Universal Health Coverage as a Distinct Sustainable Development Goals Target: Dispelling Doubts and Underlining Implications

Citation: Acharya M (2015) Universal health coverage as a distinct sustainable development goals target: dispelling doubts and underlining implications. United Nations General Assembly is preparing proposal for Sustainable Development Goals (SDGs), and it has recently made explicit its working group proposal. Health-related SDG (SDG3) focus on health, envisioning healthy lives for people at all ages. Targets, such as reducing the global maternal mortality ratio to <70 per 100,000 live births by 2030, ending preventable deaths of newborns and under-five children by 2030, and halving global deaths and injuries from road traffic accidents by 2020, among others, have been set to attain the goal. One among them is to achieve universal health coverage (UHC), ensuring financial health protection and accessibility to essential health services for all (1). Universal health coverage has permeated the health discourse and is garnering worldwide attention. Despite that, it is an unusual target, for it has traditionally been regarded as a means for – and not a component of – better health outcomes. Millenium development goals (MDGs), the predecessor to SDGs, included health-related targets along the lines of reducing under-five mortality, maternal mortality, and halting the spread of HIV/AIDS, malaria, and other diseases. Inclusion of UHC in SDG3 has been taken with a pinch of salt, and doubts have been raised whether this undermines public health measures and health equity (2). Notwithstanding some practical issues, setting UHC as a SDG target has positive implications for health equity and overall health status. First, UHC is a desirable outcome of a health system, even if it does not inevitably lead to improvement in other health measures. Providing accessibility to essential health services and ensuring financial risk protection are in themselves good features of a health system and are worth striving for (3, 4). Further, evidence has shown that UHC, in fact, leads to improved population health (5). UHC, thus, can as much be a means for better health as a component of it, and it is prudent to select it as a SDG target. Second, UHC when attained has a positive bearing on health equity (6). But, this is not as simple because complete attainment of UHC requires many years of persistent efforts. Additionally, there are different paths for it – as is shown by diverse political, economic, and policy measures adopted by different countries. Concerns have been brought up as to the pursuit of UHC contributing to inequity …