Universal health coverage must prioritize health needs of the poor

 New Delhi, 17 April 2012: Health experts from the 11 Member States of WHO’s South-East Asia Region met in New Delhi on 16-17 April to brainstorm about universal health care in the Region. WHO is urging countries in the Region to give priority to public health and the health needs of the poor through appropriate technology and health systems that are anchored at the community level. The three strategic dimensions for universal health coverage are: population coverage, where all citizens are covered by health services irrespective of capacity to pay; a service package offered universally to all citizens customized to meet ground realities and all resource needs, including financing; and ensuring utilization, affordability and sustainability.

Countries have placed a different emphasis on each of these three dimensions in their path to universal health coverage. China for example is targeting access to a limited package of services for its entire population in its first phase of universal health coverage.  Nepal is committed to providing maternal and child health services free at primary level and prioritizing better access for the poor in secondary care.  Sri Lanka, on the other hand, has been successfully delivering a more comprehensive package for sometime now. 

“Equity remains the underpinning principle that we must not lose sight of” said Dr. Samlee Plianbangchang, WHO Regional Director for South-East Asia. “Health systems are becoming more complex and health ministries must now lead and coordinate multi-sector action for improving health for all”.

Experience shared from Costa Rica at the consultation highlighted the importance of leadership and governance in maintaining solidarity for equity.  This has been at the core of Costa Rica’s 50-year trajectory to universal health coverage even at low and middle levels of GDP.  Importantly, health has been part of a broader effort for social development which has had a reinforcing impact on health, and particularly on education.

Influences outside the health sector impact health as well, such as, the rising burden from high-cost, life-style related noncommunicable diseases, health risks from climate change, social determinants of health and health implications of the financial crisis.

Bhutan is now leading the world in reassessing our priorities as captured by economic growth. The UN is discussing indicators for Gross National Happiness (GNH) to replace measuring of GDP to capture development.  The nine domains under the four pillars of GNH are: living standards, health, education, culture, ecological integrity, community vitality, time use, good governance, and psychological wellbeing.

Universal health coverage must prioritize the poor and public health including a renewed focus on cost-effective prevention and promotion activities by revitalizing Primary Health Care (PHC). This is the feasible and sustainable way forward given the resource context of countries of South-East Asia.