On September 23rd, world leaders adopted a high-level United Nations Political Declaration on Universal Health Coverage (UHC), the most comprehensive set of health commitments ever adopted at this level.
“This declaration represents a landmark for global health and development,” said Dr Tedros Adhanom Ghebreyesus, Director-General at WHO. “The world has 11 years left to make good on its sustainable development goals. Universal health coverage is key to ensuring that happens.”
The meeting, which occurred at the mid-point of SDG monitoring was a major milestone on the road to achieving UHC by 2030 – and hopefully will ensure the prioritisation of palliative care in guiding documents.
Palliative care inclusion in the Political Declaration
In the lead up to the HLM, as is common, a political declaration was drafted and was approved at the High-Level Meeting. Palliative Care INGO’s put a lot of effort to ensure that palliative care was included in the declaration, and indeed it was.
There were two references to palliative care in the declaration, one describing the continuum of UHC, and the second on the importance of palliative care due to the aging of the world population. Specifically:
- [Section 9] Recognize that universal health coverage implies that all people have access, without discrimination, to nationally determined sets of the needed promotive, preventive, curative, rehabilitative and palliative essential health services, and essential, safe, affordable, effective and quality medicines and vaccines, while ensuring that the use of these services does not expose the users to financial hardship, with a special emphasis on the poor, vulnerable, and marginalized segments of the population;
- [Section 30] Scale up efforts to promote healthy and active ageing, maintain and improve quality of life of older persons and to respond to the needs of the rapidly ageing population, especially the need for promotive, preventive, curative, rehabilitative and palliative care as well as specialized care and the sustainable provision of long-term care, taking into account national contexts and priorities;
Download the official Political Declaration of the High-level Meeting on Universal Health here.
Palliative Care references at the High-Level Meeting
The Plenary Segment of the High-Level Meeting was comprised of three-minute statements by Member States and observers of the General Assembly. Three countries were noted to mention palliative care in their oral statements — Peru, Eritrea, and Eswatini (formerly Swaziland).
“Obviously we were disappointed that there were not more, but the productive advocacy story is that we worked together to ensure there were two references in the final consensus text that was adopted,” said Dr Katherine Pettus of the IAHPC.
The meetings also included a section for civil society and private sector participation, whereby oral statements could be made. Of the over 100 civil society statements submitted only one NGO was allowed to read there’s at the meeting. All the others were made part of the record of the meeting.
Most countries are not on track to achieve UHC by 2030. It is projected that 39% to 63% of the global population will be covered by essential health services, according to the Primary Health Care on the Road to Universal Health Coverage 2019 Monitoring Report. There is consensus that political will needs to accelerate for UHC goals to be met. The next High Level Meeting on UHC will not be until 2023.
The overall sentiment towards UHC acceleration means that country level palliative care inclusion is paramount.
According to Claire Morris, Advocacy Director of the WHPCA, having a strong grasp of the politics and economics around how the essential package will be decided, is important to crucially understanding what palliative care advocates can realistically expect.
“It is so important as palliative care advocates that we truly understand what we are advocating for and we partner with those with great technical knowledge of UHC,” Morris said.
According to Dr Stephen Connor, Executive Director of the WHPCA, there is a need to focus tightly on ensuring that palliative care is included in UHC at the country level. WHPCA is focusing particularly on Kenya and South Africa as models for other countries to emulate.
The WHPCA is also focusing on secondary targets that have made strong public commitments to UHC: Philippines, Ukraine, India, Uganda, Argentina, Zimbabwe, Bangladesh, Ghana, and Pakistan.
“This is a great opportunity for all palliative care champions and advocates to make your voice heard and help mobilise high-level political attention globally and in your countries,” said Connor.
To further collaboration and country level technical support around palliative care integration under UHC, the WHPCA is hosting a free webinar that will feature a panel of distinguished UHC global experts.