Acceleration of Universal Health Coverage in the Commonwealth, ensuring no one is left behind The Commonwealth is committed to actively pursue the attainment of the UN Sustainable Development Goals 2030, which reflects the values and principles of the Commonwealth Charter. SDG 3, Ensure healthy lives and promote well being for all at all ages, is central to this commitment and to sustainable development, and has an impact on all the other SDGs, which also have an impact on SDG 3. Central to SDG 3 is the achievement of universal health coverage (UHC). Commonwealth countries have a good track record and demonstrate continuing commitment to achieving and accelerating UHC. The challenge has been how to translate that commitment into practical action, particularly because resource constraints, poor integration of health services, inadequate cross-sectoral approaches, not including a rights-based approach to service development or delivery, and vulnerable and marginalised populations which are often excluded or whose priorities and needs are not inadequately met, particularly women, children, young people, the poor and rural dwellers. Women particularly face health challenges which reflect social and economic inequities, including poor access to health services, as well as gender-based violence.

The project will therefore contribute to the need to accelerate UHC,to address communicable and NCDs and to strengthen health systems, by clarifying the relevant health landscape in the Commonwealth, and sharing experience and supporting and promoting Commonwealth collaboration and collective action. For instance, working with internal and external partners, member countries, civil society and other stakeholders to share experience on UHC funding models, resource mobilisation, pooled procurement mechanisms and health facility-based coordinated response to gender based violence, as well as by supporting collective initiatives and action to address communicable and NCDs.

In its first year (2017/18), the project focused on the identification the Commonwealth landscape in the health areas outlined above, collation of evidence-based best practices and sharing of experience; thus laying the foundation for the successive years of the project. The 2nd year of the project (2018/19) focuses on operationalisation of the 1st year's findings and recommendations, to inform ministerial deliberations at the 2019 Commonwealth Health Ministers Meeting (CHMM) and Pan-Commonwealth action towards accelerating UHC.

With regard to the development of the NCD Legislative Framework and draft NCD legislation, the first year focused on the consultations to identify the Secretariat's niche areas which would add value to the nationally and regionally recognised priorities, as well as the recruitment and placement of the long-term experts. The 2nd year will focus on the development of the Framework and the draft legislation, including regional and national consultations. The 3rd and 4th years will focus on testing, adaptation and awareness raising of the Framework and draft legislation. 

The 3rd and 4th years will also focus on operationalising tools/toolkits which will have been developed based on the work undertaken in the 1st and 2nd years.  For instance, pilot testing the UHC Financing Toolkit, primary data gathering towards tracking progress on GBV, development of an information sharing database for medicines, vaccines and health technology.  The lessons from the latter will inform the possible development of a cancer database, with initial focus on the African region.

These activities and outputs will contribute to the capacity of member countries to develop and implement the relevant policies to improve health outcomes and reduce disparities, which is central to UHC. UHC principles include equity and access for all. This in turn will contribute to short-term outcome, the reduction of disparities and improvement of health outcomes because of the strengthened sustainable policies.

The work of the Commonwealth Secretariat supplements the work of organisations like the World Health Organization and The World Bank, which focuses on developing over-arching frameworks and strategies. The Secretariat on the other hand works by providing hands on context-specific support to translate these frameworks into practical action on the ground. Additionally, the Commonwealth has the advantage of having member countries with similar heritage and administrative structures, making experiencing sharing easier and more relevant; at the same time the Commonwealth also has the advantage of having high- and low-resourced members, who are at different levels of development, being able to assist each other in different ways and share experience form a different angle.