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• W2950582249 abstract "When Irene A Agyepong1Agyepong IA Universal health coverage: breakthrough or great white elephant.Lancet. 2018; 392: 2229-2236Summary Full Text Full Text PDF PubMed Scopus (8) Google Scholar discussed the potential risk of universal health coverage (UHC) becoming a white elephant in low-income and low-income and lower-middle-income countries, she also demonstrated how, from 1945 to 2019, global dominant ideologies have been alternating between vertical and horizontal approaches to UHC, with the exception of Ghana. In Japan, ideologies have not changed so often and have only changed once since 1945. Between 1953 and 1958, before Japan achieved UHC, the Japanese Ministry of Health and Welfare allocated more than 20% of total medical expenditure on tuberculosis alone.2Shimao T Contribution of tuberculosis control on economic development: a lecture note.Shiryo to Tenbo. 1992; 1 (in Japanese): 50-69Google Scholar In addition to the successful prioritisation of tuberculosis control through legislation, this vertical approach prompted a 25% decrease in the number of patients with tuberculosis during this period.2Shimao T Contribution of tuberculosis control on economic development: a lecture note.Shiryo to Tenbo. 1992; 1 (in Japanese): 50-69Google Scholar The successful control of tuberculosis was key for Japan to achieve UHC in 1961.3Shimao T Tuberculosis prevention law reform was a key to achieving universal health coverage in Japan.KouseiRoudou. 2013; 12 (in Japanese): 50-51Google Scholar Similar vertical approaches have been implemented at the global level for almost 20 years, such as the Millennium Development Goals. Consequently, HIV infection, malaria, and tuberculosis have been well controlled in many low-income and lower-middle-income countries. However, these successes did not lead to the achievement of UHC in many of these countries. Agyepong proposes that strong leadership and locally inspired approaches are crucial to bring about change. Sally Theobald and colleagues4Theobald S Brandes N Gyapong M et al.Implementation research: new imperatives and opportunities in global health.Lancet. 2018; 392: 2214-2227Summary Full Text Full Text PDF PubMed Scopus (173) Google Scholar eloquently argued that implementation research is about how to improve implementation. To achieve UHC, it is particularly important to reconsider the case study in Ghana described by Theobald and colleagues4Theobald S Brandes N Gyapong M et al.Implementation research: new imperatives and opportunities in global health.Lancet. 2018; 392: 2214-2227Summary Full Text Full Text PDF PubMed Scopus (173) Google Scholar as a breakthrough, not a white elephant. We declare no competing interest. Universal health coverage: breakthrough or great white elephant?Will the Sustainable Development Goal 3 sub-goal “Achieve universal health coverage, including financial risk protection, access to quality essential health care services and…safe, effective, quality and affordable essential medicines and vaccines for all” be judged a breakthrough or a great white elephant in implementation, when we look back with the clear eyes of hindsight in 2030? What are the ways in which this agenda might play out in implementation and why might it do so? Drawing on a desk review, this Essay explores dominant ideas, ideology, institutions, and interests in relation to global versus Ghana national health priorities since the WHO constitution came into effect in 1948, to reflect on these questions. Full-Text PDF" @default.
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• W2950582249 date "2019-06-01" @default.
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• W2950582249 title "How can we avoid making universal health coverage a white elephant?" @default.
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• W2950582249 doi "https://doi.org/10.1016/s0140-6736(19)30213-2" @default.
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