Vatican City — The Vatican this week convened global experts, policymakers and Church leaders for a two-day workshop focused on how to make universal healthcare both sustainable and equitable.
The February 16–17 meeting, titled “Healthcare for all: Sustainability and equity,” was organized by the Pontifical Academy for Life and presented at the Holy See Press Office.
Opening the gathering, Pope Leo XIV urged participants to prioritize life and health in a world “consumed by conflicts,” stressing that inequalities must be addressed through a renewed commitment to the common good.
Five Core Goals for Health Systems
Among the keynote speakers was bioethicist Ezekiel Emanuel, Vice Provost for Global Initiatives at the University of Pennsylvania. He outlined five essential goals shared by strong healthcare systems:
- Universal coverage
- Reasonable and sustainable costs
- Consistently high quality of care
- Reduced disparities, especially between urban and rural areas
- Satisfaction among patients and healthcare workers
Universal coverage, he argued, means everyone must be included — with children receiving free care as a social good. Private insurance can coexist with public systems, he said, provided it strengthens rather than weakens national healthcare capacity.
He also stressed the importance of defined national budgets to control spending, minimizing out-of-pocket costs to prevent medical debt, and shifting focus from hospital-centered care to community and home-based services.
Emerging AI technologies, Emanuel noted, may help expand access to diagnosis and treatment in underserved regions.
Africa’s Health Gains — and Challenges
Professor Sheila Tlou, co-founder of the African Leaders Malaria Alliance, highlighted both progress and ongoing challenges across Africa’s 54 countries.
She pointed to major advances in combating HIV/AIDS, tuberculosis and malaria, particularly in countries such as Botswana, Rwanda and Namibia, where investments in community health workers and prevention programs have yielded measurable gains.
Botswana, for example, reduced mother-to-child HIV transmission from 29% to below 1% through sustained political commitment and funding.
Yet serious challenges remain. Neonatal mortality in Africa stands at roughly 63 deaths per 1,000 live births — far above global targets — and maternal mortality remains significantly elevated.
Health investment, Tlou emphasized, is ultimately a political choice. Although African leaders pledged in 2001 to dedicate 15% of national budgets to healthcare, few countries have met that goal.
Migration and Health Equity
The workshop also addressed healthcare access for migrants and refugees.
Msgr. Robert Vitillo, Senior Advisor to the Dicastery for Promoting Integral Human Development and this year’s recipient of the Academy’s Guardian of Life Award, called for a reframing of migration.
Today, around one billion people live or work outside their country of birth, including more than 117 million forcibly displaced individuals.
Vitillo stressed that migrants are often unfairly blamed for spreading disease, despite no evidence linking them to pandemics such as COVID-19. In fact, many migrants served as frontline healthcare workers during the crisis.
True healthcare equity, he argued, requires integrating migrants into national health systems and ensuring continuity of care along the migration journey.
Lessons from the HIV/AIDS Crisis
Reflecting on decades of Catholic engagement in global health, Vitillo described the Church’s response to HIV/AIDS through Caritas Internationalis.
In the late 1980s, when no treatment existed, Church workers — particularly in Africa — provided home-based care to patients often rejected by society. As antiretroviral therapies emerged but remained unaffordable, Catholic organizations advocated globally for lower prices and contributed to the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria.
They also pressed pharmaceutical companies to develop child-friendly HIV medicines — efforts that helped transform survival rates for children living with HIV.
Health as a Moral and Political Choice
Msgr. Renzo Pegoraro, President of the Pontifical Academy for Life, emphasized that sustainable healthcare systems require long-term commitment, ethical governance and solidarity.
Participants agreed that universal healthcare is achievable where political will exists.
As Pope Leo XIV reminded attendees, war remains “the gravest attack possible against life and public health.” In contrast, investing in health systems — particularly for the poor, children and displaced — strengthens societies and safeguards human dignity.
The workshop concluded with a shared message: healthcare for all is not only a technical or economic challenge, but a moral imperative — one that demands sustained cooperation across nations, institutions and communities.