Leaving no one behind: using law to achieve universal health coverage

Out-of-pocket costs are a substantial problem for people affected by cancer around the world, especially for those in low- and middle- income countries, where availability of cancer medications is subject to higher out-of-pocket expenses.

World Health Day is marked annually on 7 April and this year the theme is Universal Health Coverage (UHC), highlighting the urgent need for all people, including those affected by cancer, to have access to the quality health services they need, when and where they need them, without financial hardship.

Law is a powerful tool in advancing UHC as it occupies a central place in health system design; implementation and governance; the delivery of health care across the life course; and disease prevention and control. Used effectively, law is an enabler of good health practices, better health outcomes, and reduced health inequities.

The vital importance of law in healthcare is recognised in major international treaties and frameworks, including within the 2030 Agenda for Sustainable Development, which aims to leave no one behind.

Target 3.8 of the Sustainable Development Goals (SDGs) makes this clear: Achieve universal health coverage, including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

All United Nations Member States have agreed to the SDGs, and therefore, must progress UHC – law is fundamental to this.

Laws and regulations support the progress towards UHC, which reinforces the commitments States have made to cancer prevention and control, as well as other SDGs in many ways, such as:

• Protection of the rights of people affected by illness through non-discrimination and equal opportunity laws as well as employment protections, regulatory measures to ensure access to insurance, and laws to protect the needs of particular populations such as women, children and indigenous communities;
• Regulation to ensure that medicines, medical devices and health technologies are safe and of high-quality;
• Establishment of qualification, training and continuing education requirements for health practitioners; or
• Provision for the collection, protection and use of health information at individual and population levels, for example through population-based cancer registries, to support health research and provide data to ensure effective, evidence-based UHC interventions are introduced.

These examples (and there are many others) of the role of law and regulation in strengthening health systems, also demonstrate that all actors that make up the health workforce — from practitioners to policymakers — work both with, and within, law and regulation.

When it comes to public health issues like UHC, law is not just a matter for lawyers – engaging with law is crucial at all stages. This extends to actors in a range of fields who can have an impact on public health, such as in trade, education or environment.

Countries and organisations must harness legal and regulatory measures as essential tools to advance UHC and meet their commitments under the SDGs. One of the ways the McCabe Centre for Law and Cancer is supporting this, is by mentoring the Cancer Warriors Foundation Inc based in the Philippines through UICC’s Treatment for All campaign.

The Cancer Warriors Foundation Inc, founded by a teen cancer survivor, is a patient-support organisation for children and young people with cancer, survivors and their families. It is recognised as a champion of breakthrough laws, national policies and programs for childhood cancer, and is the UICC designated country champion for the Treatment for All campaign in the Philippines.

The Cancer Warriors Foundation Inc worked collaboratively as part of the Cancer Coalition Philippines on the passage of the country’s National Integrated Cancer Control Act. The new law provides an opportunity for securing accessible, equitable and affordable cancer treatment and care for all cancers, all ages and stages.

Implementing rules and regulations are currently being developed to support the Act on issues such as developing a cancer registry and non-discrimination. The Cancer Warriors Foundation Inc will be involved in the ongoing development of these rules and regulations, and the McCabe Centre will provide support through sharing experiences of successful measures and approaches, both Australian and international.

Effective legal and regulatory measures – and the knowledge of how to use them – are essential for a healthy society where all people have access to the quality health services they need, when and where they need them, without financial hardship.

Preparations for the United Nations High-Level Meeting on UHC in September this year will provide an important opportunity to share approaches of effective law and regulation to advance UHC, and ensure we leave no one behind.