Working towards Universal Health Coverage: the role of research

Good health allows children to learn and adults to earn, helps people escape from poverty, and provided the basis for long-term economic development

Access to good quality, affordable healthcare is often viewed as a basic human need and could greatly improve the health and wellbeing of millions of people worldwide. For example, in developing countries, assistance from doctors and midwives during pregnancy and childbirth could significantly reduce the risk of babies dying soon after birth. Better access to medicines could improve the treatment and reduce the spread of diseases like HIV/AIDS.ⁱⁱ,^[iii],^[iv] It’s also important to reduce the risk of people falling into poverty after paying for essential healthcare for themselves or their family.^iv Health-related poverty isn’t only a problem in developing countries – people in some high-income countries who are uninsured or under-insured may also risk serious financial problems if they need expensive medicine or surgery.[v] Ensuring a basic level of affordable healthcare could improve both life expectancy and quality of life for countless people – and allow them to stay active and productive members of society for longer.

Universal health coverage is a type of government scheme that enables all residents in a country to access medicines, vaccines and other health services that are considered essential without risking financial hardship. This type of medical care is well established in Europe, and includes the UK’s National Health Service (NHS) and the Protection Maladie Universelle (PUMA)
in France, in which most (but not all) medicines and health services are freely available to citizens.

Member states of the United Nations (UN) recently agreed to try to expand universal health coverage to all countries in the world by 2030. The specific type of universal health coverage given in a country (e.g. the particular medicines and services offered as part of the scheme) will depend on the most important causes of disease and death within each population, as well as the money available to each government.ⁱ Combining money from funding sources (e.g. taxes or national insurance schemes) could help to spread the financial risks of ill health across a population, making it less likely that an illness will cause serious hardship for an individual.

What could be achieved through universal health coverage?

In 2015, the UN published a list of Sustainable Development Goals, one of which has several targets linked to improving universal health coverage. For example, one target is to reduce deaths of mothers and babies during childbirth by increasing access to good quality antenatal (pregnancy) and midwifery care. Globally, the number of women receiving care from a midwife has increased from 62% in 2000 to 73% in 2013.^iv Another UN target for 2030 is to put an end to serious diseases that affect the world’s poorest countries, including HIV/AIDS, tuberculosis and malaria. Achieving these very ambitious targets will involve lots of different activities, such as providing effective, affordable vaccines and medicines, improving early diagnosis of diseases, giving dietary or sexual health advice, and controlling mosquito breeding grounds.^xi

The role of research in designing universal health coverage

Wider access to health services and better financial protection can be expected to lead to better overall health, but every country needs to understand the best way(s) to use universal health coverage for its own citizens since the available budget will always be limited.Research can answer important questions that help to design affordable universal healthcare, such as:
Research questions like these may be addressed by international research groups or by the companies that make medicines. Some countries, such as Thailand, have set up new research organisations to answer questions about how best to design universal health coverage for their own populations. The World Bank and the World Health Organisation also support research in many low- and middle-income countries. In many cases, patients and members of the public may be asked to join research studies, or to share their personal medical information, to help answer these questions. Universal health coverage is an important social, economic and health ambition that is supported by most countries around the world. Studies that involve local researchers in looking for answers to specific local health problems can help governments understand how to use their money in a way that best improves basic levels of health for people living in their country.

• Who will benefit most from a particular type of medicine or medical treatment?
• What are the benefits and costs involved with offering a medicine or vaccine to everyone in a country who may be at risk from a particular disease?
• When is the best time to give a certain type of treatment (e.g. should it be given as soon as the disease develops, or only to those who are affected by symptoms)?
• Where is it best to provide a treatment (e.g. in hospital, at community clinics, or in a patient’s home)?

Research questions like these may be addressed by international research groups or by the companies that make medicines. Some countries, such as Thailand, have set up new research organisations to answer questions about how best to design universal health coverage for their own populations. The World Bank and the World Health Organisation also support research in many low- and middle-income countries. In many cases, patients and members of the public may be asked to join research studies, or to share their personal medical information, to help answer these questions. Universal health coverage is an important social, economic and health ambition that is supported by most countries around the world. Studies that involve local researchers in looking for answers to specific local health problems can help governments understand how to use their money in a way that best improves basic levels of health for people living in their country.