Special series 5: Universal Health Coverage (UHC)
2026/6/22
What Is Universal Health Coverage (UHC)? Delivering Quality Healthcare for All
In this new article, we would like to present the issue of healthcare—one of the most urgent challenges facing Japan as it grapples with a declining birthrate and an aging population—and explore it together with you while highlighting the significance of Universal Health Coverage (UHC). Japan’s efforts in this field within the international community have made substantial contributions to improving healthcare conditions in African countries, particularly in Cameroon, Chad, and the Central African Republic.
1. UHC High-Level Forum 2025
(1) In December 2025, the “UHC High-Level Forum 2025” was held in Tokyo. At this gathering, attended by World Bank President Ajay Banga, WHO Director General Dr. Tedros Adhanom Ghebreyesus, and finance and health ministers from around the world, Prime Minister Sanae Takaichi delivered a video message reaffirming Japan’s strong commitment to UHC.
(2) Prime Minister Takaichi clearly defined UHC as “essential for protecting the lives, livelihoods, and dignity of every individual, while also realizing sustainable economic growth supported by a healthy workforce.” She emphasized the importance of sharing Japan’s accumulated experience and expertise with the world.
2. What Is UHC? — Background and Challenges
(1) On a global scale, billions of people still lack adequate access to essential healthcare services. Many forgo medical treatment due to financial constraints, allowing illnesses to worsen, while others fall into poverty because of medical expenses. Such healthcare inequality remains a global challenge affecting both developed and developing countries.
(2) When people cannot have access to healthcare, illnesses worsen, income is lost, and access to healthcare becomes even more difficult. Breaking this vicious cycle of poverty and disease is the fundamental mission of UHC. Universal Health Coverage means that “all people can access the quality health services they need without suffering financial hardship.” Achieving UHC requires both access to comprehensive services—including prevention, treatment, and rehabilitation—and financial protection against catastrophic healthcare costs.
3. Historical Background
The origins of the UHC concept can be traced back to the 1948 Constitution of the World Health Organization (WHO), which declared that “the right to enjoy the highest standard of health to which one is capable of attaining is one of the fundamental rights of every human being.” Following a formal resolution at the World Health Assembly in 2005, UHC was incorporated in 2015 as Target 3.8 under the United Nations Sustainable Development Goals (SDGs), making its achievement by 2030 a shared global objective. The COVID-19 pandemic beginning in 2020 exposed vulnerabilities in health systems worldwide and further underscored the importance of strengthening UHC.
4. Japan’s Initiatives
(1) Japan has achieved universal health coverage and universal pension coverage in 1961, becoming one of the first countries in the world to realize UHC. This achievement has earned Japan high praise from the international community. Japan’s multilayered social safety net—comprising free access to healthcare, low out-of-pocket costs, the High-Cost Medical Expense Benefit System, and the Long-Term Care Insurance System—forms the foundation of the country’s world-leading health outcomes.
As Prime Minister Takaichi emphasized, the achievement of UHC created a virtuous cycle of “quality employment and sustainable economic growth supported by a healthy workforce,” contributing significantly to Japan’s rapid postwar economic growth and social stability. Sharing this experience and expertise with the international community and supporting institutional development in developing countries constitute a cornerstone of Japan’s global health diplomacy.
(2) As a leading advocate of UHC, Japan has actively shaped the international agenda. In 2017, Japan hosted an international conference on UHC in Tokyo. At the G20 Osaka Summit in 2019, Japan facilitated the first-ever joint session of finance and health ministers, fostering a new international trend of closer cooperation between fiscal and health authorities.
At the G7 Hiroshima Summit in May 2023, leaders reaffirmed the importance of strengthening responses to a wide range of health-related challenges, once again demonstrating Japan’s leadership in the international community.
(3) Among these efforts, Africa has been one of Japan’s priority regions. Through the Japan International Cooperation Agency (JICA), Japan has worked for many years to strengthen health systems across African countries. It has continuously supported the training of healthcare professionals, the enhancement of community health services, and technical and financial cooperation in maternal and child health and infectious disease control.
In addition, the Tokyo International Conference on African Development (TICAD) serves as an important framework for dialogue between Japan and Africa on development issues. At TICAD 9, held in Yokohama in 2025, the promotion of UHC was positioned as a core agenda item, with particular emphasis on strengthening vaccination systems and reinforcing health financing foundations.
Furthermore, Japan’s continued contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria have significantly advanced infectious disease control efforts and the achievement of UHC across Africa. The “UHC Knowledge Hub,” established in Tokyo during the UHC High-Level Forum in December 2025, also serves as an international center that provides practical support for building sustainable health financing systems through the training of finance and health officials from developing countries, including those in Africa.
5. Remaining Challenges
Even within Japan, significant challenges remain, regarding the sustainability of the universal health insurance system, including rising healthcare and long-term care expenditures resulting from population aging, regional disparities in healthcare access, and shortages of medical personnel.
As Japan shares its UHC experience with the world—particularly with developing countries in Africa and elsewhere—it must also determine how best to preserve and further develop its own healthcare system. Finding answers to this question, translating them into concrete actions, and achieving tangible results constitute an important responsibility for Japan.
In this new article, we would like to present the issue of healthcare—one of the most urgent challenges facing Japan as it grapples with a declining birthrate and an aging population—and explore it together with you while highlighting the significance of Universal Health Coverage (UHC). Japan’s efforts in this field within the international community have made substantial contributions to improving healthcare conditions in African countries, particularly in Cameroon, Chad, and the Central African Republic.
1. UHC High-Level Forum 2025
(1) In December 2025, the “UHC High-Level Forum 2025” was held in Tokyo. At this gathering, attended by World Bank President Ajay Banga, WHO Director General Dr. Tedros Adhanom Ghebreyesus, and finance and health ministers from around the world, Prime Minister Sanae Takaichi delivered a video message reaffirming Japan’s strong commitment to UHC.
(2) Prime Minister Takaichi clearly defined UHC as “essential for protecting the lives, livelihoods, and dignity of every individual, while also realizing sustainable economic growth supported by a healthy workforce.” She emphasized the importance of sharing Japan’s accumulated experience and expertise with the world.
2. What Is UHC? — Background and Challenges
(1) On a global scale, billions of people still lack adequate access to essential healthcare services. Many forgo medical treatment due to financial constraints, allowing illnesses to worsen, while others fall into poverty because of medical expenses. Such healthcare inequality remains a global challenge affecting both developed and developing countries.
(2) When people cannot have access to healthcare, illnesses worsen, income is lost, and access to healthcare becomes even more difficult. Breaking this vicious cycle of poverty and disease is the fundamental mission of UHC. Universal Health Coverage means that “all people can access the quality health services they need without suffering financial hardship.” Achieving UHC requires both access to comprehensive services—including prevention, treatment, and rehabilitation—and financial protection against catastrophic healthcare costs.
3. Historical Background
The origins of the UHC concept can be traced back to the 1948 Constitution of the World Health Organization (WHO), which declared that “the right to enjoy the highest standard of health to which one is capable of attaining is one of the fundamental rights of every human being.” Following a formal resolution at the World Health Assembly in 2005, UHC was incorporated in 2015 as Target 3.8 under the United Nations Sustainable Development Goals (SDGs), making its achievement by 2030 a shared global objective. The COVID-19 pandemic beginning in 2020 exposed vulnerabilities in health systems worldwide and further underscored the importance of strengthening UHC.
4. Japan’s Initiatives
(1) Japan has achieved universal health coverage and universal pension coverage in 1961, becoming one of the first countries in the world to realize UHC. This achievement has earned Japan high praise from the international community. Japan’s multilayered social safety net—comprising free access to healthcare, low out-of-pocket costs, the High-Cost Medical Expense Benefit System, and the Long-Term Care Insurance System—forms the foundation of the country’s world-leading health outcomes.
As Prime Minister Takaichi emphasized, the achievement of UHC created a virtuous cycle of “quality employment and sustainable economic growth supported by a healthy workforce,” contributing significantly to Japan’s rapid postwar economic growth and social stability. Sharing this experience and expertise with the international community and supporting institutional development in developing countries constitute a cornerstone of Japan’s global health diplomacy.
(2) As a leading advocate of UHC, Japan has actively shaped the international agenda. In 2017, Japan hosted an international conference on UHC in Tokyo. At the G20 Osaka Summit in 2019, Japan facilitated the first-ever joint session of finance and health ministers, fostering a new international trend of closer cooperation between fiscal and health authorities.
At the G7 Hiroshima Summit in May 2023, leaders reaffirmed the importance of strengthening responses to a wide range of health-related challenges, once again demonstrating Japan’s leadership in the international community.
(3) Among these efforts, Africa has been one of Japan’s priority regions. Through the Japan International Cooperation Agency (JICA), Japan has worked for many years to strengthen health systems across African countries. It has continuously supported the training of healthcare professionals, the enhancement of community health services, and technical and financial cooperation in maternal and child health and infectious disease control.
In addition, the Tokyo International Conference on African Development (TICAD) serves as an important framework for dialogue between Japan and Africa on development issues. At TICAD 9, held in Yokohama in 2025, the promotion of UHC was positioned as a core agenda item, with particular emphasis on strengthening vaccination systems and reinforcing health financing foundations.
Furthermore, Japan’s continued contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria have significantly advanced infectious disease control efforts and the achievement of UHC across Africa. The “UHC Knowledge Hub,” established in Tokyo during the UHC High-Level Forum in December 2025, also serves as an international center that provides practical support for building sustainable health financing systems through the training of finance and health officials from developing countries, including those in Africa.
5. Remaining Challenges
Even within Japan, significant challenges remain, regarding the sustainability of the universal health insurance system, including rising healthcare and long-term care expenditures resulting from population aging, regional disparities in healthcare access, and shortages of medical personnel.
As Japan shares its UHC experience with the world—particularly with developing countries in Africa and elsewhere—it must also determine how best to preserve and further develop its own healthcare system. Finding answers to this question, translating them into concrete actions, and achieving tangible results constitute an important responsibility for Japan.
“We are determined to work together with all of you to build a future in which health reaches every person.”
— Prime Minister Sanae Takaichi
(UHC High-Level Forum 2025, December 2025)