For 70 years, the World Health Organization (WHO) has focused its efforts to draw attention to and cure the world of debilitating diseases and maladies, from polio and smallpox to depression and diabetes.
This year, the WHO has directed the world’s attention to a more fundamental and basic human right for all members of society – the right to attain the highest possible level of health without facing financial hardship.
The beginnings of the global call to action for UHC – this year’s World Health Day theme – took root in 1978 with the Declaration of Alma-Ata that called for urgent action to promote "Health for All." The Declaration had underlined the importance of primary health care to attaining health for all or universal health coverage.
Since then, health technology and medicinal science have tremendously extended the reach of our health services today. However, the access to health services for all still remains elusive – a deterrent to realizing the vision of Alma-Ata and the focus for the call to action at the Pan American Health Organization (PAHO), as it celebrated World Health Day at its headquarters in Washington D.C. on April 4, 2018.
Estimates suggest that the exorbitant costs of health care services in some countries push 100 million people into extreme poverty each year. In the Americas, 3 out of 10 people do not seek health care for financial reasons.
In inspiring and thought-provoking messages, twice-over former president of Chile, Michelle Bachelet and Carissa F. Etienne, the director of PAHO, evoked the values of Alma-Ata and highlighted inequities – which are particularly high in Latin America and the Caribbean – as the main barrier for a person’s ability to access quality and affordable health care.
“Geographical barriers (where people live), financial barriers (economic condition of people) and institutional barriers, including stigmatization and discrimination in health services, must all be addressed,” affirmed Etienne, noting that collective action must be taken as one-third of the Latin American region’s population faces obstacles to accessing health services.
Bachelet, a passionate advocate for the rights of the vulnerable, urged governments, civil society and other societal actors to accelerate and intensify their efforts: “We must build national consensus because the challenges are of such magnitude that they require the commitment and effort of all.”
Iterating that the values of Declaration of Alma-Ata still resonate, Bachelet emphasized, “We must redouble our strategy and efforts for primary health care as it optimizes resources, provides services close to where people live, addresses health promotion and prevention, ensures continuity of services and provides means for reducing segmentation and low (health services) performance.”
The JLN unifies UHC efforts across 30 countries, including on the South American continent, where Colombia, Mexico and Peru are working with their counterparts in countries across Asia and Africa to jointly tackle barriers to UHC.
While the call to action at the PAHO event was focused on the Americas, the message resonated with the UHC challenges of countries the world over. In our varied roles, what can we focus on to realize universal health coverage: for everyone, everywhere?
- Break down social barriers
To achieve universal health coverage, universal health access must be at the core of our efforts which means that all sections of society should have access to quality and timely health services – irrespective of gender, sexual orientation, economic strata, race or religion. Countries must investigate the social determinants of accessing health care services and expand access through bold collaborations across the public and private sectors.
- Link the right thing to smart things
For Bachelet, who steered Chile’s policies to overhaul the nation’s health care system, her guiding principle for spurring action has been, “How to link the right thing to smart things?” To catalyze policy-making and mobilize revenues for health financing, political leaders must understand what a country stands to lose under a business-as-usual scenario. Poor health diminishes GDP, incurs greater debt and decreases lifespans – all of which can be circumvented if governments focused on addressing the well-being of its people at the first level of health care. Making the case through indicators and evidence is essential to secure the buy-in of decision-makers.
- Build strong voices
Citizens are the best protagonists for their cause. Inclusion and participation from all actors of society – communities, NGOs, academia, civil society, parliaments, administration, the private sector and media – can collectively accelerate the course toward universal health care. Recognizing the power of people’s voices, PAHO launched an awareness campaign to make people of the Americas aware of their right to have health care without facing financial difficulties and empowering them to participate in broad dialogue around their health care needs.
“There are no short-cuts. It's a long journey we must take for social justice,” said Bachelet of the road that lies ahead for countries as they navigate the challenges and opportunities to make health for all a reality.