of these two components, UHC cannot be achieved.
We therefore call on Heads of State to negotiate a strong and evidence-based political declaration in which they make or reaffirm the following commitments:
• Reaffirm the right of everyone to the highest attainable standard of physical and mental health and the obligation of States to ensure healthy living and working conditions and access to necessary health services, as set out in the UN Convention on Economic, Social and Cultural Rights. States have an obligation to monitor and regulate the private sector in the health sector.
• Reaffirm the Alma Ata Declaration on Primary Health Care with its three key pillars:
　o Needs-based integrated health services throughout people’s lives
　o Addressing the wider determinants of health through multisectoral policies and actions
　o Empowering individuals, families, and communities
• Reaffirming the commitment to “leave no one behind”: providing full access and special support to vulnerable groups and protecting them from discrimination.
• Resist tendencies to limit women’s right to health and ensure that the full range of sexual and reproductive health and rights is recognized as an integral part of UHC.
• Improve the availability and use of disaggregated data on health status and access to services to make the excluded visible.
• Involve affected communities in the planning, implementation and monitoring of equitable access to health.
Current policies are not sufficient to achieve universal health coverage by 2030. In particular, increased financing is needed to make UHC a reality. We call on governments to consider international evidence and recognize their responsibility to build equitable health systems in line with their human rights obligations.