In their Viewpoint on universal health coverage (UHC), Thomas O'Connell and colleagues (Jan 18, p 277)1 discuss the lack of clarity in the global discourse on what UHC means. Despite this apparent confusion at the global level, countries are anyhow implementing UHC-related reforms on their own terms. Is this confusion? Or is it the local reality of a global aspiration? In Chinese, several definitions of UHC coexist, the most recent Quanmin Jiankang Fugai (health coverage for all) followed the publication of the new World Health Report 2013 in Chinese. Earlier, officials used to claim that Quanmin Yibao (medical insurance or medical protection for all) had been achieved. In Portuguese, Cobertura universal em saúde has strongly influenced the Brazilian health system for the last 25 years and is about narrowing health inequalities. In Filipino, Kalusugan Pangkalahatan (health for all, rather than UHC) comes with reforms focused on improving access to services for the poor. In French, Couverture Maladie Universelle (universal disease coverage), highlights the substantial burden of diseases (such as HIV, tuberculosis, and malaria) in Africa and what preoccupies policy makers; many look at disease control as an important step towards UHC. UHC is powerful as an idea because it can resonate with many. Countries are embracing UHC because it aligns with their broader efforts—although there are challenges and lessons to be learnt from countries' experiences.2 , 3 , 4 A clear description of what UHC entails is lacking, but a global dogma on UHC could well be equally perilous.
Bermejo, R. A., Xu, J., Henao, D. E., Ho, B. L., & Sieleunou, I. (2014). What does UHC mean? The Lancet. Lancet Publishing Group. https://doi.org/10.1016/S0140-6736(14)60477-3