by Médecins Sans Frontières, December 2017
Direct payments by patients at the point of health care delivery, commonly known as user fees, lead to low utilisation of or exclusion from available health care services and impoverish households. Vulnerable groups are particularly affected. Over the past decade, many countries transitioned away from their user fee policies in favour of health care free at point of care for all or for specific population groups, such as pregnant women, children, and people with certain illnesses. Médecins Sans Frontières teams report in this paper witnessing evidence which starkly contrasts the discourse around Universal Health Care. The authors argue that if the global health community is serious about making UHC a reality and ‘leave no one behind’, removal of user fees for essential medicines and services must be tackled as a priority.