This blog is part of a series on Universal Health Coverage (UHC). The series includes contributions from external bloggers and reflects their view. Follow the conversation on Twitter #HealthForAll.
I think for me the first question is what is Universal Health Coverage (UHC)?
To doctors it means a higher salary. To pharma maybe it means selling more drugs. To the private sector it means more patients through the door. To some it means primary healthcare--that’s the Gates Foundation’s approach. To other people it means financing. To my mother it means something the President always talks about.
I think this is the first thing that we really, really need to focus on. UHC literacy-- what does it mean?
If we do not agree on this, then we are not going to move forward. If we cannot agree, I shudder to think on what basis Finance Ministers are being asked to assist Ministers of Health.
So the first thing is literacy-- UHC literacy--that we really need to look at to support this Human Capital development agenda. The next thing is about efficiency and equity. If you come from the literacy side, then you start to understand that we do have a common literacy--we understand that it is about putting the last first.
Then you have to start thinking about what is the power and the responsibility of the state to rebuild the public health system? The private sector is only part of the solution-- meaning that government builds the public health infrastructure and then strategically contracts with the private sector, especially for services. So the role of public sector in achieving UHC is critically important and comes from, again, the literacy and the common understanding of UHC.
And then comes the role of civil society to mobilize people and support the public sector in accountability. Within this, let’s talk about strategic purchasing, ensuring that, as you go towards building the public sector, there are also efficiency gains from strategic purchasing mechanisms.
The last thing I want to talk about is regulation and legislation. If we are going to understand that Universal Health Coverage is for the last first, it is, therefore, about equity and efficiency. We cannot achieve that if we do not drive the agenda of regulation and legislation. That needs to be on board and that needs to be discussed so that everyone is on the same page. Thank you.
These remarks were made by Dr. Githinji Gitahi, Group Chief Executive Officer, Amref Health Africa and Co-Chair, UHC2030 at the 2019 World Bank Spring Meetings Session entitled Sustainable Financing Universal Health Coverage: Aligning Around A Country-Led Vision on Saturday, April 13, 2019