Asia’s Journey towards Universal Health Coverage: From Alma Ata to Sustainable Development Goals

Universal Health Coverage (UHC) stands as a cornerstone of global health equity, echoing the principles laid out in the Alma Ata declaration of 1978. Rooted in the conviction that health is a fundamental human right, the pursuit of UHC has evolved over the decades, culminating in its recognition as a key Sustainable Development Goal (SDG 3.8) by the United Nations. However, as Asia navigates its path towards UHC, challenges persist, necessitating a reevaluation of strategies and priorities.

Download the Asia Position Paper on Universal Health Coverage (UHC)-2023 here.


Evolution of UHC:

The concept of UHC has evolved since Alma Ata, encompassing not only access to essential healthcare services but also financial risk protection and quality care. The Sustainable Development Goals (SDGs) underscore this evolution, emphasizing the importance of equity and comprehensive service coverage.

Financial Implications:

High out-of-pocket expenditure (OOPE) remains a significant challenge across Asian countries, with notable implications for poverty levels. Countries such as Afghanistan, Bangladesh, China, and Lebanon face a substantial risk of pushing their populations into poverty due to healthcare expenses.

Government Spending:

Government healthcare expenditure plays a pivotal role in enhancing health outcomes and achieving UHC. While some countries have demonstrated progress in increasing government health spending, disparities persist, highlighting the need for tailored financing strategies.

Models of Success:

Sri Lanka’s emphasis on public financing and primary healthcare infrastructure, Thailand’s Universal Health Coverage Scheme, and India’s Ayushman Bharat initiative offer valuable lessons for achieving UHC. These models prioritize accessibility, equity, and quality of care while navigating diverse socio-economic landscapes.


  • Progressive Coverage: Roll out UHC as a progressive coverage starting with comprehensive primary care, ensuring accessibility and affordability for vulnerable populations.
  • Digital Health Integration: Incorporate digital health across care delivery systems to enhance efficiency, accessibility, and quality of services.
  • Value-based Care: Transition towards value-based care and holistic health indicators to measure outcomes and optimize investments in healthcare.
  • Knowledge Sharing: Develop a UHC best practices toolkit based on implementation experiences across Asia to facilitate informed decision-making and minimize implementation challenges.
  • Shift to Universal Health Usage: Emphasize not only coverage but also utilization of healthcare services, promoting wellness indicators and facilities alongside sickness care.
  • Pre-emptive Care: Invest in pre-emptive care models, starting with school health programs, to prevent the occurrence of diseases and promote lifelong wellness.
  • Data-driven Insights: Establish a UHC Digital Dashboard to monitor progress and empower nations with data-driven insights for effective decision-making and action.

Paths Forward

As Asia advances towards Universal Health Coverage, it must navigate complex socio-economic landscapes while prioritizing equity, accessibility, and quality of care. By drawing on lessons from successful models and embracing innovative strategies, Asian nations can accelerate progress towards achieving health for all, fulfilling the vision set forth by Alma Ata and the Sustainable Development Goals.