Ministers of health and other high-level delegates from North, South and Central America and the Caribbean have expressed broad support for the goal of universal health coverage this week, during the 52nd Directing Council meeting of the Pan American Health Organization (PAHO).
The Americas could become the world's first region to achieve health for all, says PAHO Director
Ministers of health and other government representatives from North, South and Central America and the Caribbean expressed broad support for the goal of universal health coverage this week, during the 52nd Directing Council meeting of the Pan American Health Organization (PAHO).
In a series of debates and discussions, participants said that progress toward universal access to quality and affordable health care is fundamental to ensuring a healthy population, reducing health inequities, and promoting social and economic development in the region's countries. While achieving universal coverage is a progressive progress, they said, it is a goal to which countries of all income levels can aspire.
"Universal health coverage is entirely realizable and can be achieved by redoubling our efforts to develop health systems that are inclusive and are built on the principles of primary health care," said PAHO Director Carissa F. Etienne.
A number of countries in the Americas have made significant advances toward universal health coverage, including Brazil, Chile, Colombia, Costa Rica, Cuba, El Salvador, Mexico, Peru, and Uruguay, along with Canada and several countries in the Caribbean. For example:
- Costa Rica's 70-year-old social security system provides health coverage for about 90% of the population.
- Colombia's two national health insurance programs provide coverage to more than 95% of Colombians.
- Roughly 3 in 4 Brazilians receive care through the publicly funded Unified Health System. Virtually all Chileans have health insurance through a government program or regulated private insurers.
- Mexico's Seguro Popular ("Popular Insurance") program added 50 million of the poorest Mexicans to the ranks of those with health coverage in the past decade.
- The United States took a historic step in the direction of universal health coverage with the enactment of the 2010 Patient Protection and Affordable Care Act.
Etienne said the progress and leadership shown by the countries of the Americas is positioning the region to become the first in the world to achieve universal health coverage.
"Our Member States are showing that universal health coverage is not only for the wealthiest countries," said Etienne. "They are showing that it is within reach of countries throughout the Americas. Each country will take its own path to advance this goal, but we can all aspire to achieve it."
Nils Daulaire, assistant secretary for global affairs of the U.S. Department of Health and Human Services (HHS), welcomed the emerging regional consensus on universal health coverage and he said its new health-care law has put the United States "on the cusp of reaching a major milestone in progressing toward that goal." He added that "each country will take its own path" toward universal health coverage, according to its own historical, economic and social context.
Minister of Health of El Salvador María Isabel Rodríguez said her country's progress toward universal health coverage was made possible by a broad coalition of social forces including labor unions, social activists, academia, the general population, and the international community. "This is not a recipe dictated from outside," said Rodríguez. "It is the product of solidarity."
Felicia Marie Knaul, director of the Harvard Global Equity Initiative, said that in addition to being a moral imperative, ensuring universal access to affordable health care makes economic sense. She said it is important for health leaders to make the economic case with their countries' finance ministers and other policymakers. Although financing universal health coverage is primarily the responsibility of national governments, international development banks, bilateral agencies and philanthropic organizations should also support low- and middle-income countries as they work toward universal coverage, said Knaul.
Former Secretary of Health of Mexico Julio Frenk, who received the 2013 Abraham Horwitz Award for Excellence in Public Health Leadership on the meeting's first day, said universal health coverage is a "global imperative." He called for a "paradigm change" in which "health is no longer viewed as a service that is delivered but rather as a basic right, which makes it universal."
During this week's meeting, country delegates approved a new five-year strategic plan for PAHO that has the progressive realization of universal health coverage as a central priority. The delegates also passed a resolution on social protection that urged PAHO to make work in this area a key part of its technical cooperation.
WHO Director-General Margaret Chan urged PAHO member countries to set an example on universal health coverage for other regions of the world. "The region of the Americas has long led the world in primary health care, and we expect the same leadership as countries of the world—at all levels of development—make the commitment to universal health coverage," she said.
