L’adoption des Objectifs de développement durable (ODD) lors de la récente assemblée générale des Nations Unies a apporté une excellente nouvelle : désormais, l’avenir que nous voulons inclut, entre autres, la couverture santé universelle, telle que définie par l’ODD n° 3, cible 8. La même semaine, un groupe d’économistes venant de 44 pays a déclaré publiquement (a) que la couverture santé universelle était « économiquement justifiée ». Il semble donc qu’un changement de cap s’opère pour permettre à tous ceux qui en ont besoin d’accéder à des soins de santé sans rencontrer de difficultés financières.
universal health coverage
The launch of the Sustainable Development Goals (SDGs) at the recent U.N. General Assembly meetings brought especially welcome news: The future we want now officially includes universal health coverage (UHC), as defined under SDG 3, target 8. We also heard, the same week, from a group of economists from 44 countries, who publicly stated that “UHC makes economic sense.” It seems the tide has turned toward making essential health care available to all who need it, without creating financial hardship.
Somehow, everyone in the universal health coverage (UHC) universe seems to assume that the future of health financing will be built on centralized financing institutions fed by a mix of general tax revenue, payroll taxes and other contributions. This large pot of money, so the assumption goes, is administered by bureaucrats sitting in big buildings in national or provincial capitals. They contract with providers and pay them through capitation, diagnosis-related groups, fee for service, and reimburse retailers (pharmacists) for medicines that the patient takes home.
Maya is waiting for the physician to call her name. Her three children play in the waiting room, making happy noises, but she is worried about her health. The physician confirms her worst fears: it turns out that she has cervical cancer. Now what? A social worker tries to comfort her, saying that the medical staff will do their best to get her treated soon so that she can keep on working to sustain her family.
Last Friday, I had the privilege of attending the launch of a new global report that provides the clearest picture to date of countries’ progress moving toward universal health coverage (UHC). UHC is critical for building resilient health systems, which protect communities and strengthen societies in times of crisis and calm alike.
As we know from many health financing studies, drug expenditure typically ranks first or second among out-of-pocket expenses. In fact, it is often the cause of catastrophic expenditure, driving people from lower middle class into poverty once a severe or chronic disease affects a family member.
As the world moves into the post-2015 era and toward the 2030 goal for health, which includes universal health coverage and making sure everyone has access to essential, quality care, results matter more than ever. To show results and translate them into action, however, countries need better quality data, better capacity for health information and civil registration systems, and better incentives to use data for decision-making.
This week’s links include support for UHC and continuing coverage of the global Ebola crisis response. Each Friday, we share a selection of global health Tweets, infographics, blog posts, videos and more. Follow us @WBG_Health.
As we honor World AIDS Day 2014, perhaps it is time to pause and take stock of the gains achieved over the last three decades by the extraordinary social movement that emerged across the globe to confront HIV.