Universal Health Coverage to counteract the economic impact of the COVID-19 infection


COVID-19; economic crisis; health crisis; health policy; health financing; universal health coverage


In December 2019, the first case of Coronavirus was identified. The novel virus appears to be highly contagious and is rapidly spreading worldwide, becoming a pandemic. The disease is causing a high toll of deaths. Effective public health response to a new infectious disease is expected to mitigate and counteract its negative impact on the population. However, time and economic-financial constraints, as well as uncertainty, can jeopardize the answer. Appropriate financing of the health system and ensuring equitable access to health services for all can protect individuals against high medical costs, which is one of the most important goals of any health system. Financing profoundly affects the performance of the health system, and any policy that the health system decides to implement or not directly depends on the amount of available funding. Various countries are injecting new funding to cope with the disease and prevent it faster. In addition to psychological support and increased social participation for the prevention, control, and treatment of COVID-19, extensive financial support to governments by the community should be considered. Developed and rich countries should support countries that do not have financial viability. This disease cannot be controlled without international cooperation. The experience of the COVID-19 should be a lesson for further developing universal health coverage in all countries. In addition to promoting equity in health, appropriate infrastructure is provided to address these crises. Governments should make a stronger political commitment to implement this crucial policy fully.



1. Chin MH, King PT, Jones RG, Jones B, Ameratunga SN, Muramatsu N, et al. Lessons for achieving health equity comparing Aotearoa/New Zealand and the United States. Health Policy. 2018;122(8):837-53.
2. Gase LN, Pennotti R, Smith KD. "Health in All Policies": taking stock of emerging practices to incorporate health in decision making in the United States. J Public Health Manag Pract. 2013;19(6):529-40.
3. Baker EL, Potter MA, Jones DL, Mercer SL, Cioffi JP, Green LW, et al. The public health infrastructure and our nation's health. Annu Rev Public Health. 2005;26:303-18.
4. de Silva A, Ranasinghe T, Abeykoon P. Universal health coverage and the health Sustainable Development Goal: achievements and challenges for Sri Lanka. WHO South East Asia J Public Health. 2016;5(2):82-8.
5. Ruducha J, Mann C, Singh NS, Gemebo TD, Tessema NS, Baschieri A, et al. How Ethiopia achieved Millennium Development Goal 4 through multisectoral interventions: a Countdown to 2015 case study. Lancet Glob Health. 2017;5(11):e1142-e51.
6. Adua E, Frimpong K, Li X, Wang W. Emerging issues in public health: a perspective on Ghana's healthcare expenditure, policies and outcomes. EPMA J. 2017;8(3):197–206.
7. McDaid D, Quaglio G, Correia de Campos A, Dario C, Van Woensel L, Karapiperis T, et al. Health protection in times of economic crisis: challenges and opportunities for Europe. J Public Health Policy. 2013;34(4):489-501.
8. Bloom DE, Cadarette D. Infectious Disease Threats in the Twenty-First Century: Strengthening the Global Response. Front Immunol. 2019;10:549.
9. Bredenkamp C, Evans T, Lagrada L, Langenbrunner J, Nachuk S, Palu T. Emerging challenges in implementing universal health coverage in Asia. Soc Sci Med. 2015;145:243-8.
10. Cuevas García-Dorado S, Cornselsen L, Smith R, Walls H. Economic globalization, nutrition and health: a review of quantitative evidence. Global Health. 2019;15(1):15.
11. World Health Organization. Strategic Partnership for International Health Regulations (2005) and Health Security (SPH) 2020 [updated 7 May 2020. Available from: https://extranet.who.int/sph/.
12. Ghebreyesus TA. All roads lead to universal health coverage 2020 [updated 7 May 2020. Available from: https://www.who.int/news-room/commentaries/detail/all-roads-lead-to-universal-health-coverage.
13. Ministry of Foreign Affairs of Japan. G7 Ise-Shima Leaders’ Declaration 2016 [updated 7 May 2020. Available from: https://www.mofa.go.jp/files/000160266.pdf.
14. Remuzzi A, Remuzzi G. COVID-19 and Italy: what next? Lancet. 2020;pii: S0140-6736(20):30627-9.
15. Livingston E, Bucher K. Coronavirus Disease 2019 (COVID-19) in Italy. JAMA. 2020.
16. Gable L, Courtney B, Gatter R, Kinney ED. Global public health legal responses to H1N1. J Law Med Ethics. 2011;39 Suppl 1:46-50.
17. Suner S. Assessing and Planning Health Actions During a Crisis. Turk J Emerg Med. 2015;15(Suppl 1):8–10.
18. Tambo E, Madjou G, Khayeka-Wandabwa C, Tekwu EN, Olalubi OA, Midzi N, et al. Can free open access resources strengthen knowledge-based emerging public health priorities, policies and programs in Africa? F1000Res. 2016;5:853.
19. Spina S, Marrazzo F, Migliari M, Stucchi R, Sforza A, Fumagalli R. The response of Milan's Emergency Medical System to the COVID-19 outbreak in Italy. Lancet. 2020;395(10227):e49-e50.
20. World Health Organization. Primary Health Care on the Road to Universal Health Coverage 2019 monitoring report 2019 [updated 7 May 2020. Available from: https://www.who.int/healthinfo/universal_health_coverage/report/2019/en/.
21. Phelan AL, Katz R, Gostin LO. The Novel Coronavirus Originating in Wuhan, China: Challenges for Global Health Governance. JAMA. 2020.
22. Feldstein LR, Ellis EM, Rowhani-Rahbar A, Hennessey MJ, Staples JE, Halloran ME, et al. Estimating the cost of illness and burden of disease associated with the 2014-2015 chikungunya outbreak in the U.S. Virgin Islands. PLoS Negl Trop Dis. 2019;13(7):e0007563.
23. Kim JM, Chung YS, Jo HJ, Lee NJ, Kim MS, Woo SH, et al. Identification of Coronavirus Isolated from a Patient in Korea with COVID-19. Osong Public Health Res Perspect. 2020;11(1):3-7.
24. Roncarolo F, Boivin A, Denis JL, Hébert R, Lehoux P. What do we know about the needs and challenges of health systems? A scoping review of the international literature. BMC Health Serv Res. 2017;17(1):636.
25. Reich NG, Lessler J, Varma JK, Vora NM. Quantifying the Risk and Cost of Active Monitoring for Infectious Diseases. Sci Rep. 2018;8(1):1093.
26. Bedford J, Enria D, Giesecke J, Heymann DL, Ihekweazu C, Kobinger G, et al. COVID-19: towards controlling of a pandemic. Lancet. 2020;pii: S0140-6736(20):30673-5.
27. Kruk ME, Gage AD, Joseph NT, Danaei G, García-Saisó S, Salomon JA. Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries. Lancet. 2018;392(10160):2203-12.
28. Hanefeld J, Mayhew S, Legido-Quigley H, Martineau F, Karanikolos M, Blanchet K, et al. Towards an understanding of resilience: responding to health systems shocks. Health Policy Plan. 2018;33(1):1144.
29. Halloran ME, Longini IM Jr. Emerging, evolving, and established infectious diseases and interventions. Science. 2014;345(6202):1292–4.
30. WHO. Coronavirus disease 2019 2020 [updated 27 March 2020. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen.
31. COVID-19 Coronavirus Pandemic 2020 [updated March 29, 2020. Available from: https://www.worldometers.info/coronavirus/.
32. Jain V, Alam A. Redefining universal health coverage in the age of global health security. BMJ Glob Health. 2017;2(2):e000255.
33. Williams JS, Walker RJ, Egede LE. Achieving Equity in an Evolving Healthcare System: Opportunities and Challenges. Am J Med Sci. 2016;351(1):33–43.
34. Zagmutt FJ, Sempier SH, Hanson TR. Disease spread models to estimate highly uncertain emerging diseases losses for animal agriculture insurance policies: an application to the U.S. farm-raised catfish industry. Risk Anal. 2013;33(10):1924-37.
35. Ivers LC, Walton DA. Novel Coronavirus Disease (COVID-19): Global Health Equity in Pandemic Response. Am J Trop Med Hyg. 2020.
36. Wang Z, Tang K. Combating COVID-19: health equity matters. Nat Med. 2020;26(4):458.