The pursuit of universal health coverage (UHC) has gained unprecedented momentum. Across the world, ensuring all people can access the health care they need, without financial hardship, is recognized as the best way to advance health and well-being and to respect, protect and fulfill the right to health. This is with good reason. UHC is about overcoming the systemic barriers people face when seeking health care, whether geographic, financial or discriminatory. It is also about quality: Unsafe or poor-quality care can be just as bad as no care. Since 2014 the WHO South-East Asia Region has pursued UHC as a Flagship Priority, with a specific focus on access to medicines and human resources for health.
The Region’s progress has been steady. A WHO report released in September 2019 notes that the coverage of essential services has increased to 61% from 47% in 2010. The density of health workers has expanded from 21.5 per 10 000 people in 2014 to 27.1 in 2017. The safety of medicines and medical products is improving; their cost is decreasing. The primary health care movement, which was renewed globally in 2018 via the Astana Declaration, continues to inspire action. So too does the imperative at the heart of the Sustainable Development Goals (SDGs) and the UN’s recent Political Declaration on UHC: Leave no one behind.
To achieve the Region’s Flagship Priority on UHC, as well as WHO’s global ‘triple billion’ targets and the SDGs, Member States are striving to sustain and accelerate progress, and to innovate to do so. The challenges are many. An estimated 800 million people in the Region continue to lack access to essential health services. Over 65 million are impoverished due to out-of-pocket expenditures. While there are many roads to UHC, all of them require steadfast commitment, both within and beyond government, as well as across sectors. As the theme of this year’s Universal Health Coverage Day emphasizes, we must ‘keep the promise’ and chart bold, game-changing progress.
Investing more public funds in health is key. Increased public funding, if strategically allocated, will help reduce out-of-pocket expenses. It is no coincidence that countries in the Region that spend a larger share of the government budget on health have lower rates of impoverishment due to health spending. The benefits are many. Reduced out-of-pocket costs promote timely health care-seeking. Better health promotes economic productivity and generates decent jobs.
Medicines must likewise be more affordable. To make that happen, Member States are pursuing a range of policies, with some countries devising medicines benefit packages to guide procurement and reimbursement decisions. WHO is working to ensure the key lessons from good practices are understood and disseminated across the Region so that countries can adapt and implement policies as per their needs. Our joint success is dependent on our shared learning.
Member States are also increasing the quality and safety of essential medicines and medical products. To that end, the WHO-supported South-East Asia Regulatory Network (SEARN) is proving a valuable tool. Since it was first convened in 2016, the SEARN has agreed to pursue a range of initiatives, from creating an online information-sharing platform to developing training modules on medicines and vaccine safety monitoring. The SEARN’s continued action will be especially useful for the Region’s smaller countries, whose regulatory authorities can be stretched.
The Region’s Decade for Health Workforce Strengthening continues. All countries are striving to recruit and train a health workforce that is of adequate volume and which has the right skill mix. Improving rural retention is a particular concern, reflecting the Region’s primary health care approach to UHC. WHO has recently developed six country case studies to identify promising practices to strengthen rural staff retention. We look forward to further advances in this area.
Importantly, the pursuit of UHC must be a collective endeavor. Increasing engagement with all stakeholders, including communities, civil society and, where appropriate, the private sector is core to ‘keeping the promise’. Innovative forums such as national health assemblies or youth town halls provide important avenues for political leaders to include civil society in policy dialogue and to ensure people’s voices and concerns are heard. That in turn increases public buy-in for UHC and promotes accountability and trust. Both outcomes are essential to our journey.
The promise of UHC is bold: for all people to access the health care they need, without financial hardship. Across the WHO South-East Asia Region, Member States have already shown that by developing and implementing appropriate policies they can deliver strong progress, regardless of their starting point. On Universal Health Coverage Day, WHO reiterates its commitment to supporting Member States as they continue their journey towards UHC, and with it, SDG 3. Our goal is ambitious. Our commitment is fixed. A healthier, more equitable South-East Asia Region is being created.