Washington International Law Journal


Andrea L. Frey


Protecting and promoting health is central to sustained economic and social development. Three of the eight United Nations Millennium Development Goals (“MDGs”) focused on health, including reducing incidences of HIV and malaria, improving maternal health, and reducing child mortality. Although specifying disease areas and health outcomes ensured that the targets had a clear focus, it also created many problems. In particular, the approach neglected the creation of strong, effective health systems. The UN’s adoption of the MDGs in 2000 created greater recognition that sustaining progress in health depends on such systems in the international community. The MDGs conclude at the end of 2015, making it an opportune time to shape policies and practices in the post-2015 development agenda that establish strong health systems. Such systems can be achieved by advancing the principle of universal health coverage (“UHC”) as a Sustainable Development Goal (“SDG”). UHC implies that all people have access, without discrimination, to nationally determined sets of the needed promotive, preventive, curative, and rehabilitative basic health services. Further, UHC would provide all people with essential, safe, affordable, effective, and quality medicines. It would also ensure that the use of these services does not expose individuals to financial hardship, emphasizing the needs of low-income and marginalized segments of the population. Accordingly, this piece introduces the Washington International Law Journal’s special issue devoted to the transition from MDGs to SDGs and proposes UHC as a goal for the post-2015 development agenda. In implementing this goal, negotiators should incorporate key lessons from the MDGs’ successes and limitations, as well as workable solutions based on national UHC experiences.

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