Making Fair Choices

on the Path to Universal Health Coverage

Members of the WHO Consultative Group:
Trygve Ottersen,* Ole F Norheim,* Bona M Chitah, Richard Cookson, Norman Daniels, Frehiwot B Defaye, Nir Eyal, Walter Flores, Axel Gosseries, Daniel Hausman, Samia A Hurst, Lydia Kapiriri, Toby Ord, Shlomi Segall, Gita Sen, Alex Voorhoeve, Daniel Wikler, Alicia E Yamin

WHO staff:
Tessa T T Edejer, Andreas Reis, Ritu Sadana, Carla Saenz

* Lead authors

Countries around the world are moving towards Universal Health Coverage. Along the way, they face difficult choices. The WHO Consultative Group on Equity and Universal Health Coverage has produced a report to offer guidance on how to make these choices fairly, which you can access:

This website presents the Group’s recommendations and offers a record of the impact of the report.

We welcome feedback; one of the Report's authors is Alex Voorhoeve, e-mail < a dot e dot voorhoeve at-sign lse dot ac dot uk>. 



1. The Director-General of the WHO, Dr. Margaret Chan, endorsed the Report in this article: "Making Fair Choices on the Path to Universal Health Coverage", Health Systems and Reform (2016) 2 (1): 5-7.


2. Editorial on the Report in the Bulletin of the World Health Organisation (2014) 92: 389.


3. Review in Salute, June 18, 2014.


4. Symposium on the Report in Health Economics, Policy and Law 11 (2016):

Introduction. (Published; pre-typesetting version [access free])

Albert Weale.


Précis of Making Fair Choices on the Path to Universal Health Coverage. (Published; pre-typesetting version [access free]).

Alex Voorhoeve, Trygve Ottersen and Ole Frithjof Norheim.


The Administrator's Perspective. (Published; pre-typesetting version.)

Addis Tamire Woldemariam.


Information Will be the Key to Successful Implementation. (Published; pre-typesetting version).

Peter Littlejohns and Kalipso Chalkidou.


Reasonable Disagreement and the Generally Unacceptable. (Published; pre-typesetting version).

Benedict Rumbold and James Wilson.


The Path from Nowhere? (Published; pre-typesetting version)

Albert Weale.


Response to Our Critics. (Published; pre-typesetting version).

Alex Voorhoeve, Trygve Ottersen and Ole Frithjof Norheim.

5.  Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health CoverageOle Frithjof Norheim. International Journal of Health Policy and Management (2015).


6. Three Case Studies in Making Fair Choices on the Path to Universal Health Coverage. Alex Voorhoeve, Tessa TT Edejer, Lydia Kapiriri, Ole F Norheim, James Snowden, Olivier Basenya, Dorjsuren Bayarsaikhan, Ikram Chentaf, Nir Eyal, Amanda Folsom, Rozita Halina Tun Hussein, Cristian Morales, Florian Ostmann, Trygve Ottersen, Phusit Prakongsai, Carla Saenz, Karima Saleh, Angkana Sommanustweechai, Dan Wikler, Afisah Zakariah. Health and Human Rights Journal 18:2 (2016): 11-22.


7. Universal Health Coverage, Priority Setting and the Human Right to Health. Benedict Rumbold, Rachel Baker, Octavio Ferraz, Sarah Hawkes, Carleigh Krubiner, Peter Littlejohns, Ole Frithjof Norheim, Thomas Pegram, Annette Rid, Sridhar Venkatapuram, Alex Voorhoeve, Daniel Wang, Albert Weale, James Wilson, Alicia Ely Yamin, and Paul Hunt. The Lancet 390:10095 (2017): 712-14.


8. Making Fair Choices on the Path to Universal Health Coverage: Applying Principles to Difficult Cases. Alex Voorhoeve*, Tessa TT Edejer,* Lydia Kapiriri*, Ole F Norheim*, James Snowden*, Olivier Basenya, Dorjsuren Bayarsaikhan, Ikram Chentaf, Nir Eyal, Amanda Folsom, Rozita Halina Tun Hussein, Cristian Morales, Florian Ostmann, Trygve Ottersen, Phusit Prakongsai, Carla Saenz, Karima Saleh, Angkana Sommanustweechai, Daniel Wikler, Afisah Zakariah (* = lead author). Health Systems and Reform 3:4 (2017): 1-12.

Analysis for Table 1 is here.




1. Launched at LSE on May 1, 2014 with responses by leading academics and the Director-General of the Ethiopian Ministry of Health. Details here.


2. Basis of a "Writeshop" at the Pan-American Health Organisation in Washington, D.C. on May 5-9 2014, with participants from the World Bank, PAHO, WHO, and departments of health from several countries. The purpose was to develop several illustrative country case studies; the first three are forthcoming in Health and Human Rights Journal; others are under review. Details of the writeshop here.


3. Center for Global Development, Washington D.C., May 6, 2014.


4. Presentation at PAHO with comments by Amanda Glassman, Center for Global Development, May 8, 2014.


5. Webinar via PAHO at May 8, 2014. Details here. To view this webinar: Spanish English

6. Priorities 2020 meeting in Bergen, May 11-13, 2014.


7. UCL & KCL Social Value Workshop, London, May 23, 2014. 


8. WHO, Geneva, June 12, 2014.


9. Global Summit of National Bioethics Committees, Session on Universal Health Coverage, with comments on the report from National Ethics Committees of Mexico, Sri Lanka, Bolivia, Cuba, Tunisia and Sweden, June 22-23, 2014. Details here.


10. World Congress on Bioethics, Session on the Ethics of Universal Health Coverage, June 24-27. Details here.


11. Chilean Institute of Nutrition, Santiago, Chile, 6 October 2014.


12. National Health Technology Committee, Ministry of Health, Santiago, Chile, November 19 in an event on “Procesos en evaluación de tecnologías sanitarias: desde la evidencia a la recomendación".


13. Global Health and Population Frontiers Seminar, Harvard University, December 9, 2014. Details here. Recording here.


14. Medsin Conference: "Global Health: The Bottom Line", London, March 8, 2015.


15. Global Health Policy Center at the Center for Strategic and International Studies, Conference on "Advancing toward Universal Health
Coverage through Smart Choices." Washington D.C. Spring 2015. Details here.


16. Theory and Practice Roundtable: Fulfilling Rights, Realising Goals and Meeting Duties in the Drive towards Universal Health Coverage, June 25-26, 2015 UCL.


17. Conference on the Ethics of Priority-Setting co-organized by PAHO and the University of Puerto Rico in San Juan, September 16-17.


18. Presentation to the Colombian Ministry of Health in Bogotá, December 1, 2015.


19. Presented to an academic audience in Cali, December 3, 2015.


20. Presented at the Prince Madihol Conference on Priority Setting for Universal Health Coverage, Bangkok, January 2016.


21. Conference on 20 years of the Health Law, Ministry of Health, The Netherlands, March 13, 2016.


22. Launch of the Spanish version of the Report at PAHO, Washington DC, December 1, 2016, with commentary by health-technology assessment leaders from Argentina, Colombia and the Department of Health Economics, World Bank. Details here.


23. Case studies in making fair choices presented at a meeting of the Health Financing Global Solutions Group (GSG) of the World Bank and the Norwegian Institute of Public Health in Oslo, Norway, September 6-7, 2017.


24. The Lancet article and Making Fair Choices are the topic of a Consultative Meeting “What to Purchase/Deliver for UHC? by WHO's Eastern Mediterranean Office, Cairo, Egypt, September 25-28, 2017. 


Political impact of the report


1. The Report formed the basis of a question to the European Commission in the European Parliament by Nicola Caputo on January 6, 2015.


2. It has influenced the Norwegian Government's Report: 'Open and Fair: Priorities in Health' (2014).


3. It has influenced the decision by the Ethiopian Ministry of Health to establish a Center for Medical Ethics and Priority Setting at the College of Health Sciences, Addis Ababa University. Authors of the report have set up a training programme in these areas for teachers of medical ethics and priority setting at Ethiopian universities.