<br>From: <b class="gmail_sendername">Ruggiero, Mrs. Ana Lucia (WDC)</b> <span dir="ltr"><<a href="mailto:ruglucia@paho.org">ruglucia@paho.org</a>></span><br><div class="gmail_quote">crossposted from: <a href="mailto:EQUIDAD@listserv.paho.org">EQUIDAD@listserv.paho.org</a><br>
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<p class="MsoNormal" style="margin-left:.5in"><b><font size="3" color="maroon" face="Arial"><span style="font-size:12.0pt;font-family:Arial;color:maroon;font-weight:bold">Universal health coverage: friend or foe of health equity?<u></u><u></u></span></font></b></p>
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<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span lang="PT-BR" style="font-size:10.0pt;font-family:Arial">Davidson R Gwatkin a,
Alex Ergo b<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">a Results for Development Institute,
<u></u><u></u>Washington<u></u>, <u></u>DC<u></u> <u></u>USA<u></u><u></u><u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-right:0in;margin-bottom:12.0pt;margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">b Broad Branch Associates, <u></u><u></u>Washington<u></u>, <u></u>DC<u></u>, <u></u>USA<u></u><u></u><u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><b><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold">The Lancet, Volume 377,
Issue 9784, Pages 2160 - 2161, 25 June 2011<font color="navy"><span style="color:navy"><br>
</span></font></span></font></b><font size="1" face="Arial"><span style="font-size:8.0pt;font-family:Arial"> doi:10.1016/S0140-6736(10)62058-2<u></u><u></u></span></font></p>
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<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">Website: <a href="http://bit.ly/mJpecA" target="_blank"><font color="black"><span style="color:windowtext">http://bit.ly/mJpecA</span></font></a>
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<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">“…..Once again, calls
for universality are being heard from health advocates and planners. Last time
around, such calls were for achieving the health-for-all goal at the 1978 <u></u><u></u>Alma-Ata<u></u><u></u> conference. Now
they are re-emerging, as more limited but nonetheless stirring appeals to seek
universal coverage or access in a wide range of health-related areas such as
HIV/AIDS,1 reproductive health,2 health insurance,3 and free health services,
particularly for women and children.4 Reflecting such interest, universal
coverage will figure as the organising theme of a large WHO research meeting on
Nov 16—19 2010.</span></font><font size="1" face="Arial"><span style="font-size:8.0pt;font-family:Arial">5</span></font><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial"><u></u><u></u></span></font></p>
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<p class="MsoNormal" style="margin-right:0in;margin-bottom:12.0pt;margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">This quest for universal coverage is often advocated as a
way of improving health equity. If fully achieved, it would clearly do so.
Everyone—rich and poor, men and women, ethnic or religious majorities and
minorities—would enjoy full equal access to the services concerned. <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-right:0in;margin-bottom:12.0pt;margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">Such an achievement would obviate both the stigma thought to
accompany use of services designed specifically for people who are poor, and
the possibility that such services might be of low quality.<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font size="2" face="Arial"><span style="font-size:10.0pt;font-family:Arial">But beware—universal coverage
is much more difficult to achieve than to advocate. And people who are poor
could well gain little until the final stages of the transition from advocacy
to achievement, if that coverage were to display a trickle-down pattern of
spread marked by increases first in better-off groups and only later in poorer
ones. Should the resulting rise in inequality endure for an extended
time—or worse, become permanent as a drive for universal coverage falls
short of fully realising its goal—the result would be to reduce rather
than enhance health equity….”<font color="navy"><span style="color:navy"><br>
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