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Universal Health Coverage is about the right to health. Everyone – rich or poor – should get the health care they need without suffering financial hardship. Unfortunately, some donors and developing country governments are promoting health insurance schemes that exclude the majority of people and l may also reinforce inequality – by prioritizing people who are formally employed and excluding the most poor and marginalized who cannot afford to pay premiums, especially women.

However, a number of developing countries are rejecting this model and prioritizing general government spending for health to successfully scale up health coverage. Funding through progressive taxation and international aid is the key to achieving Universal Health Coverage. Oxfam estimates that improving tax collection in 52 developing countries could raise an additional $269bn – enough to double health budgets in these countries. 

This paper explains why urgent action on global tax evasion and avoidance is needed to ensure that countries can generate and retain more of their own resources for health. Donors and governments should abandon unworkable insurance schemes and focus on financing that delivers universal and equitable health care for all.

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