World leaders will gather in New York City on Sept. 21 for the 78th session of the United Nations General Assembly (UNGA) to review progress toward universal health coverage (UHC). They will face this critical moment amid a hostile political climate—sexual and reproductive health (SRH) is being politicized and threatened (both in the U.S. and globally). Powerful anti-rights groups are lobbying to restrict access to critical SRH services and to exclude safe abortion care from health and development initiatives. How can advocates and activists harness this global convening to combat the anti-choice movement while protecting and expanding SRH, including access to safe abortion?
The goal of UHC is to create just and effective health systems that deliver healthcare services that cover everyone, everywhere, regardless of their ability to pay. To be truly just and effective, any UHC package must include comprehensive SRH services so that all people can fully protect their health and exercise their right to bodily autonomy and reproductive self-determination. When access to abortion is restricted, many people are left unable “to determine whether or when they have children and may be forced to continue unwanted pregnancies or end pregnancies in dangerous and degrading ways.”
We will never achieve UHC or realize the U.N.’s goal of ensuring health and well-being for all by 2030 without securing equitable access to SRH services, including access to safe abortion care. Globally, unsafe abortion accounts for as much as 13 percent of maternal mortality—deaths that are entirely preventable with access to safe and legal abortion. On top of this, 9 million people do not receive the necessary care for complications, such as hemorrhage or infection, after an unsafe abortion—resulting in entirely preventable suffering and injuries, including infertility.
Just as health and well-being cannot be achieved without comprehensive SRH services, UHC offers a critical pathway to unlocking equitable access to SRH care. Many people face powerful barriers when they seek SRH services, including cost and geographic barriers. Accessing safe abortion can be even more complex: Abortion is criminalized or highly restricted in many settings. Even when abortion is legal, people seeking abortion face stigma, healthcare workers may refuse to provide abortion care and safe abortion may be excluded from routine SRH packages of care or insurance schemes. Ensuring that abortion is a core component of the basic SRH service package covered by UHC could go a long way to ensuring affordable abortion care is available to every person who needs the service.
Globally, gender equity and reproductive justice advocates are raising their voices to demand that SRH—and abortion care specifically—are included as a non-negotiable component of UHC. At the recent Women Deliver Conference held in Kigali, Rwanda, in July 2023, many advocates made an unapologetic call for abortion to be included in UHC.
They noted, “Abortion is a common health intervention in many countries … The global health system largely considers it as simply a medical procedure.”
They also emphasized that the right to bodily autonomy—“the right to govern one’s own body”—is the foundation of gender equality.
A key goal of UNGA this year is advancing plans toward a healthier world through UHC. Building on the momentum from Women Deliver, we call on world leaders to step up and make clear and strong commitments defining sexual and reproductive health services—including safe abortion care—as non-negotiable components of UHC.
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