The Legal Determinants of Health: How Can We Achieve Universal Health Coverage and What Does it Mean?

Abstract

How can we keep people – wherever they live – healthy and safe? Among all global health initiatives, universal health coverage (UHC) has garnered most political attention. But can UHC (as important as it is) actually achieve the two fundamental aspirations of the right to health: keeping people healthy and safe, while leaving no one behind? There is a universal longing for health and security, but also a deep-seated belief in fairness and equity. Can UHC achieve both health and equity, or what I have called, “global health with justice?” What makes a population healthy and safe? Certainly, universal and affordable access to healthcare is essential, including clinical prevention, treatment, and essential medicines. But beyond medical care are public health services, including surveillance, clean air, potable water, sanitation, vector control, and tobacco control. The final and most important factor in good health are social determinants, including housing, employment, education, and equity. If we can provide everyone with these three essential conditions for good health (healthcare, public health and social determinants), it would vastly improve global health. But we also need to take measures to leave no one behind. To achieve equity, we need to plan for it, and here I propose national health equity programs of action. Society’s highest obligation is to achieve global health, with justice.

Keywords

• universal health coverage
• global health
• public health
• equity
• justice