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Washington, DC, 20 April 2018 (PAHO/WHO)-The Pan American Health Organization/World Health Organization coordinated the session "Discussions on universal pooling in the Americas", at the World Bank Third Annual Universal Health Coverage (UHC) Financing Forum: Greater Equity for Better Health and Financial Protection. The Forum took place on April 19, 2018, in Washington DC.

Speakers included Robin Roberts from The Bahamas, Luis Vega from Panama, Janice Seinfeld from Peru, PAHO´s Camilo Cid and Lorena Prieto. They formed a panel that commented on recent discussions in their countries around the creation or expansion of a unified, universal, solidary national health fund to ensure health access and coverage to the largest share of their populations.


"Health systems of the Americas are segmented with a public and private financing mix. These structures translate into inequities in access and health outcomes within countries, and depending on how they address the issue, among countries," said Cid, PAHO Advisor on Health Economics and Financing. In the Americas, few countries have made significant progress in mitigating or eliminating segmentation. "The countries in the Region that have advanced the most in terms of public expenditure in health and reducing out of pocket expenditure, are the ones that also have advanced the most in terms of pooling risks," said Lorena Prieto, PAHO´s consultant on Health Services and Access.

The panelists discussed the main challenges, enabling factors, and expected outcomes of establishing of a national health fund. They also addressed reform proposals in these countries for improving equity through better pooling. "Unifying multiple risks pools, especially social security funds with public funds from general taxation, is a very bold movement that usually encounters a lot of resistances. Peru and Panama are two examples of countries trying to move in that direction," Juan Pablo Pagano, PAHO´s consultant on Health Economics and Financing and panel moderator.

With the adoption of the Strategy for universal access to health and universal health coverage in 2014, countries of the Americas declared their commitment to advance in the direction of universal health, improving and strengthening the efficiency of health system financing and organization. In this context, the session sought to contribute to the dialogue and exchange of experiences dealing with overcoming segmentation and advancing towards equity and financial protection.

The activity was part of the Third Annual UHC Financing Forum hosted by the World Bank Group and the U.S. Agency for International Development (USAID), from April 19-20, 2018, in advance of the World Bank Group's Spring Meetings.

This year, the Forum focused on mobilizing and shaping health financing to achieve equity and access to health services. This two-day event builds on previous Forum discussions, which looked at resource mobilization and strategic policies and practical interventions to help governments use health system resources more efficiently.