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How to realise the dream of universal health coverage  

Samir Kumar Saha   | Wednesday, 11 December 2019


With its health sector still remaining in the doldrums, Bangladesh, along with other countries of the world, will today (December 12) celebrate the Universal Health Coverage Day. The day is promoted by World Health Organisation (WHO). Universal Health Coverage (UHC) is based on the principle that all individuals and communities should have access to quality essential health services without suffering financial hardship.

WHO calls for stronger and more equitable health systems to achieve UHC, leaving no one behind. The day has become the annual rallying point for the growing movement for health for all.

On December 12, 2012, the UN General Assembly (UNGA) unanimously endorsed a resolution urging countries to accelerate progress toward universal health coverage (UHC) - the idea that everyone, everywhere should have access to quality, affordable health care - as an essential priority for international development.

On 12 December 2017, the UN proclaimed December 12 as International Universal Health Coverage Day (UHC Day).

In September, all UN Member States agreed to a Political Declaration on UHC. At the High-Level Meeting on UHC at the United Nations General Assembly in New York on September 23, 2019, Heads of state demonstrated strong political vision and commitment to ensuring UHC for the people they serve.

When all 193 Member States of the UN agreed on the Sustainable Development Goals (SDGs) in New York in 2015, they set out an ambitious agenda for a safer, fairer and healthier world by 2030. The target to achieve UHC is a beacon of hope for a healthier world.

UHC advocates raise their voices to share the stories of the millions of people still waiting for health, to call on leaders to make bigger and smarter investments in health, and to remind the world that Health for All is imperative to create the world we want.

The theme of UHC Day 2019 is 'Keep the Promise'. Governments, international organisations, civil society organisations, the private sector, academia and media are encouraged to use this year's theme to keep holding leaders, our health systems and ourselves accountable to the promise of health for all.      

The UN has adopted 17 Sustainable Development Goals for eliminating poverty and building a more resilient planet. One of those goals includes providing universal health coverage. The global coalition of leading health and development organisations emphasize the importance of universal access to health services for saving lives, ending extreme poverty, building resilience against the health effects of climate change and ending deadly epidemics.

To achieve this vision of UHC by 2030, we need collective action now.

UHC means everyone can access quality health services without financial hardship. It is an inherently political goal rooted in the human right to health. It also makes economic sense. Health is a human right, that no one should go bankrupt when they get sick, and that universal health coverage underpins our collective security and prosperity.

WHO's constitution affirms that the enjoyment of the highest attainable standard of health is a fundamental human right. More than half of the world's countries have included the right to health, public health or medical care in their national constitutions.

UHC aims to achieve better health and development outcomes, help prevent people from falling into poverty due to illness, and give people the opportunity to lead healthier, more productive lives. There is growing global consensus that UHC is a smart investment and an achievable goal everywhere. Lack of affordable, quality health care traps families and nations in poverty.

UHC aims to achieve better health and development outcomes in line with the SDGs. SDG 3 includes a target to "achieve universal health coverage (UHC), including financial risk protection, access to quality essential health care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all.

When health care is accessible and affordable, families can send their children to school, start a business and save for emergencies. Universal health coverage pays a resilience dividend. In times of distress, health minimises the shock to lives and livelihoods. In times of calm, health promotes community cohesion and economic productivity. Health is a right, not a privilege.

Countries implementing universal health coverage are seeing the benefits: healthier communities and stronger economies.

In Bangladesh, is still a dream. We have to devise ways for ensuring the UHC. In my opinion, traditional medicine can play an important role in ensuring healthcare of all if we can take necessary steps.        

According to WHO, "Traditional medicine refers to health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral-based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being."

WHO launched the Traditional Medicine Strategy 2014- 2023 for its academic promotion, quality production and mainstream integration into public health care to achieve universal health coverage.

So, inclusion of traditional medicine in our national health care system can play a complementary role to achieving the objectives of the universal health coverage. Its accessibility at the doorsteps of marginalised people will be very cost-effective and worthy in regards to population coverage and reducing financial burden as well.

In the recent past, there has been a growing interest in Traditional Medicine/Complementary and Alternative Medicine (TCAM) and their relevance to public health both in developed and developing countries.

Diversity, flexibility, easy accessibility, broad continuing acceptance in developing countries and increasing popularity in developed countries, relative low cost, low levels of technological input, relative low side effects and growing economic importance are some of the positive features of traditional medicine (WHO 2002).

In this context, there is a critical need to mainstream traditional medicine into Bangladesh's public healthcare to achieve the objectives of improved access to healthcare facilities.

In countries such as Bangladesh, India, China and many other parts of Asia one can observe traditional medical knowledge in various forms such as codified medical systems, folk systems, allied disciplines and new systems of knowledge.

In Bangladesh, Alternative Medicine Care (AMC) means Unani, Ayurvedic and Homeopathic system of treatment. But there are problems prevailing in our health sector, which is hampering health services. There are many poor people, who are unable to take health services due to financial crisis.

UHC Day is an opportunity to put aside our differences and work together for a movement that brings benefits to people and patients and reduces poverty and promotes inclusive growth. On the occasion, it can be said that taking necessary steps regarding the traditional system of medicine can contribute to healthcare of our people. It is hoped that authorities concerned would look into the matter.

We need to see action plans to guarantee health as a right, not as a privilege. We need to see real investment in our society where all the people can get the quality health care they need and trust without facing financial hardship. We need to see strong, equitable health systems that truly leave no one behind.

Higher financial allocation in the health sector, research on traditional medicine and its proper evaluation can go a long way in fulfilling the targets of UHC in Bangladesh.  

Dr. Samir K. Saha  Vice-Chairperson and ex-CEO of Public Health Foundation, Bangladesh & Founder President of AYUNS.

ayusamir@gmail.com