UHC Coalition: Realizing the Promise of Universal Health Coverage
When we marked UHC Day at this time last year, the world had just adopted the Sustainable Development Goals, including Universal Health Coverage as a target. This was worth celebrating.
The World Region
Kofi Annan, the former Secretary-General of the United Nations, observed that knowledge is power and information is liberating. Indeed, the collection, analysis and dissemination of data and information should not be seen only as an instrument of scientific inquiry but more importantly, as a critical tool for guiding the formulation and implementation of policies to address complex problems in society.
While recent health crises, such as the deadly Ebola outbreak in West Africa, have caused much human and economic devastation in the affected countries and tested the resolve of the international community, the past hundred years have witnessed dramatic improvements in human health not seen in previous centuries when life was in most cases “poor, nasty, brutish and short” as Thomas Hobbes, the English philosopher, observed in the 17th Century.
It really caught my attention when a friend of mine, an otherwise healthy chest physician in his late 40s, told me recently that he almost died of pneumonia. He had to be hospitalized twice, given an IV cocktail of antibiotics each time, only to recover about a month later, totally drained and weak. He told me that it was caused by Klebsiella pneumoniae -- a bacterial infection increasingly resistant to antibiotics and known to strike the immunocompromised, frail and alcoholics -- which he thought he must have gotten from a patient. He considered himself lucky to have survived.
Today, the UN Maternal Mortality Estimation Inter-Agency Group (MMEIG)* released Trends in Maternal Mortality: 1990 to 2015. It reports that, worldwide, maternal mortality ratio (MMR) declined by almost 44% between 1990 and 2015, from 385 maternal deaths per 100,000 live births to 216.
The debate in the United States on how to change a health system that is geared to treat illnesses to one that focuses on preventing people from getting sick stirred my curiosity on how companies can improve employee health. After all, employees spend most of their waking hours at the workplace.
Today, World Bank Group President Jim Yong Kim announced a special funding mechanism to enable donors to scale up their funding to meet the urgent needs related to Millennium Development Goals 4 and 5, leveraging the International Development Association (IDA), the World Bank's fund for the poorest.
Dr. Kim announced the special funding mechanism during his remarks at the Every Woman, Every Child event at the UN General Assembly.
His remarks, as prepared for delivery, are available on the World Bank's website (http://www.worldbank.org/en/news/2012/09/25/world-bank-president-kim-every-woman-every-child-un-general-assembly).
This week (August 1-7) is World Breastfeeding Week, an occasion to remind ourselves of the important role that optimal infant and young child feeding plays in the healthy growth and development of individuals, communities, and nations. For more than 30 years, the World Bank has championed the importance of breastfeeding. This includes investing in advocacy and communications to policymakers, strengthened health systems, and effective community-based outreach to provide the knowledge and support needed by women and their families.
To mark World Breastfeeding Week, World Bank nutrition experts have updated this helpful Q/A on the topic:
What are the health benefits of breastfeeding?
Breastfeeding is one of the most powerful tools available to a mother to ensure the health and survival of her child from the moment he/she is born. Optimal breastfeeding practices, which include initiating breastfeeding within an hour of birth, feeding only breast milk until 6 months, and continuing to breastfeed up to 24 months, are key elements in the fight against malnutrition. Breast milk provides all the nutrients a child needs for healthy development in the first six months of life. And the antibodies that are transferred from a mother to her child during breastfeeding help protect infants against common childhood illnesses that can lead to death, such as diarrhea and pneumonia.
The Lancet’s 2008 series on Maternal and Child Undernutrition has estimated that the relative risk of death (all cause mortality) is 14 times higher for a child who is not breastfed versus one who is exclusively breastfed. When broken down by disease, the relative risk of death from diarrhea and pneumonia is 10.5 and 15 times higher, respectively, for children who are not breastfed versus those that are exclusively breastfed.
Amid political statements and declarations of commitment, several sessions at the ongoing International AIDS Conference 2012 have shined a bright light on the future of the pandemic and the global response.
In one session, Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) at the U.S. National Institutes of Health, gave a keynote address, “Ending the HIV/AIDS Pandemic: From Scientific Advances to Public Health Implementation.”
According to Dr. Fauci, who has been at the forefront of the fight against HIV/AIDS since the discovery of the virus in the early 1980s, the scientific developments in the last three decades that have helped understand, treat and prevent HIV infection bode well for the promise of a world free of AIDS. He noted that the robust arsenal of nearly 30 antiretroviral drugs and scientifically proven interventions now available to treat and prevent HIV infection and improve people’s health and longevity, offer an unprecedented opportunity in the years ahead. However, he was clear in cautioning that this will not be accomplished without sustained global commitment and effort. This means that the international community cannot retreat in the face of the current economic slowdown, but rather build upon those advances, adjusting, adapting and strengthening the response on the basis of accumulated experience and lessons learned from across the world.
If we heed Dr. Fauci’s advice, it should be clear to all of us that while we need international funding from current and new donors to sustain the global effort, developing country governments also can and should step in and prioritize funding and investments to contribute to the fight against HIV/AIDS and for other health priorities. While some people argue that the unprecedented funding for AIDS in the last decades has created imbalances in the global health agenda, we should also remember that in previous decades the underfunding and underdevelopment of health systems in most of the world, and the resulting lack of or limited access to basic health services for the majority of the population, was a common phenomenon that came before the AIDS response.
Now that the XIX International AIDS Conference is in full swing this week in Washington, DC, it’s worth reflecting not only on past achievements but on future challenges.
As recounted by Dr. Peter Piot, the former executive director of UNAIDS, in his recently published memoire, No Time to Lose, after overcoming many obstacles and naysayers, the UN system, with its many organizations and agencies, working together with governments, civil society and religious organizations, groups representing people living with AIDS, and eventually the pharmaceutical industry, came together this past decade to redefine existing HIV/AIDS prevention and treatment paradigms.
There have been landmark political events as well, such as the UN Security Council Session held in January 2000 that for the first time focused on AIDS as a global health challenge, and the UN Special Session on AIDS held in June 2001, which paved the way for establishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria and the U.S. President's Emergency Plan for AIDS Relief (PEPFAR).
Not only was the power of scientific and technological developments leveraged to confront the global epidemic, but an unprecedented commitment of funds helped scale up the international response.