Universalising Health Coverage or Crisis? Contours of the Challenges and Solutions

Despite strides in healthcare innovation, information technology, and delivery systems, global health systems continue to face complex challenges. Health Systems Strengthening (HSS) with Universal Health Coverage (UHC) is a priority for the G20 countries. Adopting the sustainability lens to analyse the current crisis, this Policy Brief argues that the existing UHC model requires a rethink. Advancing the Astana Declaration’s proposition that Primary Health Care (PHC) be brought together with UHC (UHC-with-PHC), this Brief suggests applying the tenets of the PHC approach to a continuum of healthcare (from home to tertiary care), i.e., PHC-with-UHC. Deepening and pluralising primary-level care and transforming the structure and functioning of secondary and tertiary services can make health systems sustainable and holistic. Additionally, PHC-with-UHC would include non-medical preventive action through whole-of-society and whole-of-government approaches. This Brief further offers alternate systems design principles to deliberate on how the G20 priority of HSS can become a reality.