France, longtime leader in universal health coverage


Nearly half the world’s population do not have access to essential health services and nearly 100 million people every year are plunged into extreme poverty when paying for the healthcare they need.

In Africa and Southeast Asia, nearly one third of households have to borrow money or sell their property to pay for healthcare.

France has made Universal Health Coverage (UHC) a focus of its 2017-2021 Global Health Strategy.

The COVID-19 health crisis has emphasized how important and vital the goal of Universal Health Coverage is.

Universal Health Coverage: Definition

Access for all, including vulnerable and marginalized populations, to quality health services without risk of financial difficulties.

Impacts well beyond the areas of health and well-being

Progress to achieve Universal Health Coverage is an investment which has benefits far beyond the areas of health and well-being (SDG 3). It also generates inclusive and sustainable economic growth (SDG 8), better education results of children, adolescents and young people (SDG 4), and improved nutrition (SDG 2).

A French priority

France promotes a new approach to universal health coverage. It is considered a cross-cutting objective. National health systems need to be improved comprehensively if UHC is to be achieved.

Since 2012, France has advocated at the highest level for UHC in international organizations and bodies. This investment came to fruition in September 2015 when UHC was chosen as a target in goals of the 2030 Agenda for Sustainable Development. France also played a driving role in the adoption of the political declaration of the High-Level Meeting on Universal Health Coverage at the United Nations General Assembly in 2019.

The COVID-19 crisis and the need to achieve Universal Health Coverage
The COVID-19 pandemic has challenged all health systems and worsened blatant disparities in access to health services in the world. A total of 90% of countries have seen their essential health services disrupted since the start of the pandemic. This health crisis calls for us to confirm our commitments to strengthening the health systems of the most vulnerable countries with a view to achieving Universal Health Coverage.

The financing of the basic functions of our health systems, such as monitoring, preparation and research & development, is the appropriate response to today’s pandemic and potential future crises. Also the financing of common goods for public health is a first step towards Universal Health Coverage.

P4H Network

In 2007, France and Germany co-founded the Providing for Health (P4H) Network. Joined by 16 other members including multilateral agencies, bilateral partners and academic institutions such as Switzerland, the Global Financing Facility (GFF) and the Asian Development Bank, this network aims to coordinate and facilitate joint efforts and planning at national, regional and global level to establish fair and effective health social protection systems moving towards UHC. The World Health Organization, World Bank and International Labour Organization are responsible for the coordination of this network. In 2020, France is contributing €4.7 million.

France is also a member of the multipartite platform UHC2030, which promotes collaborative working at global and country levels on strengthening health systems in order to achieve UHC. Its Secretariat is provided by the World Bank and WHO.

France also encourages various health funds, including the Global Fund to Fight AIDS, Tuberculosis and Malaria and GAVI, the Vaccine Alliance, to take action to strengthen national health systems.

France assists countries directly in defining and implementing UHC policies through its bilateral development assistance managed by the Agence Française de Développement (French Development Agency, AFD) and Expertise France, which are both agencies of the Ministry for Europe and Foreign Affairs. They have made UHC a priority for their action.

In 2019, the AFD invested €327 million in the promotion of UHC by strengthening health systems and affordability of healthcare through loans (sovereign and non-sovereign) and in grants including through European Union fund delegation. It also earmarked €175 million for assisting countries in the implementation of lasting and inclusive national social protection systems, including social protection in the area of health.

Focus on the Solidary and Health Initiative for the Sahel

This €30-million initiative financed by the Ministry for Europe and Foreign Affairs, managed by the AFD since 2013, aims to promote access to healthcare for children under five in four countries of the Sahel (Mali, Niger, Senegal and Chad) via support for mutually supportive mechanisms for exemption from payment promoted by States and/or non-governmental organizations.

Updated: October 2020