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In a new report, experts emphasize the need to guarantee the right to health and recommend transforming health systems based on primary care and ensuring effective funding.

universal health comiss report enMexico City, 9 April 2019 (PAHO) – A report outlining ten recommendations on how countries can ensure that all people have access to health in the Region of the Americas was launched today in Mexico by the country’s highest authorities, the Pan American Health Organization (PAHO), the United Nations, and members of the High-level Commission “Universal Health in the XXI Century: 40 years of Alma-Ata”.

In recent years, the region has made progress and implemented health reforms. However, it is estimated that 30% of the population lacks access to the care they need. To help countries move towards universal health in line with the Sustainable Development Goals (SDGs), in February 2018 the Director of PAHO, Carissa F. Etienne, established the Commission that today released its recommendations.

“The report reaffirms that health is a fundamental human right. It is not a privilege, nor a commodity.”

The Commission’s report reveals that health for all can only be achieved if the effective enjoyment of the human right to health is guaranteed. It also highlights the need to transform health systems and create models of care based on primary health care (PHC), which respond to the needs of the population and have the necessary human and financial resources.

World Health Day. Launching of Commission Report

The launch event for the report was led by President Andrés Manuel López Obrador; the Director of PAHO; the Assistant Secretary General of the Organization of American States (OAS) and President of the Commission, Néstor Méndez; and the United Nations High Commissioner for Human Rights and former President of the Commission, Michelle Bachelet.

Health, a human right

“The report reaffirms that health is a fundamental human right. It is not a privilege, nor a commodity,” highlighted Etienne, stressing that the report also identifies primary health care as the sustainable strategy for making health for all a reality. The Director of PAHO also warned that “without the necessary resources, the firm commitment of the State, and political will, universal health will not be a possibility.”

“We will integrate the health system, federalize it, and create a national institute of health for well-being that takes care of those that do not have the possibility of obtaining insurance.”

The President of Mexico, Andrés Manuel López Obrador, said that the meeting comes at a time when the country is beginning a new stage of transformation. “We are going to guarantee that the right to health is a reality, outlined in the Constitution,” he said.

López Obrador announced that his government will carry out changes to provide health care to the 60 million Mexicans who, today, have no right to social security.

Dr. Etienne congratulated President López Obrador for his “decision to reform Mexico’s health system to ensure that universal health is a reality in the country.”

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Tackling inequalities

Néstor Méndez, Assistant Secretary General of the OAS and President of the Commission highlighted that “the Americas still suffer from persistent inequality that has resulted in insufficient access to quality public services,” including health.

“It is vital that health systems are strengthened and integrated into social protection systems, with the capacity to influence the social determinants of health, such as poverty and exclusion, in order to improve the health of the population.”

“We owe it to the most vulnerable in the Americas, those who cannot wait any longer to have a healthy life and benefit from quality, timely and accessible health care services” said Méndez.

For Michelle Bachelet, “health is one of the rights which we must ensure for everyone, without any kind of exclusion. However, it is also one of the areas where there is greatest infringements.” The United Nations High Commissioner for Human Rights highlighted that “we must offer explicit and verifiable guarantees” so that health is a right for all. She also asked states to “do more” and “commit themselves to the progressive realization of greater equity and quality” in health.

“The right to health is built by leaving unequal relationships behind and by investing in health services that are close to people,” she said, highlighting that “it is time to act. Governments, civil society and the private sector must all get involved.”

“Health is one of the rights which we must ensure for everyone, without any kind of exclusion. However, it is also one of the areas where there is greatest infringements.”

The report was presented within the framework of the World Health Day celebrations, and 40 years after the Declaration of Alma-Ata, which advocated for health for all and claimed health as a fundamental human right. It provides a path for action around PHC, conceived as an integral strategy for addressing the social determinants of most health problems.

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The 17 members of the Commission participated in the presentation of the report, including academics, former health ministers, activists and representatives of social movements, as well as delegations from 28 countries, including 18 ministers of health in the Region, including from Bahamas, Barbados, Bolivia, Curacao, Ecuador, El Salvador, Guatemala, Guyana, Nicaragua, Paraguay, Peru, Dominican Republic, Saint Martin, St. Lucia, Suriname, Trinidad and Tobago, Uruguay and Venezuela.

The main recommendations for achieving universal health include: 

  1. Ensure the right to health.
  2. Develop models of care based on primary health care (PHC).
  3. Generate social participation mechanisms.
  4. Generate mechanisms for regulation and control of the private sector.
  5. Eliminate barriers to health access.
  6. Address social determinants with intersectoral interventions.
  7. Reposition public health as the guiding axis of the State’s response.
  8. Value human resources as protagonists of PHC.
  9. Promote the rational use and innovation of technological resources.
  10. Ensure efficient and sustainable financing.

The report of the Commission will guide the work of PAHO, as well as its technical cooperation at all levels. It will also contribute to regional preparations for the High-level Meeting on Universal Health Coverage, to be held next September in the General Assembly of the United Nations.

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— Link to Universal Health in the XXI Century: 40 years of Alma-Ata

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