Global health security and universal health coverage: Understanding convergences and divergences for a synergistic response

PLoS One. 2020 Dec 30;15(12):e0244555. doi: 10.1371/journal.pone.0244555. eCollection 2020.


Background: Global health security (GHS) and universal health coverage (UHC) are key global health agendas which aspire for a healthier and safer world. However, there are tensions between GHS and UHC strategy and implementation. The objective of this study was to assess the relationship between GHS and UHC using two recent quantitative indices.

Methods: We conducted a macro-analysis to determine the presence of relationship between GHS index (GHSI) and UHC index (UHCI). We calculated Pearson's correlation coefficient and the coefficient of determination. Analyses were performed using IBM SPSS Statistics Version 25 with a 95% level of confidence.

Findings: There is a moderate and significant relationship between GHSI and UHCI (r = 0.662, p<0.001) and individual indices of UHCI (maternal and child health and infectious diseases: r = 0.623 (p<0.001) and 0.594 (p<0.001), respectively). However, there is no relationship between GHSI and the non-communicable diseases (NCDs) index (r = 0.063, p>0.05). The risk of GHS threats a significant and negative correlation with the capacity for GHS (r = -0.604, p<0.001) and the capacity for UHC (r = -0.792, p<0.001).

Conclusion: The aspiration for GHS will not be realized without UHC; hence, the tension between these two global health agendas should be transformed into a synergistic solution. We argue that strengthening the health systems, in tandem with the principles of primary health care, and implementing a "One Health" approach will progressively enable countries to achieve both UHC and GHS towards a healthier and safer world that everyone aspires to live in.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Child Health
  • Female
  • Global Health / statistics & numerical data*
  • Health Expenditures
  • Humans
  • Male
  • Maternal Health
  • Universal Health Insurance / statistics & numerical data*

Grant support

The research was funded by the University of Queensland. The University had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.