On UHC Day, ICN calls for bold investment in nursing and health to meet 2030 targets

As the world marks Universal Health Coverage Day 2024, the International Council of Nurses (ICN) today issued an urgent call for bold, sustained investment in nursing, primary health care, and financial protection as the path to UHC.

With just over five years remaining to achieve the UN 2030 Sustainable Development Goals and universal health coverage targets, ICN emphasized that without urgent action to finance affordable care and strengthened health systems and workforces, the world will fail to deliver on its promise of health for all.

ICN’s President, Dr Pamela Cipriano, is co-chair of the UHC2030 Steering Committee and chaired yesterday’s UHC2030 flagship Town Hall event, which brought together youth advocates, parliamentarians and health leaders to discuss UHC progress and challenges. Dr Cipriano emphasized the urgent need to invest in accessible care for both current and future generations, noting that today’s decisions will determine the realities of tomorrow’s health systems. She stressed the importance of translating political commitments into tangible actions that make care accessible to everyone, everywhere.

In her opening remarks, Dr Cipriano highlighted that financial safeguards for health services have deteriorated in 70% of countries over the last decades, eroded further by the pandemic and growing global inequities. This is why the key focus of this UHC Day is financial protection and why ICN calls on leaders to remove monetary and social barriers to care and implement laws and budgets that ensure all individuals can access essential health services without risking poverty or sacrificing their economic security.

Currently, over 4.5 billion people, more than half of the world's population lack access to essential health services, while nearly 2 billion people are experiencing financial hardship due to paying out of pocket for health care. Dr Cipriano emphasized that “these are not just numbers, these are people struggling, making impossible choices every day as to whether they can pay for health services or essential needs like food and shelter”.

Nurses are the largest global health profession and often serve as the first and only health workers patients see, which means investment in the nursing profession is critical to accelerate progress towards UHC. ICN has described the world’s grave shortage of nurses as a global health emergency and calls for urgent action to build and retain the sustainable nursing workforce needed to provide essential, affordable, and accessible treatment to all.

As a member of the World Health Professions Alliance (WHPA), ICN has co-signed two statements urging WHO member states to invest in health professionals to deliver the safe, high-quality PHC needed to achieve universal health coverage.

As outlined in the WHPA statement, ICN believes that PHC must be built on a foundation of health professionals rather than over-relying on community health workers (CHWs). While CHWs can play a supportive role, sustainable UHC requires a regulated professional workforce fully equipped to provide safe, effective, and cost-efficient care and avoid risks of unnecessary errors, complications and hospitalizations.

The World Health Organization (WHO) has stated that up to 90% of UHC goals can be achieved through holistic primary health care that centres preventative and community services delivered by multidisciplinary teams.

Dr Cipriano said: "Nurses are the backbone of universal health coverage: there can be no health for all without nurses for all. ICN’s recent Primary Health Care report highlights how nurse-led models of care, from rural clinics to community mental health support and vaccination programmes, are safely and effectively improving access to high-quality health services around the world.

Nurses do not only treat symptoms — they build long-standing relationships with patients and communities on the ground, addressing both immediate health needs and underlying social factors, which means they are ideally positioned to deliver comprehensive primary care accessible to all populations.”

At a webinar yesterday launching the UHC Compass, a tool designed to support patient organizations, hosted by the International Alliance of Patients’ Organizations (IAPO), ICN’s President highlighted “the importance of the lived experience of patients and civil society, including marginalized groups” in ensuring equitable and inclusive care.

In a video recorded by ICN for UHC Day 2024, Dr Cipriano further urged nurses to raise their collective voice by engaging with nursing organizations and calling on parliamentarians to invest in accessible health care and financial protections.

She commented: “As our UHC Day slogan says, Health is on the government. But right now, it's on us to hold them accountable and rally for change. The evidence is clear that spending on nursing and health is not a cost — it is an investment. When governments provide accessible care and protect people from crushing health costs, children stay in school longer, gender equality improves, and economies thrive.

We call on decision-makers to step up with concrete and ambitious laws and budgets to finance health professionals and health care. We cannot afford the cost of inaction.”