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How universal health coverage could change the lives of millions

Juliet Milgate, December 2014
Sisters Awa and Arame Ndiaye sit next to each other, both of them are smiling.

“Everyone should have access to the health services they need, and those services must be affordable”

Each year, an estimated 150 million people are impoverished because of high, often catastrophic health care costs, and 100 million people each year are pushed into poverty.

Millions more, like Mohammad, simply avoid seeking health care in the first place because it is unaffordable, or the quality health services people need are not there.

“For just a hospital appointment it costs 20 taka, but any tests or medicine are extra,” says Mohammad. “We cannot afford it and we come back without being treated.”

Others are unable to seek treatment for their children. “My son’s father has been sick these last three years,” says one mother. “We’ve spent a lot of money on his treatment. We hardly pass a day without borrowing money from people. That’s why we haven’t taken my son, Parvez, for treatment.”

It is estimated that one billion people don’t have access to health care services and that’s why today, Universal Health Coverage (UHC) Day, is so important.

The concept is quite simple – that everyone should have access to the health services that they need and that those services must be affordable.

The voices of Mohammad and Parvez’s mother tell the story of just two families’ experience, but represent the situation of millions more. They were gathered as part of an innovative research project between Sightsavers, IDS, Helpage International, ADD International and Alzheimer’s International.

Voices of the Marginalised draws on the real-life stories of people with disabilities and older people living in Bangladesh. These groups often experience poorer levels of health than their peers. For people with disabilities this can be linked to their impairment but also commonly due to a lack of accessible health facilities, information or barriers to treatment or discrimination.

To them UHC is not a technical concept for health coverage and financial risk protection, but a daily reality of the disastrous experience for many people, not just people with disabilities, living without access to health care today, right now.

That’s why Sightsavers’ programmes work to strengthen health systems so that they can deliver effective, quality, affordable eye care services. We support governments to meet the needs of the population in a number of ways: by investing in the training and development of eye health workers; supporting national governments to strengthen access to essential medicines; supporting national eye health policy planning; and working to improve health management information systems. If health systems are strong it means people can thrive and are able to go to school or work and live productive, socially inclusive lives.

Globally we’re advocating for the inclusion of UHC in the post-2015 development agenda. Over the past decade the Millennium Development Goals have led to substantial progress being made in improving people’s health and reducing mortality. Significant progress has been made in reducing mortality for children under five years of age and reducing maternal mortality, improving nutrition and reducing disability and death owing to HIV infection, Tuberculosis and Malaria.

However the fundamental problem is that quite simply health systems are just not up to the job of delivering the critical health interventions that people need. Heath systems require underlying structural changes in order to meet people needs, longer term investment and political commitment. The post-2015 development framework can deliver the necessary change and for that reason we’re advocating for UHC as a key mechanism to strengthen health systems.

In 2005 at the World Health Organisation’s (WHO) World Health Assembly, 180 countries committed to realising UHC (health for all). On this day two years ago, the United Nations unanimously endorsed universal health coverage. Today is about us reminding our governments of their commitments, and urging them to invest in strong health systems to deliver health for all. Not just developing countries but for all of us.

The path to UHC is incredibly complex and no single policy solution exists – each country must find its own way. It involves political will and commitment by governments to meet the health needs of their people (to uphold their right to health); it involves putting the right resources in place (financing and health services) to ensure that services are accessible to all; it involves ensuring that the right steps are in place to protect people from financial catastrophe; and it involves using what resources are available more wisely. As the WHO admits, “there is no magic bullet to achieving universal health coverage”.[1]

The current Ebola crisis is an all too timely reminder of what can happen when our health systems are weak and cannot protect people from disease outbreaks or respond to their needs. But good health systems aren’t just there for the emergencies – they are there to protect us all each and every day, making sure that we are healthy and providing quality health services when we need them most.

That is what people like Mohammad and Parvez’s Mother need – that every day basic protection for them and their families.

Join us in supporting UHC day today – its about health for all.

News story: Supporting Universal Health Coverage Day

[1] WHO (2010) Health Systems financing, the path to universal coverage.

By Juliet Milgate, Director of Policy and Advocacy at Sightsavers

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