Community health worker in Cambodia, 2014. Image: Tom Maguire
Health worker in Cambodia, 2014. Image: Tom Maguire


The theme of this year’s World Health Day on Sunday April 7th is Universal Health Coverage (UHC). However, as we continue to face a number of serious global health challenges, the vision of a world in which everyone has access to essential healthcare is a distant one. This World Health Day, it’s time have a real conversation about concrete steps we can take to make sure that this right is universally realised. 2019-2020 offers a unique opportunity to accelerate progress towards this goal.


The vision of UHC stipulates that all people have access to essential and quality healthcare and are able to enjoy healthy and productive lives without suffering from financial hardships as a result of healthcare costs. Fundamentally, UHC is about equity and ensuring that the right to health is afforded to everyone, everywhere regardless of who they are and where they live.


A number of global health multilateral organisations, including the Global Fund to fight AIDS, TB, and Malaria, and Gavi, the Vaccine Alliance, require renewed funding commitments this year and next, through funding cycles called replenishments. Such investments will need to be complimented by investment in nutrition, through ambitious pledges at the Nutrition for Growth (N4G) summit, also planned for 2020. These platforms are not only individually crucial, but they must be supported collectively to improve global health, support healthy and productive populations and ultimately accelerate progress towards achieving the vision of UHC.


The work of the Global Fund and Gavi are fundamental for facilitating life-saving prevention, diagnosis and treatment. However, the impact of these platforms goes beyond simply saving lives. They also help to strengthen health systems and are integral to fostering much-needed national ownership – which in turn creates lasting, sustainable impact. Health and nutrition are also strongly interrelated. For example, a severely malnourished child is up to eight times more likely to die from diseases such as diarrhoea. Investing in nutrition is integral to supporting investment in global health multilaterals, given the co-dependence of health and nutrition.


People living in poverty and the most marginalised and vulnerable are disproportionately denied access to quality and essential healthcare, which is an integral component of UHC. For example, people in the hardest to reach areas and born to families with lowest levels of education are less likely to receive basic vaccines. Women and girls are more susceptible to malnutrition, and infectious diseases such as TB are most prevalent in the poorest and most marginalised populations. Despite huge progress, vaccination rates having stalled since 2010, rates of TB incidence are declining at a slow 2% per year, and the number of undernourished people has risen since 2014.


Poor health means that individuals and communities are unable to ‘survive and thrive’. Children are less likely to go to school, young adults miss out on employment opportunities, and people are pushed into financial hardship. Healthcare costs push 100 million people  into poverty each year, fostering a vicious cycle of poverty and inequality.


In order to achieve UHC, we need to prioritise interventions that reach the poorest and most marginalised people. Vaccination, adequate nutrition, and services for tackling diseases such as TB are all integral parts of a quality healthcare system, and access to each is imperative if we are to realise the vision of UHC. Failure to access all these interventions places lives at risk and greatly undermines progress towards enabling people living in poverty to realise their right to health.  


DFID has played a fundamental role in supporting global health multilaterals. The Department is a founding and leading donor of Global Fund and Gavi, and a leader of crucial international partnerships such as N4G. The next 18 months are critical for DFID to reaffirm its global leadership in improving global health.


As World Health Day approaches, it’s time to have a real conversation about what is needed to deliver UHC and what concrete actions donors can take to ensure that this vision becomes a reality.