Universal health coverage, UN declaration

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14 January 2020

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2 February 2020

Published by Dario Dongo and Sabrina Bergamini on 22 January 2020

Universal health coverage, the theoretical goals

Universal health coverage 'it means that all individuals and communities receive the health services they need without experiencing financial hardship. Includes the full range of essential and quality health services, from health promotion to prevention, treatment, rehabilitation and palliative care'(WHO, see note 2).

Making the Universal Health Coverage (UHC) by 2030 is one of the Sustainable Development Goals (Sustainable Development Goal, SDGs) already agreed by the UN General Assembly in 2015. Objective n. 3 - 'Ensure healthy lives and promote wellbeing for all at all ages'- is in fact declined with Goal 3.8. 'Achieve universal health coverage, including protection from financial risks, access to quality essential health services and access to safe, essential, effective, quality and affordable medicines and vaccines for all'.

'The world is still 11 years old to achieve its sustainable development goals. Universal health coverage is key to ensuring this happens'(Tedros Adhanom Ghebreyesus, WHO Director General. See note 3).

Public health, the current reality

The WHO report 22.9.19 shows how to date more than half of the planet's population is deprived of coverage of basic health services. About 100 million people are in extreme poverty (<US $ 1,90 / day) due to the cost of healthcare. 200 million humans spend over 25% of their income on health. Another 925 million spend at least 10% of the family budget - and not the individual, it should be noted - to pay for treatment.

'If we are serious about it to achieve universal health coverage and improve people's lives, we must take primary health care seriously. This means providing essential health services like immunization, prenatal care, healthy lifestyle advice as close to home as possible - and making sure people don't have to pay for these care out of their own pocket. ' (Tedros Adhanom Ghebreyesus, WHO Director General).

5 billion people at risk. A political choice

The 194 WHO Member States they must invest at least 1% more of GDP in primary health care. (4) That is, to double health coverage, between now and 2030. Otherwise,

'up to 5 billion people they will still not be able to access health care in 2030, the deadline world leaders have set for achieving universal health coverage. Most of those people are poor and already disadvantaged'. (5)

An investment $ 200 billion annually - to strengthen primary health care in low- and middle-income countries (LMIC, Low-Medium Income Countries) - can save 60 million lives, increase average life expectancy by 3,7 years by 2030 and contribute significantly to socio-economic development. But governments they continue to favor armaments to hospitals, the industry of death to life.

'Public health is ultimately a political choice. We must realize that health is an investment in the future. Countries invest heavily in protecting their people from terrorist attacks, but not against a virus attack, which could be far more deadly and far more damaging economically and socially. A pandemic could bring economies and nations to their knees'(Tedros Adhanom Ghebreyesus, WHO Director-General).

Universal health coverage, commitments undertaken at the UN on 23.9.19

On 23.9.18 the Member States UN are committed to working effectively to achieve the goal of Universal Health Coverage'(UHC) by 2030. In words, at least. Bearing in mind that the USA, the second largest economic power in the world, is still a long way from guaranteeingbasic health care for the less well off. In any case, governments will have to periodically report to the UN on the progress of the work, in view of the United Nations General Assembly in 2023.

Investments must be oriented on four areas, with the objectives of:

1) guarantee that no one suffers the economic and financial repercussions of facing the costs of health care,

2) implement health interventions with a high social impact to fight disease,

3) protect women's and children's health,

4) strengthen health infrastructure, increase the workforce in health care and together strengthen the capacity for governance.

Global health, the great challenges

Areas of conflict and crisis are the first to turn attention to, especially towards children. At a global level, it is essential to introduce equity in access to services and to expand access to medicines. About a third of the people on the planet still do not have access to medicines, vaccines, diagnostic tools, with dire consequences in particular on chronic diseases and disabilities.

Prevention it must also be based, as is obvious, on the actual food supply safe and nutritious as well of water to all the inhabitants of the planet. Highlighting the responsibility of all member states of the United Nations to guarantee these human rights which the UN General Assembly has declared to be fundamental and indispensable. And it is no coincidence that they appear in the first places among the Sustainable Development Goals (SDGs) in the UN Agenda 2030.

Malnutrition, obesity and climate change are the three key factors of Global Syndemic, the global epidemic threat highlighted last year by the Commission The Lancet. Ultraprocessed foods - mostly junk food - make the populations of the world sick, as recently pointed out. FAO report. Finally, lantibiotic resistance, which depends on both the irresponsible management of farms in some areas of the world, both from the abuse of antibiotics for human use. Also in Italy, as seen.

Dario Dongo and Sabrina Bergamini

Note

(1) High-level United Nations Political Declaration on universal health coverage (UHC),

(2) Universal health coverage (UHC)

(3) WHO welcomes landmark UN declaration on universal health coverage, press release 23.9.19

(4) WHO, press release 22.9.19. Countries must invest at least 1% more of GDP on primary health care to eliminate glaring coverage gaps,

(5) WHO, Urgent health challenges for the next decade

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