Allotey et al. BMC Public Health 2012, 12(Suppl 1):S1 http://www.biomedcentral.com/1471-2458/12/S1/S1 E D I T O R I A L Open Access Universal coverage in an era of privatisation: can we guarantee health for all? Pascale Allotey1*, Shajahan Yasin1, Shenglan Tang2, Su Lin Chong3, Julius Chee Ho Cheah1, Daniel D Reidpath1 From Universal Coverage: Can We Guarantee Health For All? Bandar Sunway, Malaysia. 3-4 October 2011 A government that claims to provide universal health coverage (UHC) needs to establish that access to health services is available for the whole population for the full spectrum of services without risk of undue financial hardship. Embedded within the idea of UHC are two distinct notions. First, access to the full spectrum of health services needs to include access to preventive care through to palliative care and rehabilitative services. Second, access to services for a whole population means that everyone should be able to enjoy the benefits of the health system, regardless of individual economic, social, or geographic position. Those in favour of UHC see health as a public good not simply an individual benefit, and they recognise that, as a consequence of this view, the implementation of UHC requires a level of regulation and a kind of investment that is inconsistent with an unconstrained free market. The challenge for government is in select- ing the mix of regulatory and financing mechanisms for the chosen, universally available, health services. This also presupposes that the parcel of health services that will be available has been identified, and there are sys- tems in place to monitor and evaluate the system. It was around these issues that the International Sympo- sium on Universal Health Coverage in Malaysia, convened by Global Public Health at the School of Medicine and Health Sciences, Monash University Sunway Campus on 3 – 4 October 2011 cohered. The symposium provided an opportunity for lively and robust discussions between the private health care sector, including private health care and insurance providers, government and academics. The proceedings of the symposium are expected to feed into the background papers for the Second Global Symposium on Health Systems Research to be held in Beijing, 1School of Medicine and Health Sciences, Monash University, Sunway Campus Malaysia Full list of author information is available at the end of the article 31 October to 3 November 2012 and copies of presenta- tions are accessible [1]. The gathering also presented the opportunity for the Monash 2011 Global Health Oration on the topic, presented by Professor Timothy Evans [2]. This supplement presents a compilation of select papers from the symposium which attempt to examine the con- cept of UHC from a series of different perspectives. 1. Equity and vulnerability; 2. Insurance and financing; 3. Coverage and satisfaction; and 4. Implementation. These perspectives necessarily overlap and the insights from one perspective help to inform the considerations from another perspective. Equity and vulnerability UHC is about the delivery of health care to whole popu- lations. The long standing work on the social determi- nants of health identifies socio-economic stratification as one of the most significant factors affecting health and, most importantly in the context of the work in this Supplement, one of the most significant factors affecting access to health services: preventive, palliative, and reha- bilitative. Social vulnerabilities are important because they interfere with the universality of UHC. Health sys- tems need to be designed so that everyone can access them. It is not enough for great services to be available; if UHC is to be achieved those services must be accessi- ble to those people usually most vulnerable to exclusion. The topic was addressed in some detail in Tim Evans’ Global Health Oration [2]. In presentations by Allotey, Ravindran, Kamarulzaman and Alvarez-Castillo, the challenges of working with vul- nerable and hard to reach populations [3] were explored. The paper by Ravindran is included in this collection. Vulnerable groups are explored with exam- ples of how social stratification negatively affects health © 2012 Allotey et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.