Advancing universal health coverage for people who use drugs

This policy brief addresses the critical need to ensure Universal Health Coverage (UHC) for people who use drugs in the European Union and neighbouring countries, a marginalized population facing systemic barriers to accessing comprehensive health and social care. UHC refers to ensuring that all individuals and communities have access to the health services they need, when and where they need them, without suffering financial hardship. The core components of UHC include: quality of care, providing effective and evidence-based health services; equity in access, ensuring that marginalized and underserved populations can access essential health services; and financial protection, eliminating financial hardship when accessing healthcare. UHC is a fundamental goal of the World Health Organization (WHO) and is enshrined in the United Nations Sustainable Development Goals (SDG 3.8). The most recent United Nations High-Level Meeting on UHC (September 2023) reaffirmed the global commitment to achieve UHC by 2030 through a political declaration titled “Universal Health Coverage: Expanding Our Ambition for Health and Well-being in a Post-COVID World.” This brief aligns with the European Union Drugs Strategy 2021–20255, the BOOST Advocacy Strategy, and the Drug Policy Manifesto for the 2024 European Parliament Elections and supports the implementation and transformation of UHC systems across Europe to ensure they are inclusive, evidence-based, and responsive to the needs of people who use drugs. It calls for integrating harm reduction, mental health care, sexual health services, and prevention and treatment for chronic infectious diseases into UHC frameworks, addressing existing gaps in service design, coverage, and accessibility.