Making Fair Choices on the Path to Universal Health Coverage

Author: World Health Organization


Since 2010, more than one hundred countries have requested policy support and technical advice for universal health coverage (UHC) reform from the World Health Organization (WHO).  As part of the response, WHO set up a Consultative Group on Equity and Universal Health Coverage. This final report by the Consultative Group addresses the key issues of fairness and equity that arise on the path to UHC by clarifying these issues and by offering practical recommendations.

To achieve UHC, countries must advance in at least three dimensions. Countries must expand priority services, include more people, and reduce out-of-pocket payments. However, in each of these dimensions, countries are faced with a critical choice: Which services to expand first, whom to include first, and how to shift from out-of-pocket payment toward prepayment? A commitment to fairness—and the overlapping concern for equity—and a commitment to respecting individuals’ rights to health care must guide countries in making these decisions.


Contributions from DCPN

Figure 3.2 on page 14 discusses how to use cost-effectiveness and pro-poor policies to move toward universal health coverage.  This figure was adapted from research by DCP3 Series Editor Dean Jamison and Senior Health Economist Stéphane Verguet. Dr. Jamison presented their key messages at the Harvard Program in Ethics and Health meeting in April, 2013. 

Dr. Ole Norheim, member of the DCP3 Advisory Committee, served as co-chair of the Consultative Group on Equity and Universal Health Coverage and lead author of the report.

Dr. Toby Ord, also a member of the DCP3 Advisory Committee and the DCP3 Communications Technical Advisory Group, served as a member of the Consultative Group responsible for writing this report.


World Health Organization. 2014. Making fair choices on the path to universal health coverage. Final report of the WHO Consultative Group on Equity and Universal Health Coverage. WHO: Geneva.