Jean Claude Mugunga is a physician and associate director of monitoring, evaluation, and quality at Partners In Health, a social justice health care organization working with 10 countries. He leads the organization’s planning and costing efforts around universal health coverage.

I believe that it is the obligation of the state to respect, protect, and fulfill the right to health. It is the role of the community to participate actively in its achievement. And it is the necessity of duty bearers in the international community to work with communities and governments to assure that in a globalized world, the attainment of human rights is truly global.

The version of universal health coverage presented in the political declaration that world leaders adopted in the United Nations General Assembly on Monday definitely doesn’t align with my beliefs.

The central problem is that it represents selective “sets of services.” The danger of “nationally determined sets” is that governments could interpret the phrase to mean a limited range of health services, such as those that are profitable commodities, and leave much of the health needs to the whims of private markets.

A UHC that means a few select services for everyone while the rest are left to the market does not serve to promote equity. It also exaggerates the agency of resource-poor countries to “determine” these sets of services.

Overall, this serves to undermine the meaning of health as a human right.

The 1978 Declaration of Alma-Ata stands in stark contrast to this declaration. It called for the achievement of health for all by the year 2000, and it made clear that “a new international economic order” was required. However, the establishment of a sustainable and equitable economic order was ultimately not advanced by signatories.

Rather, global capitalism was taken over by neoliberalism, resulting in increased national and global inequities, instability and crises, and the promotion of selective primary health care. The idea of health for all was turned into the idea of some health for some. Read more via Devex