Universal Health Coverage (UHC) and the Coronavirus Crisis – Challenges and Responses: maintaining essential health services while responding to COVID-19


Access to quality and affordable health services is a significant element of Social Protection, in particular, through Universal Health Coverage (UHC). While many countries struggle to provide UHC, extended health emergencies such as the outbreak of COVID-19 puts enormous pressure on the supply side as health systems come under severe stress. In the process, social protection and access to essential health services of vulnerable populations further deteriorate, particularly hitting hard those without health insurance. In the first quarter of 2020, national health systems, including in countries with strong health systems, struggled to cope with the COVID-19 emergency response while at the same time maintaining the delivery of essential health services, including HIV, tuberculosis, malaria, non-communicable diseases, mental health, sexual and reproductive health, and child health. UHC includes all these services, and inadequate health coverage, exacerbated by overwhelmed health systems, could result in severe human and economic consequences. The UN Secretary-General underlined such risks in a call for urgent action to protect children from the impact of COVID-19 stating that “as health services become overwhelmed in caring for large numbers of infected patients requiring treatment, children and pregnant women are less able to access standard care /../ While children are not the face of this pandemic, its broader impacts on children risk being catastrophic and amongst the most lasting consequences for societies as a whole.”1

During the 2014-2015 Ebola outbreak, the World Health Organization (WHO) reported that the increased number of deaths caused by measles, malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from Ebola. 

Based on lessons from previous experiences of outbreaks where indirect mortalities from vaccine-preventable and treatable conditions can increase dramatically as a result of overwhelmed health and social protection systems, the WHO recently published the “Operational guidance for maintaining health services during an outbreak.” In collaboration with UNICEF, WHO also published a set of guiding principles for immunization activities during the COVID-19 pandemic. "We’re worried about their access to basic health services, including immunization and the treatment of childhood diseases. We cannot save a child from COVID-19, and then lose many to pneumonia, measles and cholera". Henrietta Fore, Executive Director, UNICEF.

The WHO and UNICEF continued to advocate that the best defence against any outbreak are strong health systems with effective Universal Health Coverage, which are complemented by social protection schemes that have the capacity to cover persisting gaps in available health services and social protection coverage.

The experiences of the People’s Republic of China and South Korea, both hit early by the Coronavirus outbreak but also, both with Universal Health Coverage, are interesting for other countries as part of ongoing country-to-country learning and South-South cooperation efforts and the global response to the COVID-19 pandemic. Speakers from China and South Korea have shared their countries’ experiences from the health sector perspective and how health systems delivered essential health services at the height of the pandemic in their respective countries. They also addressed some of the plans for recovery.

1Policy Brief: The Impact of COVID-19 on children



Dr. Robin Nandy, Principal Advisor & Chief of Immunizations, UNICEF

Dr. Choe Young June, MD, PhD, Department of Social and Preventive Medicine, University College of Medicine, Republic of Korea

Dr. Yu Wenzhou, National Immunization Center of China, Center for Disease Control, People’s Republic of China


Dr. James Fitzgerald, Director of Health Systems and Services, PAHO/WHO


This is the tenth webinar of the “Social protection responses to COVID-19” webinar series. The series is a joint effort initiated by the IPC-IGGIZ on behalf of the German Federal Ministry for Economic Cooperation and Development (BMZ), and the Australia Government's Department of Foreign Affairs and Trade (DFAT) collaboration with the socialprotection.org platform, and in cooperation with partners from different organisations. Join our online community ''Social protection responses to COVID-19 [Task force]'' to learn more about the initiative and the future webinars.