Speech by Co-chair Ban Ki-moon
Prince Mahidol Award Conference (PMAC) 2020
Bangkok, Thailand
January 31, 2020
“If there is one lesson the world has learned, it is that you can only reach UHC through public financing.”Therefore one of the simplest ways we can hold political leaders to account in reaching UHC is tracking how much public financing they allocate and disburse to their health systems. Transitioning from a health system dominated by private out-of-pocket financing to one mostly financed by public financing has become one of the defining steps in achieving UHC. It’s a transition my own country, the Republic of Korea, made in 1977 and was also seen as the key step to bringing UHC to the United Kingdom in 1948 and Japan in 1961. And of course one of the most celebrated and impressive transitions to publicly financed UHC happened right here in Thailand in 2002, with the launch of the Universal Coverage scheme. It’s worth remembering that this was implemented in the immediate aftermath of the Asian Financial Crisis, when the World Bank advice was that Thailand couldn’t afford to increase public health spending to cover everyone. But as my good friend and former World Bank President, Jim Kim, said at the World Health Assembly in 2013, the Thai Government wisely ignored this advice and in one year injected around half a percent of GDP in tax financing into its health system. In the process, the country swiftly moved from around 70% coverage to almost full population coverage – a shining example of how to accelerate progress towards UHC. In fact, during my time as Secretary-General, I have introduced this story every time we talk about public health and UHC. What Thailand, the Republic of Korea, Japan, the UK and many other countries have also shown is that UHC reforms are so effective and so popular, they can become part of a nation’s identity and prove resilient in the face of changes of government. So what are the implications for the theme of this year’s PMAC: accelerating progress towards UHC? On a global level, we need to prioritize helping countries that are still to make the transition to a universal publicly financed health system. Here our focus should be on countries with low levels of public health spending, often less than 1% of GDP, where up to three quarters of health spending is in the form of user fees. These countries need to double or triple their public spending on health over the next decade and prioritize funding a universal package of services, focusing on primary care services provided free at the point of delivery. These low-spending countries tend to be in Sub-Saharan Africa and South Asia but there are already shining examples of countries in these regions using public financing to extend health coverage – for example Sri Lanka in South Asia and Rwanda in Africa. Also, it is perfectly feasible to increase public spending on health this quickly, if there is political will, as shown by Thailand and China. This reinforces the point made by the WHO Director-General Dr Tedros that UHC is a political choice. Your Royal Highnesses, Excellencies, Ladies and Gentlemen, let me conclude. The focus of our UHC program at The Elders is to encourage political leaders to make this choice, by helping them appreciate the health, economic, societal and political benefits of achieving UHC. Some of my fellow Elders have spearheaded successful UHC reforms themselves, like former President Ricardo Lagos of Chile and former President Ernesto Zedillo of Mexico – so we are speaking from experience. In doing this we are very keen to work with you, the UHC community, to identify opportunities to promote UHC reforms at the highest level of government. We have already engaged with political leaders in Indonesia, India, South Africa, Tanzania and the United States to promote UHC and are always on the lookout for windows of opportunity to champion UHC to the next generation of global leaders. So if you feel political commitment to UHC is lacking in your country and we can be of assistance, do please let us know, as we want to play our part in accelerating UHC as a means to deliver the SDGs. UHC makes medical, economic, political and social sense. But as the founder of The Elders, Nelson Mandela, so powerfully stated:
“Health cannot be a question of income; it is a fundamental human right.”At the start of a new decade which also marks the 30th anniversary of Mandela’s freedom from prison, let us commit to work together to realize his vision and make UHC a reality for all. Let us join our hands together to help make the world healthier and stronger Thank you. Source: The Elders