MARCH 5 — Imagine a world where one has to choose whether to pay for a doctor’s visit or to pay for dinner later that night.
A saying as old as time; the access to healthcare is a basic human right, not a luxury.
When we talk about UHC, it is not just about the healthcare systems and policies. It is about equality, dignity and most importantly, the fundamental right of every human being.
Apart from that, good health and wellbeing is one of the Sustainable Development Goals (SDGs). The International Health Regulations (IHR), established in the year 2005, also supports this notion.
The IHR regulates public health emergencies and ensures that healthcare is accessible for everyone in the face of a global health crisis.
The right to health
The goal of navigating inclusive healthcare systems of UHC is backed up by human right laws and is clearly outlined in the Article 25 of the Universal Declaration of Human Rights (UDHR).
Additionally, Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) asserts the right to enjoyment of the highest attainable standard of physical and mental health.
Failure of a country to do so results in massive scrutiny from international bodies like the United Nations.
However, achieving UHC is no child’s play as many nations face significant impediments when they try to make quality health services a reality for everyone.
These include treatments for illnesses, vaccinations, emergency services and mental health support.
An undated file photograph shows healthcare workers at a hospital in Kuala Lumpur. — Bernama pic
Even in the Global North, there is discrimination when it comes to accessing quality healthcare, where certain communities are left behind.
UHC means every single person – from the energetic metropolises of Europe to the remote villages of Africa – should be able to get the basic healthcare they need.
This calls for adequate leadership where minorities and underprivileged communities to be represented in the global perspective.
For instance, Rocio Lazcano – an indigenous leader and the President of the Social Health Council in Northern Bolivia – is devoted to ensuring the health of the indigenous community by advocating and representing the needs of the community. Albeit being half of Bolivia’s population, the indigenous population lives in remote and rural areas.
As reported by the World Health Organisation (WHO) recently, unhygienic water supplies, inadequate waste management and hazardous health facilities are the factors influencing poor health in the indigenous population.
Currently, the Ministry of Health and Sport of Bolivia is implementing changes to ensure the voices of minorities are part of national policies.
Consequently, indigenous people can partake in decision-making regarding access to healthcare. If we were to look closely, this significantly connects to the SDG 10, reducing inequalities within and among countries.
Financing the dream
According to an article published in the Journal of Preventive Medicine and Public Health in March 2022, mismanagement of insurance schemes, poor funding for primary healthcare systems, mismatches of subsidies allocation, socioeconomic status and disproportionate copayments for laboratory tests and medicines are among the challenges in funding UHC.
We can see many developing countries fall short in offering health services without proper investments. It is evident by now that there is a significant gap between high-income countries and low-income countries when it comes to healthcare resources, infrastructures or access to specialised treatments.
This fact is cemented during global health crises, like the Covid-19 pandemic.
Discriminations in healthcare should be disdained as people have a right to health, irrespective of income, status and nationality. Investing in healthcare infrastructures, providing adequate training to health professionals and ensuring that quality healthcare is provided to the nation’s people should be a priority.
However, there is progress in certain nations. For instance, the National Health Services (NHS) – founded by the NHS Act of 1946 – covers the costs of most health services in the UK through a tax-funded system.
Recently, the Malaysian government established the National Health Financing Act (2018) to fund health services in public hospitals and clinics, providing affordable healthcare to its people.
Overcoming the barriers
First of all, we need to demolish inequality. Why? It is because we cannot achieve SDG 3, the goal of “Good Health and Well-Being” for all people at all ages if we keep being indifferent to this issue.
The government of a nation should ensure that quality healthcare must be available to everyone, especially those who are typically overlooked.
No one can be excluded for UHC to be truly universal, this includes rural population, elderly and children as well as people with disabilities.
On top of that, healthcare should be affordable. Governments should allocate sufficient resources so that financial barriers do not restrict access to quality healthcare.
There are many cases where governments struggle to balance UHC goals with other national policies, which undermine compliance with human rights.
Did you know that if a government fails to provide basic healthcare, it is a violation of human rights? Citizens can challenge the government in courts, forcing the government to provide compensation.
The road ahead
Though the path to achieving UHC in alignment with human rights is tough, we are gaining ground.
In Thailand, a public health insurance program established by Thailand’s UHC Act (2002) guarantees that healthcare is affordable and accessible for all of its citizens.
This was executed through expanding investments in public health and insurance coverage.
Mexico’s UHC Law (2003) focuses on providing health insurance coverage to vulnerable groups, who were previously overlooked.
Various NGOs in many countries strive to make UHC a reality by making specialised medicines and treatments affordable.
If the pandemic taught us anything, it is that global healthcare systems are quite fragile, especially in low-income countries.
Just because we live in a better situation does not mean someone else is too. We should come out of this nonchalant mindset as UHC matters to all of us.
Healthy communities yield strong economies, as it is an enabler to achieving the SDGs for a sustainable future. Together, let us continue to forge ahead and make health for everyone, everywhere.
• Shanthini Chandrasegaran and Dr Mohd Istajib Mokhtar are from the Department of Science and Technology Studies, Faculty of Science, Universiti Malaya, and may be reached at [email protected]
** This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.
