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Blog Action Day: Universal Health Coverage


Health Poverty Action and others write to The World Bank Today is global Blog Action Day and the theme is The Power of We, so we thought we’d tell you about a joint effort which could make a huge difference…

Last week Health Poverty Action and 109 other health organisations from 40 countries around the world united to present a letter to Dr. Jim Yong Kim, the new President of The World Bank, calling for Universal Health Coverage: that is, affordable, accessible health services for all.

We came together because if the world agrees to support Universal Health Coverage the lives of millions of people can be saved. Health organisations hope that Dr Kim’s background in health will help him drive forward progress in this area at the Bank.

The World Bank has an opportunity to stand up for equality and to support governments in ensuring that all their citizens have access to healthcare. If they do that, millions more people will be able to get the care and treatment which is their right.

Have a look at the letter given to Jim Kim…



Dr. Jim Yong Kim, President                                                                                                               October 11, 2012

The World Bank

Dear President Kim,

We, as civil society organizations working on health, call on you to open a new chapter in the World Bank’s health sector work.  Now is the moment for the Bank to play a truly progressive and transformative role in health, by supporting countries to achieve universal health coverage (UHC). UHC does not just mean protection from catastrophic expenditure; it means that all people, especially the poorest and most vulnerable, are able to access quality essential health services when they are needed. Achieving UHC is possible in low- and middle-income countries – and it requires bold steps by national governments and the international community, including;

–       The removal of all financial barriers to accessing services, especially user fees.

–       Robust and sustained public funding predominantly from general revenues and international aid – as well as innovative financing mechanisms such as a Financial Transaction Tax – to build and strengthen public health systems to reach all people.

–       Investing in improved quality of care. This means investing in each element of the health system: health workers, primary and secondary care facilities, information systems, and drug supply chains, especially for affordable generic medicines. This also means ensuring accountability for measurable improvement in health outcomes, including through civil society participation in policy development and oversight of service delivery.

The World Bank is well-placed to be a vocal champion of UHC by deploying its knowledge and experience in health system reform, as well as its financial support. However, the Bank must reform the approach of its programs and policy advice in order to deliver on this potential, and ensure it positively impacts poor and vulnerable populations.

For too long, the Bank has advised developing countries to levy user fees for health services in order to recover costs and ration services. The Bank now says it will help countries remove fees, but only if sustainable financing and comprehensive planning are already in place, rather than helping countries achieve these conditions. There is clear demand from client countries to abolish user fees: 12 countries in sub-Saharan Africa have removed fees for maternal and/or child health services over the last decade.  In the fight against HIV/AIDS and tuberculosis, the abolition of user fees for patients has proven a highly effective intervention to expand access to lifesaving health services. We understand you have recently said the World Bank will not endorse user fees for basic healthcare.  We welcome this commitment and look forward to its implementation.

The Bank has also frequently promoted the use of private voluntary health insurance schemes and the privatization of public health systems in its lending and policy advice. In developing countries, insurance premiums act as another barrier to affordable health services for large sections of the population, such as the – often female – workers in the informal and agricultural sectors. Successful community health insurance schemes such as Rwanda’s mutuelles de santé rely on heavily scaled-up public financing to achieve real gains in coverage.  In its work with countries, the Bank must now emphasize the critical role of sustained public financing and public delivery of services in scaling up to universal health coverage.

Health is a major focus of the 2012 World Bank Annual Meetings. We urge you to lead the Bank to:


  1. Actively support countries to offer care that is free at the point-of-use for all people.
  2. Scale up investment in public health systems in developing countries, by supporting them to expand public financing, and by offering balanced policy advice that does not privilege private sector solutions over publicly financed and delivered health systems.
  3. Ensure all Bank programs benefit the poorest two quintiles in the countries where it works.
  4. Actively support involvement of civil society in national health policy development, in order to improve democratic oversight and accountability for improved health outcomes.
  5. Collaborate with the World Health Organization and other global health institutions in the push for UHC

We look forward to partnering with you to make universal access to healthcare a reality for all.


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