Dr. Samir Kumar Saha :
Each year on December 12, the world celebrates Universal Health Coverage (UHC) Day. It is an official UN-designated day to raise awareness of the need for strong, equitable and resilient health systems and universal health coverage. On Dec 12, 2017, the UN General Assembly proclaimed Dec 12 as International Health Coverage Day, making it an official UN-designated day.
UHC is based on the principle that all individuals and communities should have access to quality essential health services without suffering financial hardship. It 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.
The theme of the day this year is “Leave No One’s Health Behind: Invest in Health Systems for All”.
Considering the global Corona pandemic that currently we are facing, the theme is very relevant. The pandemic is testing our resolve to deliver health for all and threatens to undo decades of progress.
We need to invest in health systems that protect us all now in order to end that crisis and build a healthier and safer future. It is needed to prioritize investments in strong, equitable health systems that protect everyone, respond to emergencies and leave no one behind in the future.
UHC advocates 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 UN has adopted 17 Sustainable Development Goals (SDGs) 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 organizations emphasizes 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.
If we are to prevent future pandemics and achieve health and well-being for all by 2030, we must prioritize equity-investing more in health and allocating resources efficiently and equitably according to need.
UHC 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, including Bangladesh, 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 minimizes 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, the matter of UHC is still a dream. Many people have been deprived of getting proper health services. According to health economics unit under the Health Ministry, high rate of out of pocket expenditure (patient’s personal spending) is the main obstacle to achieving UHC in Bangladesh. Researchers showed that annually 64% is spent on buying medicine for health and treatment purpose, which is alarming.
About 86% people of our country take health services from the private sector where the cost of getting services is very high and the government has no control over this sector.
The more disquieting fact is that 93% patients do not get medicine from government-run hospitals though the quality of health services, offered there, has improved.
Though Bangladesh has achieved successes in a number of fields in health sector, we have failed to properly handle the situation, which arose due to Covid pandemic. There were many instances of weakness in our health sector, which were manifested during the pandemic.
We have to ensure quality healthcare for people within the affordable cost. It is needed to increase allocation in health budget for reducing ‘out of pocket expenditure’ and saving patients from financial trouble. Improving the quality of health service at government-run hospitals, increasing manpower, updating list of essential medicines, and increasing monitoring over private hospitals and clinics are also imperative for improvement in the health sector.
We have to ensure overall satisfactory medical management and transparency in the government’s health department. It is needed to formulate far-reaching plan for which adequate financial allocation is imperative. In my opinion, traditional system of medicines such Unani and Ayurveda can play an important role in ensuring healthcare of all.
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 medicines (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 Bangladesh, there are many modern infrastructures for providing medical services, but people are being deprived of getting the services due to lack of skilled manpower. Trouble will erupt for operation of modern medical equipment if there is lack of skilled manpower. Medical equipments worth crores of taka are now lying unused at many hospitals for lack of skilled teachers.
Medical students are also being deprived of receiving proper education for the scarcity of skilled manpower.
There is a major deficiency of proper management regarding healthcare services. A monitoring committee, formed for monitoring health care activities of hospitals from capital to upazila level, remained inactive. A section of physicians are engaged in grouping at hospitals across the country.
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.
Ensuring UHC can halt the tendency of a section of people who go abroad for better treatment. Research on traditional medicine and its proper evaluation can go a long way in fulfilling the targets of UHC in Bangladesh.
(Dr. Samir Kumar Saha, The author is Ex-Executive Director of Public Health Foundation, Bangladesh)
