Many low- and middle-income countries aspire to universal health coverage (UHC), but for rhetoric to become reality, the health services offered must be consistent with the funds available, which may require tough tradeoffs. An explicit health benefits package—a defined list of services that are and are not subsidized—is essential in creating a sustainable UHC system. Defining the services to be made available requires careful attention not just to cost-effectiveness, but also to issues of governance and ethics. Donors and advocates can support health benefits package design with technical and financial resources, and by respecting local resource constraints.
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