Commonwealth Health Ministers and Heads of Delegation have reaffirmed their commitment to achieving universal health coverage (UHC) and ensuring the most vulnerable and marginalised have equal access to health services across the 56 member countries by 2030. They joined the Commonwealth Secretary-General, Patricia Scotland KC, and health experts for the 35th Commonwealth Health Ministers Meeting (CHMM) on Saturday 20th May in Geneva, Switzerland. They agreed to work together to accelerate efforts to achieve UHC by 2030, in line with the UN Sustainable Development Goals (SDGs), recognising that the COVID-19 pandemic has caused setbacks to hard-won UHC gains and exposed rife health inequalities within and between countries, including inequities of access to quality care. Critically it was highlighted that the increasing daily threats of climate change continue to have an impact on the health of countries, their communities and their loved ones, and this needs collaborative action from all across health, finance, environment and climate ministries. Opening the meeting, the Scotland said: “If we have learnt anything from the pandemic, it's that investing in health for all is not optional – it is essential. “Despite the Commonwealth making significant progress on universal health coverage before 2019, the COVID-19 pandemic has exposed the vulnerabilities of many of our health systems and significantly eroded our hard-won health gains, putting the delivery of universal health coverage in the Commonwealth at risk.... “We need to convert our focus and urgency into hard-headed action right now. If we fail, we risk losing the impetus to transform our health systems for the better. “If we succeed, we will have transformed the lives and prospects of millions of people in our Commonwealth Family.” CHMM Chair, Susan Nakhumicha Wafula, Cabinet Secretary for Health, Kenya, said: “It has been a privilege to Chair the 35th Commonwealth Health Ministers Meeting, and to discuss the critical need to accelerate action on UHC. Whilst the Commonwealth had made significance progress on UHC before 2019, the COVID-19 pandemic exposed the vulnerabilities of many of our health systems, putting achieving UHC in the Commonwealth at risk. “The deliberations today - on investing in primary health care, utilising digital health technologies, integrating mental health services and building greater country capacity for pandemic prevention, preparedness and response – will help us work towards a more equitable and healthier Commonwealth where no one is left behind. I look forward to supporting the outcomes from this meeting as part of my role as CHMM Chair in Office,” said Wafula. Giving a keynote address, WHO Director-General Dr Tedros Adhanom Ghebreyesus, said: “We have lived through an unprecedented crisis [COVID-19], one that made crystal clear that health is central to development, prosperity, and national security. We need to take those lessons and apply them. “The WHO highly values our partnership with the Commonwealth, and we remain committed to working with you closely to fulfil the shared commitments in our Memorandum of Understanding.” Ministers agreed a Ministerial Statement containing commitments to collaborate on efforts to monitor progress and share expertise on strengthening primary healthcare (PHC) services; leverage increased investment for digital innovations to improve population health and pledged to work jointly with Commonwealth Finance Ministers to identify innovative and sustainable funding solutions for health systems. They acknowledged the significant capacity shortages of health workers to ensure quality services are delivered at the PHC level, and agreed to build multisectoral partnerships in areas including training and to address international migration. They also agreed priorities for accelerated action to address the increased burden of mental health conditions in the Commonwealth, particularly amongst children and youth, as well promising to collaborate on strengthening country pandemic prevention, preparedness and response, including investing in sustainable manufacturing capacity, and to address climate change threats through an integrated and evidence-based agenda. The Commonwealth has long advocated for the realisation of UHC – with efforts being made to ensure equitable access to medicines, sustainable financing, global health security, healthy ageing, and a reduction in noncommunicable diseases, in successive meetings. Some 75per cent of the projected health gains from the SDGs can be achieved through primary healthcare systems, including saving over 60 million lives and increasing average global life expectancy by 3.7 years by 2030, according to the UN. It was acknowledged that many Commonwealth countries have been made strides in leveraging innovative strategies and solutions to address PHC in an integrated manner, in alignment with the 2018 Astana Declaration. Minsters at the meeting also noted progress has been made on the Commonwealth Heads of Government commitments to halve malaria by 2023 and to eliminate blinding trachoma across member countries. Despite the disruption to elimination efforts caused by the COVID-19 pandemic, the number of people affected by trachoma, across 22 of the Commonwealth’s 54 countries, is falling rapidly. In 2020, just over 24 million people across the Commonwealth were at risk of trachoma, down from 42 million in 2018. It was acknowledged that the US$4 billion commitment from world leaders to prevent malaria and neglected tropical diseases will assist in further accelerating progress, but said further investment is needed to attain collective targets by 2030. They similarly applauded the commitment made by Commonwealth Heads of Government last year to ensure all girls by the age of 13 have access to the HPV vaccine by 2025.The Commonwealth is disproportionately affected by cervical cancer, with countries accounting for 40per cent of global cervical cancer incidence and 43per cent of cervical cancer mortality, despite having only 30per cent of the world’s population. Noting that prevention is one of three critical pillars for cervical cancer elimination strategy, they pledged to strengthen primary health services to ensure equitable access to quality screening and treatment services. Ministers also promised to work together to address noncommunicable diseases and mental health challenges by promoting multisectoral coordination, utilising sport and physical activity and promoting healthy diets. In addition to health ministers, the meeting included participation by representatives from Commonwealth health professional associations, civil society, youth leaders and development partners, as well as international and regional organisations such as the World Health Organization.