The movement towards universal health coverage (UHC) is currently among the most  prominent global health policies. According to the United Nations Sustainable  Development Goals, all UN Member States agreed to work towards achieving  Universal Health Coverage by 2030. This includes financial risk protection, access to  quality essential health-care services and access to safe, effective, quality and  affordable essential medicines and vaccines for all. As more countries make  commitments to universal health coverage especially in these tough times caused by  the C-19 pandemic, they face challenges on how to quantify it and track progress  towards its key goals, both in terms of health services and financial protection  coverage. The Joint WHO/World Bank Group report released on 2015 entitled  ‘Tracking universal health coverage: First global monitoring report” provided  guidance about how states can achieve universal health coverage and build more  resilient health systems and we the People’s Health Movement Uganda chapter  believe that some of the suggested guidelines are ether realistically non-applicable  or pose a barrier to attainment of sustainable development goals and Universal Health  Coverage all together most especially in the face of Covid-19 pandemic.

PHM Uganda recognises the importance of universal health coverage (UHC) although  it needs to be qualified due to its interpretation proximity with primary health care  and the diversity of interpretations of both PHC and UHC circulating. Some of these  interpretations, such as the World Bank’s multi-player, stratified access, mixed  delivery models, as PHM we believe are affecting health for all as clarified In the  foregoing.  
The marketisation of UHC most especially at a time of the raging COVID-19 pandemic  did undermine the implementation of comprehensive primary health care in most  countries like Uganda. Health care was unaffordable and it reduced PHC to arbitrarily  defined ‘interventions’ and as a result limited and distorted the analysis of needs and  priorities; precluded effective community accountability; ignored public and  community action around the social determination of health; and prevented best use  of limited resources. Uganda experienced the emergency of public health policies  and laws that criminalized illness. The contemporary policy debates around UHC    

being framed by macroeconomic instabilities globally and the neoliberal policies  being put in place to manage those instabilities has weighed in negatively. Widening  social and economic inequalities associated with neoliberal economic policies have  greatly contributed to the fraying of social solidarity and consequently weakened political support for single pool single payer systems. Transnational corporations, as  the principal conduits of foreign direct investment, are driving a race to the bottom  with respect to tax policies (through tax competition) with increased restrictions on  public funding of health care as a consequence. Neoliberal pressures to open new  markets for corporate investors through health system privatization (supported by  trade in services provisions and investor protection provisions in contemporary trade  agreements) contributed to the privileging of market models in health policy debate. 

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