‘Universal Health Coverage: Health for All’

Let’s make this dream come true for everyone, everywhere

Written by Muthuswamy Balasubramanyam  |  Madras Diabetes Research Foundation (MDRF), Chennai, India

Every year, World Health Day is celebrated on 7th April to mark the anniversary of the founding of World Health Organization (WHO) in 1948. Each year a theme is selected that highlights a priority area within public health. The theme for World Health Day 2019 was “Universal Health Coverage: Health for All”, a topic relevant to each and every country across the globe. “Let’s all work together to make this dream comes true to Everyone and Everywhere” says Muthuswamy Balasubramanyam, Dean of Research Studies and Senior Scientist, Madras Diabetes Research Foundation (MDRF), Chennai, India.

Universal health coverage (UHC)¹ is a vision in which all people and communities have access to quality health services where and when they need them, without suffering financial hardship. It includes the full spectrum of services needed throughout life, from health promotion to prevention, treatment, rehabilitation, and palliative care, and is based on a strong primary healthcare system.

Global health faces a broad spectrum of old and new challenges. Besides epidemiological problems, political conflicts, economic crisis, and austerity policies are jeopardising progress towards UHC, affecting the most vulnerable populations. Improvements in health financing and revamping of policies and overall health system by respective governments with public-private partnerships can help to achieve UHC and build a healthier country. However, this ambition cannot be made overnight and a key principle for achieving it should be possible by ‘progressive universalisation’, i.e., starting with what is available and gradually adding health services and improving financial protection for larger populations as the capacity of the health system improves, sustains, and grows.

Key messages¹ from World Health Day

• Health is a human right; it’s time for health for all.
• UHC means that all people have access to the quality health services they need, when and where they need them, without financial hardship.
• Health is a human right; everyone should have the information and services they need to take care of their own health and the health of their families.
• Quality, accessible primary healthcare is the foundation for UHC.
• Primary healthcare is a cost-effective and equitable way of delivering health services and helping countries make progress towards universal health coverage.
• To make health a reality for all, we need individuals and communities to have access to high quality health services so that they can take care of their own health and the health of their families; skilled health workers providing quality, people-centred care; and policy-makers committed to investing in primary health care.

Universal Health Coverage: Indian context

UHC remains an elusive aim, and as per the Indian health system, it continues to be characterised by substantial shortcomings relating to workforce, infrastructure, and the quality and availability of overall health services. However, the good news is that successive Indian national governments have stated a commitment to achieving UHC. The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) initiative approved by the government of India in March 2018 was a historic step towards achieving UHC in India and the scheme aims to publicly fund the healthcare of up to 500 million people. While there are obvious resource constraints and impediments in implementing AB-PMJAY², the success of the scheme will depend on overcoming a number of existing and inter-related structural deficiencies of the Indian Health system such as issues of public and private sector governance, stewardship, infrastructure, quality control, and health system organisation.

The good news is that healthy aging is achievable. Life expectancy is making great headlines; life span is how long we live, health span is how long we live with the best possible health. Worldwide life expectancy is increasing considerably thanks to medical advancements; the average lifespan in Western countries is about 80, but there are too many people who are only healthy until about age 40 or 50, an optimistic estimate if one also considers developing countries like India. The world today is facing devastating health issues due to non-communicable diseases such as cardiovascular disease, cancer, Type 2 diabetes mellitus, and Alzheimer’s disease along with the double burden of ever-troubling communicable diseases. Appropriate implementation of UHC for everyone everywhere will guarantee a long lifespan and health span

References:

1. https://www.who.int/campaigns/world-health-day/world-health-day-2019
2. Angell BJ et al. The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana and the path to universal health coverage in India: Overcoming the challenges of stewardship and governance. PLoS Med. 2019;16(3):e1002759.