Public Services International responds to the World Bank vision of Universal Health Coverage

PSI welcomes:

• The vision to build “health, dignity and prosperity for all people”
• The direction of “sweeping change” toward “shared prosperity” and “health equity”
• The will “to ensure that everyone in the world has access to affordable, quality health services, within a generation" under the umbrella of Universal Health Coverage
• The understanding that “social protection for all” is an “investment… to drive growth”
• The World Bank’s commitment to WHO and other partners, and, most recently, the World Bank’s enhanced commitment to eradicate poverty, notably in Africa

But ensuring that the global post-2015 development agenda is truly founded on principles that are clearly agreed, understood and expressed is of greater urgency than the need to produce indicators of health by September 2013. We need to first establish and agree the principles, and we have to get that part right.

PSI is aligned with the principles underlying the initial attempt, 35 years ago at Alma-Ata, to strive for “health for all” based on the “spirit of social justice”.

Such values underlie the Millennium Declaration, only partially operationalized in the Millennium Development Goals.

The post-2015 development agenda is the exceptional opportunity to ensure that the values of the Millennium Declaration are, at last, more fully realized in the actions to achieve universal health.

PSI’s vision of Universal Health Coverage is founded on true universality, equity and inclusion, which are principles that will brook no compromise.  

Universal Health Coverage is achievable only if supported by a strong commitment to health service systems that are public, in the service of quality, availability, accessibility and acceptability.  Only public services can ensure the affordability required for true universality.

Indeed, Universal Health Coverage and Social Protection Floors are concepts founded - and deeply embedded - in human rights and in the realization of the right to health, as embodied in the Constitution of the World Health Organization in 1946 and then enshrined as a right in Article 12 of the International Covenant on Economic, Social and Cultural Rights in 1966.

However, the World Bank proposal “to close the gap in access to health services and public health protection for the poorest 40 per cent of the population in every country” would partition people into deserving and undeserving subgroups – denying Universal Health Coverage to all.  Furthermore, rolling out Universal Health Coverage should not carry the responsibility of eradicating poverty.

Extreme poverty must be eradicated.  But the eradication of poverty should not be an alibi for partial health for all.  Nor should it be made to compete with benefits deriving from the application of universal principles of equity and inclusion.

Universal Health Coverage is universal and applies to all people, not only “citizens.”

Universal Health Coverage is equitable and addresses all households, not only “vulnerable households”.

Universal Health Coverage is to protect all people from impoverishment due to illness and cannot wait upon the measurement of “the number of people forced into poverty by health expenditures in every country each year”.

Universal Health Coverage is inclusive and cannot be charged with major responsibility for reducing or mitigating economic inequality.

Public Services International is a global trade union federation with over 650 affiliates in 150 countries.  The federation represents 20 million working women and men who deliver vital public, of whom 8 million are health workers.  PSI champions human rights, advocates for social justice and promotes universal access to quality public services. PSI works with the United Nations system and in partnership with labour, civil society and other organizations.


For more information, please contact PSI Health Officer Odile Frank odile.frank@world-psi.org