Article Text

Setting priorities to address cardiovascular diseases through universal health coverage in low- and middle-income countries
  1. David A Watkins1,2,
  2. Rachel A Nugent3,4
  1. 1Division of General Internal Medicine, University of Washington, Seattle, Washington, USA
  2. 2Department of Medicine, University of Cape Town, Cape Town, South Africa
  3. 3Research Triangle Institute International, Research Triangle Park, North Carolina, USA
  4. 4Department of Global Health, University of Washington, Seattle, Washington, USA
  1. Correspondence to Dr David A Watkins, Division of General Internal Medicine, University of Washington, 325 9th Ave Box 359780, Seattle, WA 98104, USA; davidaw{at}


Over the past decade, universal health coverage (UHC) has emerged as a major policy goal for many low- and middle-income country governments. Yet, despite the high burden of cardiovascular diseases (CVD), relatively little is known about how to address CVD through UHC. This review covers three major topics. First, we define UHC and provide some context for its importance, and then we illustrate its relevance to CVD prevention and treatment. Second, we discuss how countries might select high-priority CVD interventions for a UHC health benefits package drawing on economic evaluation methods. Third, we explore some implementation challenges and identify research gaps that, if addressed, could improve the inclusion of CVD into UHC.


Statistics from


  • Contributors DAW conceived the study, gathered the literature and wrote the first draft. RAN reviewed the literature and revised the draft for important intellectual content.

  • Competing interests DAW and RAN are supported by the Disease Control Priorities Network grant from the Bill and Melinda Gates Foundation to the University of Washington. Additionally, DAW is funded by Medtronic Foundation through support to Rheumatic heart disease Evidence-Advocacy-Communication-Hope (RhEACH) and RHD Action, and RAN is funded by RTI International.

  • Provenance and peer review Commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.