Opinion: Health is falling off the UN agenda, but time for action is now

Heads of state and government are meeting in New York for the 78th session of the United Nations General Assembly, and a key concern is that progress on the Sustainable Development Goals is far off track. At the current rate, 575 million people will live in extreme poverty and 84 million children will not be in school in 2030. We, the UHC Movement Political Advisory Panel, are deeply concerned about this stagnation and of the development in which world leaders are taking SDG 3 on good health and well-being off the highest political agenda despite the political commitment they expressed in 2019 and the global COVID-19 pandemic experience. Yet urgent action and strong political commitment to health is the only way to reverse this trend that is leaving people without access to essential health services, compromising our health security, and exacerbating inequities worldwide. Health and achieving universal health coverage is critical for the implementation of the Agenda 2030. “Health remains a privilege that depends on whether people have resources rather than a right.” --— A wake-up call: The global monitoring report on UHC 2023 Progress on UHC, which means that everyone, everywhere has access to the health services they need without risk of financial hardship, is tracked jointly by the World Health Organization and the World Bank with biannual global monitoring reports. This year’s report shows that all UHC indicators are far off track. Confirming findings of UHC2030’s most recent state of UHC commitment review, the global monitoring report outlines how service coverage is stagnating (availability and access to essential health services) and financial protection (protection against financial hardship caused by, for example, out-of-pocket payments for health services) has worsened. The report also highlights that inequalities persist between and within countries. In short, half of the world’s population, especially women and girls, cannot access affordable, quality care when they need it, and 1.3 billion people are pushed into poverty due to out-of-pocket health expenditures. Health remains a privilege that depends on whether people have resources rather than a right protected and fulfilled by governments’ commitment to health equity. Put bluntly, the right to health, enshrined in the Universal Declaration of Human Rights, is not being delivered. We need to keep health on the agenda Earlier this year, the UHC Movement launched an Action Agenda, providing a road map on action areas that cannot be neglected. We, the UHC Movement political advisers, have rallied behind the Action Agenda, its ambition level, and its eight concrete action areas. We have called for leaders to commit to these ambitious actions as part of the political declaration that is projected to be adopted at the U.N. high-level meeting on UHC this week. We continue to call on all countries to implement these actions by adopting laws and regulations at national, territorial, and local levels, involving all decision-makers in their implementation, and tracking milestones and accountability. The action areas include ensuring gender equality, addressing health care workforce shortages, connecting UHC and health security, and investing more public financing to build sustainable and integrated primary health care systems. Now is the time for world leaders to show that they are truly committed to protecting “people and the planet.” They can do so by keeping health on the highest political agenda, ensuring health policy frameworks are independent of political cycles, and turning their commitments into sustained action. An SDG Summit that does not place people’s health and well-being at its core does not follow the values of the SDGs. World leaders who do not champion and accelerate progress on strengthening equitable and resilient health systems are not implementing lessons learned from COVID-19 and decades of prior health emergencies. Dropping health off the agenda will lead to further financial hardship and inequality, will put millions of lives and economies at risk, and undermine health emergency preparedness and the entire 2030 Agenda. Call for action and ambition In 2023, heads of state and government should renew political commitments that are not empty rhetoric. We call on leaders to: • Keep health on the highest political agenda, nationally and in international and multilateral fora. This includes the U.N. high-level meetings on health, negotiations of a Pandemic Accord, as well as the Group of Seven leading industrial nations, G-7, and the larger Group of 20, the BRICS economic bloc, and other regional processes. • Guarantee inclusive decision-making processes for health policy by involving local and regional governments and other stakeholders at all levels to ensure that needs of all people, especially women and the most marginalized and vulnerable, are taken into account. • Deliver ambitious action at country level following the SDG Summit and U.N. high-level meetings on health, using the UHC Action Agenda as a blueprint for areas that cannot be neglected, and advocating for the achievement of SDG 3 as a goal and as a catalyst for Agenda 2030 as a whole. Billions of lives depend on concrete, ambitious actions. Leaders must realize people’s right to health now.