Promoting universal health coverage
- Author(s):
- Parliamentary Assembly
- Origin
- Assembly debate on 2 October 2025
(35th sitting) (see Doc. 16243,
report of the Committee on Social Affairs, Health and Sustainable
Development, rapporteur: Mr Stefan Schennach). Text adopted by the Assembly on
2 October 2025 (35th sitting).
1. Universal health coverage (UHC),
based on the principle of “leaving no one behind”, is a central
political commitment of the United Nations 2030 Agenda for Sustainable
Development and is the subject of target 3.8 of Sustainable Development
Goal (SDG) 3. In the Pact for the Future, adopted in 2024, the heads
of State and government meeting at the United Nations General Assembly
reiterated their commitment to redoubling efforts to achieve this
goal.
2. Health is a political priority for the Council of Europe.
As the Secretary General pointed out on the occasion of World Health
Day (7 April 2025), “Health is our most precious gift – and a top
concern for all Europeans... Now more than ever, health care is
about trust, safety and access – and this calls for a holistic approach...
On this day, and every day, let us reaffirm that equitable, high-quality
health care is essential to a healthy democracy”.
3. The objectives pursued in the field of health, both at global
and regional levels, are based on a solid legal foundation for which
there is broad consensus. The right to the highest attainable standard
of physical and mental health, the right to the protection of health
and the right to social protection without discrimination are fundamental
human rights, inseparable from human dignity and crucial for the
effective exercise of all other rights.
4. The Parliamentary Assembly has already put UHC on its agenda
in
Resolution 2500 (2023) “Public health
emergency: the need for a holistic approach to multilateralism and
healthcare”. In that resolution, it underlines that primary healthcare
is the cornerstone of UHC – providing prevention, health promotion, treatment
and financial protection – and requires sustainable financing. In
this context, since preventing and combating gender-based discrimination
are essential, UHC must fully encompass sexual, reproductive and mental
health as well as comprehensive care for victims of violence.
5. UHC is a strategic investment in sustainable development.
It improves health outcomes, social cohesion, equity, gender equality
and economic stability. It is recognised as an essential basis for
global health security to be able to withstand health, geopolitical,
economic and climate crises. Despite this, progress towards UHC
has stalled, with more than 4.5 billion people not fully covered
by essential services, 2 billion facing hardship due to out-of-pocket
health spending and 344 million living in extreme poverty due to
health costs and worsening financial protection.
6. Although Council of Europe member States are making better
progress than the world average, inequalities in access to healthcare
and health disparities persist and are, in some cases, worsening.
The Assembly stresses the urgent need to step up action to achieve
target 3.8 of SDG 3 by 2030, by fully leveraging the 2024-2027 Strategic
Framework of the UHC2030 platform ahead of the next high-level meeting
scheduled for 2027.
7. A leading advocate for the advancement of UHC, the Council
of Europe makes a unique contribution based on human rights. Through
its treaties – the European Convention on Human Rights (ETS No. 5),
the European Social Charter (revised) (ETS No. 163) and the Convention
for the Protection of Human Rights and Dignity of the Human Being
with regard to the Application of Biology and Medicine: Convention
on Human Rights and Biomedicine (ETS No. 164, Oviedo Convention)
– it influences the social and public health legislation and policies
of its member States. This holistic approach, centred on human dignity,
combines the case law of the European Court of Human Rights and
the European Committee of Social Rights, the efforts of the Steering
Committee for Human Rights in the fields of Biomedicine and Health
(CDBIO), the work of the Commissioner for Human Rights and initiatives
by the Congress of Local and Regional Authorities of the Council
of Europe. It is a crucial lever for making the right to health
a reality for everyone, in line with the objectives of UHC and SDG 3.
8. The Assembly recognises that the European Social Charter (revised)
is the Council of Europe’s key instrument for promoting UHC. Its
Articles 11 and 13, interpreted in the light of the World Health
Organization’s (WHO) definition of health, guarantee the right to
the protection of health and medical assistance for all persons present
in the territory of the States parties, regardless of administrative
status. The case law of the European Committee of Social Rights
reinforces this framework by specifying the positive obligations
on States: to guarantee available, economically and geographically
accessible, culturally acceptable and quality care, while ensuring
effective access to essential healthcare. It also incorporates the
social determinants of health (housing, energy, food), thus emphasising
a comprehensive and integrated approach to UHC.
9. The Oviedo Convention directly supports target 3.8 of SDG 3
by establishing the principle of equitable access to quality care,
taking into account health needs and available resources. Building
on this, Recommendation CM/Rec(2023)1 of the Committee of Ministers
calls on States to provide equitable access to medicines and medical
equipment, including during times of shortage, for people with serious
health conditions. The Assembly also welcomes the efforts of the
Steering Committee for Human Rights in the fields of Biomedicine
and Health, which has made equitable and rapid access to medical
innovations a strategic priority.
10. Against a backdrop of diminished political support, growing
geopolitical tensions and budgetary constraints, the Assembly stresses
the importance of conveying a clear, collective message that will
galvanise support for UHC. The SDG commitments are binding on Council
of Europe member States. For UHC to become a reality, it is vital
that each State embrace these objectives and that each parliament
play an active role in implementing them in national public policies.
11. The Assembly considers that the Council of Europe is fully
justified in joining the UHC2030 platform, alongside other international
organisations such as the Organisation for Economic Co-operation
and Development. Membership would enhance its contribution to the
global alignment of efforts to achieve UHC and provide an opportunity
to promote its standards and tools within a multilateral framework.
By joining the platform’s steering committee and endorsing the UHC2030
Global Compact, the Council of Europe could further rally support
among its member State governments and parliaments, strengthen the
place of human rights in health systems and help to make UHC a common,
shared and measurable goal.
12. The Assembly calls on member and observer States of the Council
of Europe and States whose parliaments enjoy observer or partner
for democracy status with the Assembly:
12.1 with regard to UHC and health policies, to:
12.1.1 include
the objective of UHC as a national political priority, in accordance
with target 3.8 of SDG 3 and the commitments reiterated in the Pact
for the Future, adopted in 2024, allocating a sufficient budget
for its achievement in accordance with, inter
alia, the WHO recommendations;
12.1.2 ensure, in particular for people in vulnerable situations,
equitable, affordable and quality access to physical and mental
healthcare, including proactive intervention mechanisms for individuals
who, due to their health condition, are unable to recognise their
need for care or to travel to services;
12.1.3 invest more and sustainably in primary healthcare, recognised
as the foundation of UHC and an essential condition for health and
social resilience;
12.1.4 recognise and integrate the social determinants of health
(such as access to housing, food, energy and a healthy environment)
into public health and social cohesion policies;
12.1.5 include, within the framework of UHC, comprehensive and
accessible services for prevention and sexual, reproductive and
mental health, as well as support for victims of sexual violence;
12.2 with regard to leveraging Council of Europe instruments,
to:
12.2.1 make progress towards wider acceptance of the
provisions of the European Social Charter (revised) that are necessary
to reduce health inequalities and move forward on the commitment
to leave no one behind;
12.2.2 refer systematically to the standards and activities of
the Council of Europe in the field of human rights when drafting
health policies, in particular the European Social Charter (revised) and
the Oviedo Convention;
12.2.3 apply the recommendations of the Committee of Ministers
on equitable access to medicinal products and care, in particular
Recommendation CM/Rec(2023)1, including during times of crisis or
shortage;
12.2.4 actively promote the work of the Steering Committee for
Human Rights in the fields of Biomedicine and Health on equitable
and rapid access to medical innovation;
12.3 with regard to co-ordination and multilateralism, to:
12.3.1 affirm their commitment to UHC in the relevant international
forums and make the case for a human rights-based approach in health
systems;
12.3.2 support Council of Europe membership of the UHC2030 multilateral
platform in order to give a voice to social rights and to promote
alignment between international commitments and European standards;
12.3.3 enhance parliamentary accountability in implementing the
objectives of UHC, in particular by providing parliaments with tools
and resources offered by the UHC2030 platform and the Inter-Parliamentary
Union handbooks, in order to monitor, guide, evaluate and adjust public
health policies;
12.3.4 translate into national legislation the multilateral commitments
made in the area of UHC (in particular within the framework of the
UHC2030 platform), by adopting laws, dedicated budgets and parliamentary
monitoring mechanisms, drawing on European standards and best practices
resulting from international co-operation.
