Senior Adviser in the Executive Office of UNAIDS, Geneva, Switzerland.
Health Hum Rights. 2019 Dec;21(2):215-228.
The political momentum around universal health coverage (UHC) provides a welcome opportunity to scale up efforts to dismantle barriers to accessing health services and to create enabling environments for people to thrive and be healthy. However, UHC lacks sufficient clarity, both conceptually and operationally, to generate the societal transformation required to ensure its successful implementation in countries. This article argues that both the messaging and the monitoring and implementation guidance around UHC are ambiguous and flawed from a human rights perspective. To leverage the reforms necessary to achieve UHC, human rights norms and principles need to signpost the direction ahead, and human rights mechanisms need to be involved to enhance the accountability of those United Nations member states that choose to "take a wrong turn." The article argues that a human rights-based approach to programming offers a practical methodological framework for designing and implementing UHC at the national level. It concludes by illustrating five key areas in which it is critical to invoke human rights as the foundation for UHC and for which consistent, authoritative, and practical guidance is needed to support countries in getting onto the right(s) road to UHC.
全民健康覆盖(UHC)的政治势头为加大力度消除获取卫生服务的障碍以及为人们的繁荣和健康创造有利环境提供了一个可喜的机会。然而,UHC 在概念和操作上都不够明确,无法在各国进行成功实施所需的社会变革。本文认为,从人权角度来看,UHC 的信息传递以及监测和实施指导都存在模糊和缺陷。为了利用实现 UHC 所需的改革,人权规范和原则需要指明前进的方向,需要人权机制参与,以加强选择“走弯路”的联合国会员国的问责制。本文认为,基于人权的方案规划方法为在国家一级设计和实施 UHC 提供了一个实用的方法框架。文章最后举例说明了在五个关键领域中,将人权作为 UHC 的基础至关重要,需要提供一致、权威和实用的指导,以支持各国走上 UHC 的正确道路。