Voorhoeve Alex, Edejer Tessa T T, Kapiriri Lydia, Norheim Ole F, Snowden James, Basenya Olivier, Bayarsaikhan Dorjsuren, Chentaf Ikram, Eyal Nir, Folsom Amanda, Tun Hussein Rozita Halina, Morales Cristian, Ostmann Florian, Ottersen Trygve, Prakongsai Phusit, Saenz Carla, Saleh Karima, Sommanustweechai Angkana, Wikler Daniel, Zakariah Afisah
Department of Philosophy, Logic, and Scientific Method, London School of Economics, London, UK and Visiting Scholar in the Department of Bioethics at the National Institutes of Health, Bethesda, US.
Coordinator of Costs, Effectiveness, Expenditure and Priority Setting, Health Systems Governance and Financing, and Health Systems and Innovation, World Health Organization, Geneva, Switzerland.
Health Hum Rights. 2016 Dec;18(2):11-22.
The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity, and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, , the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These case studies show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for those who are worse off in a number of dimensions (including health, access to health services, and social and economic status), and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting.
实现全民健康覆盖（UHC）的目标通常只能分阶段实现。此外，资源、能力和政治方面的限制意味着政府在实现全民健康覆盖的道路上常常面临艰难的权衡取舍。在2014年的一份报告中，世界卫生组织公平与全民健康覆盖咨询小组阐明了以公平方式做出此类权衡取舍的原则。我们提供了三个案例研究，说明这些原则如何能够指导实际决策。这些案例研究表明，健康权的逐步实现如何能够有效地由确定优先事项的原则来指导，这些原则包括产生最大的总体健康效益、优先考虑在多个方面（包括健康、获得医疗服务的机会以及社会和经济地位）处境较差的人群，以及财务风险保护。它们还展示了公平且可问责的确定优先事项过程的价值。
