Universal Health Coverage, Priority Setting, and the Human Right to Health

Following endorsement by WHO, the World Bank, and the UN’s Sustainable Development Goals, the drive towards universal health coverage (UHC) is now one of the most prominent global health policies. As countries progress towards UHC, they are forced to make difficult choices about how to prioritise health issues and expenditure: which services to expand first, whom to include first, and how to shift from out-of-pocket payment towards prepayment. Building on extensive philosophical literature on the ethics of priority setting in health care, a 2014 WHO report provided guidance about how states can resolve these issues. However, policy makers face a further question largely left unanswered by the report: how do states’ moral and legal obligations regarding the right to health fit with their obligations to set health priorities fairly?