Crunch Time: The Transformational Universal Health Coverage Agenda for Zambia

There is a realization worldwide that health expenditure can be catastrophic, exacerbate inequalities between poor and rich households, and drive people into poverty. As such, a number of countries seek to provide universal health coverage (UHC) to all of their citizens in order for everyone to access quality health care without financial adversity. However, attaining UHC is difficult. It has also been recognized that there is no universal formula for attaining UHC and that each country must create its own. This article describes Zambia's trajectory to achieving UHC from the 1990s to date. The article highlights some of the past institutional and financing reforms, achievements made, and gaps and challenges that the government is determined to address through an explicit transformational agenda that was launched in 2011. This agenda is being pursued with renewed vigor given that Zambia's economy and population are growing rapidly, the time to transition from external support is fast approaching, and the disease profile is changing.