Health is a fundamental right of every human being, without distinction of any kind, but this is not a right enjoyed by everyone.
At least half of the world's population still do not have full coverage of essential health services. About 100 million people are still being pushed into “extreme poverty” (living on USD 1.90 or less a day) because they have to pay for healthcare. Over 800 million people (almost 12 percent of the world's population) spent at least 10 percent of their household budgets to pay for healthcare. In Bangladesh, the out-of-pocket (OOP) health expenditure is 63 percent of the total health expenditure, which is much higher than that of the world average of 32 percent. Furthermore, Bangladesh has a shortage of approximately 100,000 doctors and approximately 800,000 healthcare providers compared to the global standard.
In this scenario, Bangladesh requires proper implementation of universal health coverage (UHC). Thus, there is a need for a minimum of 15 percent of the total budget for the health sector whereas the current allocation is only five percent.
The “Health for All” agenda set by the Alma-Ata Declaration of 1978 now has a new dimension of commitment by the global community through the Sustainable Development Goals (SDGs) for the year 2030. The solution lies in UHC. The world has agreed to try to achieve UHC by 2030, as part of the SDGs, and we all have a role to play in this.
UHC: The right to health
UHC means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, which are of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship. UHC enables everyone to access the services that address the most important causes of disease and death and ensures that the quality of those services is good enough to improve the health of the people who receive them.
Moving towards UHC needs sustainable financing, skilled health workers, good governance, reliable service delivery, meticulous data management, and comprehensive access to medicines. But one of the often-overlooked aspects is the fact that UHC requires a strong legal framework. Strong laws are essential to protect and promote the right to health, as well as equity, quality, efficiency and accountability.
Connecting the Inter-Parliamentary Union, the global organisation of parliaments
Parliaments are crucial in the design, implementation and monitoring of law, policies and programmes relevant to realising the right of everyone to enjoy the highest attainable standard of physical and mental health.
Parliaments have the responsibility to protect the people they represent, including the most vulnerable groups, from the financial consequences of paying for health services out of their own pockets. That is the mandate of the Inter-Parliamentary Union (IPU), the global organisation of parliaments.
At its last Assembly in October 2018 at Geneva, the IPU adopted my proposal on behalf of the Bangladesh Parliament to develop a resolution on “Achieving Universal Health Coverage by 2030: the role of parliaments in ensuring the right to health.” It is the first time that a global parliamentary resolution on UHC will be developed and is also a testament to the commitment to health and the SDGs of the IPU and its members.
The resolution will be drafted by me and two other parliamentarians from Switzerland and Malawi. All member parliaments of IPU will also have the opportunity to contribute to the preparation of the resolution, by taking part in a debate at the next IPU Assembly in Doha next April. Member parliaments will of course also take the final decisions on the contents of the resolution through an interactive regional process, which should be adopted at the 141st IPU Assembly in Belgrade in October of this year.
Achieving UHC by 2030: IPU's call for action
Recalling the major international commitments towards the achievement of UHC, the IPU resolution we are proposing today would represent the main parliamentary instrument to contribute to this global process, and to design the role that parliaments are to play and concrete actions to be taken.
And we, as parliamentarians, wield enormous power to improve the health of millions. We have both the authority and the responsibility to promote the highest standards of health and wellbeing for our people, through our roles in legislation, oversight and accountability, budgeting, and advocacy.
This IPU resolution will be crucial in defining the role of parliaments and identifying concrete parliamentary actions for the achievement of UHC. Considering the UN high-level meeting on UHC that will take place in September 2019, it is also very timely. These two processes will provide a clear signal of the centrality of the UHC agenda not only for health, but also for equity, development, social inclusion and cohesion.
I would like to take this opportunity to call on all parliamentarians to follow the preparation of the IPU resolution on UHC and to engage in implementation by working with their parliaments as they put in place actions to implement the resolution.
The IPU will support national implementation by working closely with WHO to strengthen the capacities of parliaments to make full use of their legislative, budgetary and oversight functions for improved access to healthcare services for all.
Working together for a better future
The catchcry of the SDGs is to “leave no one behind.” That's exactly what UHC aims to do. We must ensure that the poorest and most vulnerable people—including those in the remotest areas and those living in emergency settings—enjoy the same access to services as the wealthiest in big cities.
We cannot tolerate a world in which people are forced to choose between wellbeing and financial stability. The world is moving towards this important achievement. And we need to play our role.
We want to honour a promise that is bold yet simple, and that will change the lives of millions of people across the world. Health coverage that is universal. Health coverage that is for everyone, everywhere and leaves no one behind.
Prof Dr Md Habibe Millat MP, MBBS, FRCS (Edin), is the Chair of the Advisory Group on Health, Inter-Parliamentary Union and Member, Standing Committee on Ministry of Foreign Affairs and Ministry of Science and Technology. Email: firstname.lastname@example.org