Universal Health Care’s Journey across the Policy Cycle and Scales

Universal health coverage (UHC), defined as everyone receiving the health services they need without financial hardship, has been a key component of the development agenda since the adoption of the Sustainable Development Goals in September 2015. This paper explores the political dynamics of UHC in the rapidly changing landscape of aid and development. In contrast to typical explanations of political priority, which emphasize agenda-setting processes at the global scale, I argue that UHC’s adoption and diffusion across global, regional, and national contexts shape its journey. Combining a dynamic understanding of the policy process with an analysis of policy diffusion, I examine the role of South–South cooperation networks. Based on a review of primary sources and the secondary literature, the analysis focuses on the Developing-8 Organization for Economic Cooperation as an example of South–South cooperation and identifies the various ways in which new, and sometimes competing, meanings of UHC are constructed through encounters among policy actors operating across global, regional, national, and local scales. This analysis can help us debate the unique features of South–South cooperation in shaping and diffusing policy ideas.