Health for all: United by purpose, driven by action
Today, on World Health Day, WHO celebrates 75 years of improving public health and well-being in the South-East Asia region and globally, fully committed to achieving "health for all" through universal health coverage (UHC) – when all people can access the health services they need, when and where they need them, without financial hardship.
For many decades now – and since even before the 1978 Declaration of Alma-Ata – high-level leaders and policymakers from across the region have recognised the critical role that access for all to quality, affordable and comprehensive primary health care (PHC) can play in achieving UHC, and therefore health for all.
However, global enthusiasm for UHC and the PHC approach has witnessed several peaks and troughs, resulting in public health services and programmes that have often become siloed, fragmented and divorced from wider multisectoral, social and economic processes and determinants.
Today, in the shadow of the Covid-19 crisis, around 40 percent of the region's population is unable to access essential health services. In 2017, around 299 million people in the region faced catastrophic health spending, and an estimated 117 million people in the region were pushed or further pushed below the purchasing power parity poverty line of $1.90 a day – a figure that has since been exacerbated.
History's lesson is as clear as it is urgent: Sustained whole-of-government, whole-of-society action is needed to achieve UHC and health for all – since 2014, one of eight Regional Flagship Priorities, and a core pillar of the region's vision to build back better from the Covid-19 pandemic. We must all contribute.
First, high-level leaders from across the region must maintain and strengthen political and financial commitment to achieve UHC, accelerating momentum ahead of the second UN General Assembly meeting on UHC in September this year. The Covid-19 crisis has shown that when health is at risk, everything is at risk. It has shown that investments in UHC and health system resilience underpin not just health, but social and economic security, as well as the achievement of an array of Sustainable Development Goals.
History's lesson is as clear as it is urgent: Sustained whole-of-government, whole-of-society action is needed to achieve universal health coverage and health for all.
Second, policymakers and programme managers must continue to implement the Region's Strategy for PHC, launched in December 2021. Of specific focus should be strengthening public health infrastructure, workforce and financing, while at the same time increasing equity for those at risk of or who are already being left behind. Shared learning must continue to be a core priority, leveraging the full power of the region's new forum for PHC-Oriented Health Systems.
Third, people and communities must increasingly assert their voice and right to health, including by directly engaging in local health decision-making processes. As highlighted by the 2021 WHO handbook on social participation for UHC, as well as the region's recently adopted resolution on enhancing social participation in support of PHC and UHC, individuals and communities can play a key role in monitoring health service performance and holding health providers and policy makers to account.
Fourth, partners, donors and other stakeholders in the region must go all in on UHC and health for all, recognising that the PHC approach is the most effective, efficient and equitable way to build national health systems that are unified, and which achieve healthier populations, health security and UHC. In all countries, policymakers must lead, and partners must support. Assistance must be fully aligned with national priorities, avoiding duplication and fragmentation.
Crucially, given the magnitude of the challenge, we must recognise that progress may not always grab headlines, but will nevertheless make a real difference to people's lives. Between 2010 and 2019, the region increased its UHC service coverage index from 47 to 61. Between 2000 and 2017, the region reduced the number of households impoverished or further impoverished from out-of-pocket spending on health from 30 percent to 6 percent. Since 2014, the density of doctors, nurses and midwives in the region has improved by over 30 percent – a tremendous achievement that must continue to be built upon.
On WHO's 75th founding anniversary, let us unite in purpose and be driven by action to achieve UHC and health for all, ensuring all people have good health for a fulfilling life in a peaceful, prosperous and sustainable world.
Dr Poonam Khetrapal Singh is WHO Regional Director for South-East Asia.