As the world marks 30 years since the landmark Beijing Declaration and Platform for Action on gender equality, global health leaders have called for urgent action to uphold the health and rights of women and marginalized groups — warning that Universal Health Coverage (UHC) cannot be achieved without addressing persistent gender discrimination and structural inequalities.
Speaking at a high-level side event during the 78th World Health Assembly, Nazneen Damji of UN Women emphasized that global health systems continue to fail women and girls, especially in their sexual and reproductive health rights. “The Beijing Declaration was a bold promise to the world’s women and girls that their rights, dignity and health would be non-negotiable. That promise remains unfulfilled,” she said.
Damji noted that despite decades of advocacy, gender-based inequalities continue to deny millions of women autonomy over their bodies. Only 56% of married women aged 15 to 49 can make decisions about their reproductive health, according to UN Women. Each day, over 700 women die from preventable pregnancy-related causes, while adolescent girls and young women in sub-Saharan Africa remain three times more likely than their male peers to contract HIV in at least 22 countries.
“This is not simply a funding issue. It is a crisis of political will. Sexual and reproductive health and rights are not optional — they are fundamental human rights,” Damji stressed.
Echoing these concerns, Dr. Tlaleng Mofokeng, UN Special Rapporteur on the Right to Health, warned of a growing global backlash against gender equality and human rights that threatens the vision of UHC. “We are seeing inequality, violence, discrimination, and criminalization — all incompatible with the realization of the right to health,” she said, underscoring the need for health systems to serve even the most marginalized populations.
The COVID-19 pandemic further exposed deep vulnerabilities. “During lockdowns, groups already pushed to the margins — LGBTQI+ communities, women sex workers, young girls, women who use drugs — were almost entirely excluded from care,” said Dr. Harjyot Khosa of the International Planned Parenthood Federation.
Khosa argued that health systems remain largely designed for heterosexual married couples, reinforcing harmful patriarchal norms that deny care to those who fall outside these categories. “Sexual and reproductive health and justice must be the first push to deliver on UHC at all levels,” she said.
For Fadekemi Akinfaderin of Fos Feminista, structural biases extend even into basic maternal care. Sharing her own experience, she recalled being denied epidural pain relief during childbirth because of a provider’s religious belief that she should give birth “like a Hebrew woman.” She added: “We need reforms that not only advance UHC but also address gender-based violence and link healthcare with legal protections.”
Participants also pointed to systemic racism and migration policies that further undermine access to care. Dr. Eliezer Lappots-Abreu from the Dominican Republic highlighted cases where migrant women are denied cancer care due to language barriers or lack of documentation. “Although we claim to have UHC, it does not apply equally to immigrants and women of color,” he said.
For Baba Aye of Public Services International, the solution requires more than expanding health insurance schemes. “We need Universal Health Care — not just coverage — rooted in the Alma Ata declaration of health for all. And we cannot talk about UHC without ensuring we have health workers for all, particularly when women make up the majority of health workers in contexts where services like abortion remain criminalized.”
The intersection of gender discrimination with disease stigma is equally pronounced for women affected by leprosy, said Maya Ranavare of the Association of People Affected by Leprosy. “Women with leprosy often suffer silently due to compounded social stigma, lower wages, economic dependence, and lack of agency to seek timely care.”
As multiple speakers underscored, Universal Health Coverage must not simply be about expanding insurance schemes, but transforming health systems to deliver equitable care for every person — regardless of gender, race, citizenship, or income.
The event, hosted by the Global Centre for Health Diplomacy and Inclusion (CeHDI) and partners, comes at a time of mounting global crises — from armed conflict to climate change — that are deepening health inequalities. Speakers called for stronger political leadership, greater investment in rights-based healthcare, and meaningful inclusion of marginalized voices in health policymaking.
“The promise of health for all cannot be fulfilled if rights for all are not guaranteed,” Damji concluded.
