Director-General's Office

UHC Roundtable

Dr Tedros Adhanom Ghebreyesus
Director-General of the World Health Organization

Abuja, Nigeria
12 April 2018

Your Excellency Professor Isaac Adewole, my brother, Minister of Health;

Governor, senators, honourable ministers, and also my Regional Director colleagues here,

Distinguished guests, colleagues, ladies and gentlemen,

First of all I would like to start by saying how happy we are as WHO’s top leadership, the Global Policy Group, to have our meeting hosted here in Abuja. We had a very successful session with our management, and among other things we have decided two very important things that will bring a big shift for WHO. One is the planning process, which will be a bottom-up process that focuses on country priorities, and the second is an investment case based on the 5-year strategic plan we’ve just completed, and which our board has endorsed.

So our meeting in Abjua will be very historic because we managed to agree on these two important documents that will bring a big shift to WHO. So thank you Nigeria, thank you Abuja for hosting us.

While having our sessions here we had a chance to visit the primary health care Kuchingoro, and also the Nigerian CDC. We’ve seen a lot of progress and we’re really glad to learn from the visits that we had in the last couple of days during our session, with excellent hospitality – very good authentic African hospitality. So thank you so much for the great hospitality, on behalf of my colleagues.

Then I would also like to say about the publisher of Thisday, Nduka Obaigbena. I don’t know if I said it properly. I’m really happy to witness that the media is playing its role in making universal health coverage a reality. So to you, my brother Nduka, I really encourage you to continue this excellent job. The reason I’m saying this is, universal health coverage cannot be realized by the government alone. It will need the public to be mobilized. There is no one like the media to mobilise our communities to do their share too.

When you the risk factors associated with noncommunicable diseases, or communicable diseases, I think our communities can take care of themselves if they know the risk factors. Increased awareness can come not only from the primary health care settings that we have, but from schools and also from media campaigns. That’s what I have seen today, and I would like to commend my brother Nduka for really using the media to take part in realizing universal health coverage.

Thank you for the invitation to be here today to talk about a subject that’s very close to our hearts at the World Health Organization: universal health coverage.

As you know, Saturday was WHO’s 70th birthday.

The World Health Organization was founded 70 years ago on the conviction that health is a human right to be enjoyed by all people, not a privilege for the few.

Although much has changed in 70 years, that conviction hasn’t.

The term “universal health coverage” didn’t exist in 1948 when WHO was founded, but if it did, it would have been in our constitution. But the language in our constitution is almost the same.

Universal health coverage means much more than just health insurance, and it means much more than just health care.

It means ensuring people can get quality health services, where and when they need them, without suffering financial hardship, as our colleague from DFID said earlier.

Or to put it another way, no one should get sick and die just because they’re poor, or because the services they need are too far away.

It includes the full spectrum of services, from disease prevention and health promotion to treatment, rehabilitation and palliative care.

But today, more than half of the world’s population lacks access to essential health services, and almost 100 million people are pushed into extreme poverty every year because of the costs of paying for care out of their own pockets.

This is really disappointing.

This is an outrage, and this outrage must end.

No one should have to choose between buying medicine and buying food for their family.

No one should have to choose between death and poverty. It’s not only important for the individual, it’s important for the nation.

I quote Nduka when he said a healthy nation is a wealthy nation, and every life matters. If you’re healthy, you can wish anything. If you’re not healthy, you wish only to have your health back. That’s why health is the foundation.

There’s no single path to UHC. All countries must find their own way, in the context of their own social, political and economic circumstances.

But the foundation everywhere must be a strong health system, based on primary care, with an emphasis on disease prevention and health promotion.

Such health systems do not only provide the best health outcomes; they’re also the best defense against outbreaks and other health emergencies. In that sense, UHC and health security are truly two sides of the same coin.

There are many steps on the road to universal health coverage. But the key is political commitment.

For that reason, Nigeria’s Presidential Summit on universal health coverage in 2014 was a vital step.

The National Health Act passed the same year lays a firm foundation for making UHC a reality, by guaranteeing a basic package of services.

The government’s ambition to reach 100 million Nigerians with a basic package of primary healthcare services is truly admirable. And the revitalization of primary health care which we have already witnessed in Kuchingoro is part of this.

Of course, declarations and legislation are all very well. The really hard work comes in implementing them.

The launch of the Basic Healthcare Provision Fund represents an essential next step, by helping to reduce the financial barriers people face when using health services.

We congratulate the government for its commitment to allocating at least 1% of consolidated revenue from the national budget to the Basic Healthcare Provision Fund.

The establishment of the BHCF provides a great opportunity to turn political commitment into tangible gains, and to rally partners and the private sector around revitalizing primary health care as the foundation of achieving universal health coverage.

Primary care is the bedrock of every high-performing health system.

Making health services truly universal requires a shift from designing health systems around diseases and institutions towards health services designed around, and for, people.

Not only is this year the 70th anniversary of WHO’s founding, it’s also the 40th anniversary of the Alma-Ata Declaration, which identified primary care as the foundation of “Health for All”.

But 40 years later, we must admit that we are far from achieving that vision, as a global community.

That’s why WHO’s new 5-year strategic plan sets a target to see 1 billion more people with universal health coverage by 2023.

It’s ambitious, but we have no option other than being ambitious.

This is what we must do to stay on track for achieving the UHC target in the Sustainable Development Goals by 2030.

Strong primary care in every country, designed to meet the needs of people, will be fundamental if we are to achieve that target.

Earlier this year, I wrote to every head of state globally, asking them to take 3 concrete steps towards universal health coverage.

Yes, it’s ambitious. But unless we aim high, we will continue to leave people behind.

But universal health coverage is not a pipedream for the future. It’s a reality now. It’s a question now, and it has to be answered now.

Just this year, several countries have announced plans to move closer to UHC.

In Kenya, President Kenyatta has recently announced that affordable healthcare will be one of four pillars for his second term in office.

India recently announced a large increase in their health budget, which will create 150,000 health and wellness centres, and benefit 500 million people, which is equivalent to 100 million families.

We need to think in terms of really big targets: 500 million in India, and 100 million in Nigeria. That’s the level of ambition we need.

From Botswana to Brazil, Thailand to Turkey, and from Norway to Nigeria, countries in all regions, at all income levels, are making progress with the resources they have.

Around the world, UHC is a reality that is saving lives, giving people dignity and enabling them to contribute to their communities.

It doesn’t only improve health. It reduces poverty. It creates jobs and economic growth. It helps to protect populations against outbreaks and other health emergencies. It reduces inequalities. As one of the speakers before me said, it’s human capital we need to focus on, health being one, and of course the second one being education.

But more importantly, it restores dignity and gives hope for the future. It helps people and communities to thrive.

UHC would be the right thing to do even if none of those things were true, because human health is an end in itself. But the benefits of UHC make it a no-brainer.

Health is a right, an end in itself, but it’s also a means to prosperity. So you get two benefits. Not investing in UHC is not an option. We have no option actually, if we want to prosper.

Yes, financial investments are required to build strong health systems that deliver quality services.

But that’s exactly what they are: investments, not costs.

The question therefore is not whether countries can afford to invest in their health systems; the question is whether they can afford not to.

Universal health coverage is not just an investment in a healthier future; it’s a down payment on a fairer, safer and more prosperous future.

Thank you so much. And I would like to end my speech by again thanking you, Nigeria, for the excellent hospitality we have seen.

Thank you.