TY - JOUR T1 - Health system governance and the UHC agenda: key learnings from the COVID-19 pandemic JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2021-006519 VL - 6 IS - 7 SP - e006519 AU - Carmen Huckel Schneider Y1 - 2021/07/01 UR - http://gh.bmj.com/content/6/7/e006519.abstract N2 - Immediately prior to the emergence of SARS-CoV-2 and the ensuing global COVID-19 pandemic, global health policy experienced a peak in political attention for Universal Health Coverage (UHC) as a key paradigm to strengthen health systems and achieve global health. As a set of health policy goals, UHC emphasises the responsibility of governments to enable broad equitable access to quality health services and strengthen the health system pillars that are required to maintain them. The 2019 United Nations (UN) General Assembly Political Declaration of the High-level Meeting on Universal Health Coverage was passed following months of debate and negotiation in October 2019, just weeks before the first known cases of SARS-CoV-2 emerged.1The COVID-19 pandemic has arguably added further potency to the call for attention on strengthening health systems and achieving UHC.2 The worst effects of the pandemic arose in situations where health systems became overwhelmed, as the spread of disease increased at a rate faster than public health systems could trace it, and numbers of severe cases exceeded the capacity of health services to treat it.UHC gained momentum as a unifying, broad and systems-based approach in the 2010s, although its origins can be traced back to movements a century earlier and the waxing and waning of health systems approaches to global health since.3 The 2019 declaration drew out a comprehensive and wide-ranging list of key principles that should underpin achieving UHC with a particular focus on service accessibility; equitable distribution of essential medicines and technologies; increases in overall health funding; protection from financial burden; the rights of vulnerable groups; growth of the health workforce and importantly, strong health system governance.4Despite this comprehensive list of key principles, a 2020 survey of key stakeholders in countries party to the declaration undertaken by UHC 2020 found that … ER -