Universal Health Coverage – World Health Day Theme Reflects Diverse Agendas

From healthier diets to medicines access, an unusually broad array of issues were wrapped into this year’s World Health Day theme of Universal Health Coverage (UHC), directly or indirectly – reflecting the complexity of attaining a goal that has become the health sector’s singular call to action this year.

Oxfam International asked the President of the United Nations General Assembly to convene a high-level UN discussion in September on “achieving access to safe, effective, quality and affordable essential medicines, diagnostics and vaccines for all.”

Meanwhile, other civil society groups pointed out that UHC could only be affordable worldwide if preventive health measures were deployed more effectively, reducing soaring rates of noncommunicable diseases.

The NCD Alliance highlighted the role of unhealthy diets in the global epidemic of noncommunicable diseases such as diabetes, stroke and heart disease. The global health NGO, Vital Strategies, said that prices of unhealthy foods, drinks and tobacco also needed stiffer taxation, which could be used to fund better health coverage.

Even the UN’s Basel, Rotterdam and Stockholm (BRS) Conventions got into the World Health Day mode, asking governments “for urgent and greater actions to reduce the number of illnesses and death from hazardous chemicals and waste.” The statement by the BRS Secretariat cited recent WHO estimates that about 1.6 million lives are lost annually as a result of unsafe handling of dangerous chemicals and chemical waste, increasing deaths from cancers, heart and respiratory diseases, congenital anomalies, chronic kidney disease, as well as accidental or deliberate poisonings.

The Oxfam International appeal Friday for a high-level UN discussion on the medicines access issue came just ahead of the formal World Health Day, celebrated 7 April, falling on a Sunday this year. The letter was signed by Executive Director Winnie Byanyima, along with nearly 100 civil society groups and policy leaders.

The letter builds upon the growing momentum around September’s planned UN High Level Meeting on Universal Health Coverage [see Health Policy WatchMajor UN Effort Taking Shape] as well as a recent Italian initiative by Minister of Health Giulia Grillo empowering the WHO to create a global framework for monitoring medicine prices.

“Addressing transparency among other aspects of innovation and access to medicines, diagnostics and vaccines requires a dialogue and response that engages the whole UN system. This is essential to achieving UHC and the 2030 Agenda,” said the Oxfam International letter, addressed to the Ecuadorian politician María Fernanda Espinosa Garcés, president of the upcoming 73rd UN General Assembly session.

“Convening a specific high-level discussion on achieving access to safe, effective, quality and affordable essential medicines, diagnostics and vaccines for all is essential for meaningful progress towards UHC to be made at the summit,” added Tabitha Ha, Access to Medicines Advocacy and Campaigns Officer at Oxfam. She said that, “every second 3 people are pushed into extreme poverty because of their healthcare expenses. The high prices of medicines, such as those to treat cancer and manage diabetes, are hitting the poorest, especially women, the hardest. ‘Health For All’ can only be achieved if everyone has access to the medicines that they need at prices they can afford.”  

However, other groups were quick to note that universal health coverage cannot be reached without far greater attention to preventive measures and investments – which would reduce the overall burden of disease.

This is particularly the case for noncommunicable diseases, which are rising in developing as well as developed countries, and where costly treatments tax health system resources and resilience.

The NCD Alliance used the moment to make social media calls for greater inclusion of noncommunicable disease prevention and treatment into national public health benefits as key to achieving UHC. In the lead-up to World Health Day, the Alliance also highlighted the importance of healthier food consumption, citing new research attributing some 11 million deaths to poor diets globally. The study, published last week in The Lancet by the Seattle-based Institute of Health Metrics & Evaluation (IHME), concludes unhealthy diets are thus responsible for more deaths annually than virtually any other single health risk, including smoking.

“This research… is a call to action to governments everywhere,” Katie Dain, NCD Alliance CEO, said in a Tweet. “Addressing high salt intake, low intake of whole grains and low intake of fruits has the potential to save millions of lives every year… [A]ll people are at risk and no country can afford to neglect this threat to health and development.”

In a related move, José Luis Castro, President and CEO of Vital Strategies, a global health NGO, called for higher taxes on unhealthy beverages and tobacco products – moves that could both save lives preventatively as well as help national governments fund universal health coverage.

“There are ways to pay for health care and reduce health care costs at the same time,” Castro said, quoted in a press release. “One is to tax unhealthy products that can cause disease – products including tobacco, sugar-sweetened beverages and alcohol.”

Those same tax revenues can then be used to fund universal health coverage, he said, doubly targeting noncommunicable diseases (NCD’s) that are responsible for two-thirds of deaths worldwide.

“By taxing unhealthy commodities that significantly contribute to NCDs, we make them less accessible and affordable – reducing consumption of the very products that can drive disease,” Castro asserted.

“This prevention strategy not only reduces disease but offers a source of funding for health systems and countries’ economies. Additionally, people across the globe will be faced with less preventable disease, while countries will reduce crippling health-care debt,” he said. “If we stick to the status quo, the cumulative worldwide cost of NCDs between 2011 and 2030 will exceed $47 trillion. However, with political will, proven solutions can improve people’s health and well-being.”

Some 75 percent of NCDs occur in low- and middle-income countries. They include heart disease and stroke, cancer, diabetes, chronic respiratory disease and mental and neurological disorders.

Related Stories: see also Health Policy Watch’s 5 April 2019 Interview with Vital Strategies’ Sandra Mullin.

Image Credits: WHO.

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