La adopción de los Objetivos de Desarrollo Sostenible (ODS) durante las reuniones de la Asamblea General de las Naciones Unidas celebradas recientemente fue una noticia digna de festejo: el futuro al que aspiramos ahora incluye oficialmente la cobertura sanitaria universal, tal como se define en el ODS 3, meta 8. (i) Esa misma semana, también nos enteramos de que un grupo de economistas de 44 países había manifestado públicamente (i) que “la cobertura de salud universal tiene sentido desde el punto de vista económico”. Según parece, la marea ha cambiado en favor de brindar atención médica esencial a todo aquel que la necesita, sin generar dificultades financieras.
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On this Sunday, October 11, the world marks the International Day of the Girl Child. While the day is an opportunity to advocate for girls’ rights across many sectors, one persistent, pernicious issue deserves renewed attention: the high prevalence of child marriage.
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.
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.
The recent, devastating Ebola crisis reminded the world of a hard truth: Pandemics are not just a threat to human health, they are a threat to societies and economies. That there will be another pandemic is not a question of “if,” but a question of “when.” A catastrophe on the scale of the 1918 flu epidemic could conceivably wipe out all development gains of the last century. We recognize this, but, still we are unprepared.
Nigeria has reason to celebrate. The country recently marked one year with no polio cases, bringing the world one step closer to eradicating a terrible disease that now circulates in only two remaining countries. To commemorate the global health milestone, Nigeria’s President Buhari gave his own three-month-old granddaughter a few drops of oral polio vaccine – a moment captured by a photographer and sent round the world via social media. It also sent a clear public health message: vaccination works.
I consider myself a pretty lucky person. I often work across the beautiful islands of the Caribbean, with their glistening turquoise seas, the lush greenery, fresh tropical fruit… I could go on, but I think you get the idea. Paradise is not always perfect, however: Beneath the postcard views is an often not-so-perfect public health system.
A recent “close encounter” in the Caribbean served as a stark reminder of this truth. Different from the movie “Close Encounters of the Third Kind”, it didn’t involve little green men nor giant floating spaceships, but something just as unknown, at least to me: chikungunya, a viral disease transmitted by the bite of infected mosquitoes.
Unfortunately, I was infected with chikungunya a little over a year ago during a work trip to the Eastern Caribbean in support a results-based financing project for the health sector. Our team was de-briefing near the ocean when it happened: I felt a quick sting from a mosquito bite, but didn’t think much of it. I felt unusually tired that evening, and by the next morning a number of other symptoms appeared – it was indeed chikungunya.
Exactly one year ago, I received an unexpected call from my manager just as I was finishing a week of paternity leave following the birth of my daughter. She asked me to lead an “absolutely urgent” project and said she was cutting her summer break short to return to the office. That project was on Ebola response. We had monitored Ebola cases in Guinea, Liberia and Sierra Leone over the previous months with growing concern, but now the World Bank was mobilizing its first emergency funding commitment to help the three affected countries contain the disease’s spread and help communities cope with the economic fallout.
On July 24th Nigeria celebrated a huge milestone in the global effort to eradicate polio. It has been one year since the country has had a case of wild polio. This means that it has interrupted transmission of the crippling disease.
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.