The UN’s role in accelerating health coverage
Despite our progress to advance health care over the last century, today millions face new risks, including prohibitive costs and unsuitable infrastructure
By Amina J. Mohammed, deputy secretary-general, United Nations
The world has made impressive progress over the past two decades in improving the health of millions of people, increasing life expectancy, reducing maternal and child mortality, and fighting communicable diseases. But this progress is uneven and today, half the world’s population still does not have access to quality health services. More than 800 million people spend more than 10% of their household budgets on health care – creating impossible choices between putting food on the table and seeking life-saving medical care. Millions of people are being denied a fundamental human right: health for all.
Around the world, more than 50 countries still lack the infrastructure needed to provide universal health coverage. In some cases, healthcare facilities lack basic services such as water and electricity. Elsewhere, there are shortages of medicines and medical products, and of skilled staff. In many places where healthcare services are available, demographic changes will put them under severe strain in the coming decades.
Health and well-being for all are key to building resilient, secure, prosperous societies on a healthy planet. The globally agreed roadmap to achieve that overriding aim is the 2030 Agenda, agreed by all countries in 2015 and based on the 17 Sustainable Development Goals.
SDG 3 is to ensure healthy lives and promote well-being for all, at all ages. But health is a cross-cutting issue closely linked with poverty, discrimination, education, employment and environmental protection. Achieving quality health care for all can be the foundation for significant gains in other areas of sustainable development.
Health is a political choice that depends on national priorities, not income. Countries at all stages of development can make progress towards quality health services. But it is a choice that is often obscured by other, seemingly more urgent priorities, from security concerns to economic austerity measures.
That is why the United Nations is convening a High Level Meeting on Universal Health Care on 23 September here in New York. The aim is to raise the profile of universal health coverage as an accelerator for sustainable development, and to galvanise action to achieve it around the world.
The foundations of universal health coverage are a global shift towards healthier lifestyles, sustainable food systems and primary health care for all. Health systems founded on primary health care provide quality services that are comprehensive, continuous, coordinated and people-centred. They emphasise prevention and promote well-being.
Primary health care is therefore an important way to reduce inequities in health, and is highly effective and efficient, particularly for the management of mental health problems and chronic conditions. When primary health systems are strong, families and communities are empowered, and people are able to fulfil their potential – to move from surviving to thriving.
Empowering all of society
Certainly, we have the greatest development opportunity when it comes to how we support and promote young people. Because adolescence is such a unique and formative time, the consequences of not addressing health issues, in particular mental health conditions, are likely to extend and expand to adulthood. Half of all mental health conditions start by 14 years, yet many cases go undetected and untreated. For example, nine-year-old Ahmad from Syria, who has suffered from post-traumatic stress disorder for two years, still has not received support to overcome the psychological tolls he has faced. With suicide rates increasing among youth, especially in young girls, we cannot afford to ignore these powerful agents for change.
Innovations in health and technology can make universal health coverage easier to implement and expand its benefits. For example, electronic payment platforms can give people better access to health information, hospitals and pharmacies, and can enable people working outside their country to finance health care for their families back home for a whole year with just one click.
There is plenty of evidence that universal health coverage not only leads to stronger economies and more resilient societies: it contributes to equity, social justice and inclusive economic growth. Health is a political choice, but one that makes economic sense. With that in mind, we need sustainable financing and a commitment from leaders to make health a core and priority investment in human capital, and to work across sectors, linking up with policies on education, water and sanitation, and social protection.
Universal health coverage can only succeed with strong political commitment at the highest level. I urge governments and leaders to come to the high level meeting in September ready to turn the vision of universal health coverage into a reality.
