Governments must step up efforts to expand universal health coverage

Through the United Nations Sustainable Development Goals and other global agreements, governments around the world have committed to tackling the epidemics of tuberculosis and noncommunicable diseases by 2030. But unless governments increase their investments in national health systems, those goals will not be met.

It was just a century ago that the Spanish flu epidemic spread across the world and killed tens of millions of people. Long before the moon landing, the Internet, or the discovery of the Higgs boson, the world was at the mercy of a disease that struck indiscriminately and did not respect national boundaries. The epidemic required an absolutely extraordinary response.

A hundred years on, contagious diseases continue to cross borders faster and more efficiently than people or goods. But other epidemics, of chronic and noncommunicable diseases (NCDs), are also a scourge to communities around the world. In fact, in terms of the scale of human suffering and the costs for society, these diseases can be even more devastating than their contagious counterparts.

At the United Nations General Assembly in New York, global heads of state are meeting on September 26-27 to highlight two major health threats. On the first day, they will discuss strategies to end tuberculosis (TB), an ancient bacterium that remains the world’s deadliest infectious disease. TB claims more than 4,000 lives per day, and is among the top ten causes of death globally. To make a bad situation worse, it is also a major cause of deaths linked to , as well as the leading killer of people with HIV.

Then, on the second day, world leaders will convene to discuss plans to beat leading NCDs such as cancer, diabetes, and cardiovascular and lung disease. Combined, NCDs are responsible for seven out of every ten deaths globally. All told, NCDs kill 41 million people every year, including 15 million people in the prime of their lives, aged 30-70. In addition to confronting TB and NCDs, world leaders will also discuss ways to promote mental health and wellbeing.

While the urgent need for universal health coverage is widely understood, real change will not happen without a greater commitment from the highest levels of government.

Developing countries bear the brunt of the TB and NCD epidemics, as most of the people suffering and dying prematurely from these diseases are in low- and middle-income countries. But while TB and NCDs are very different types of health threats, the best response to them is the same: We must build stronger health systems that are capable of delivering universal health coverage (UHC).

UHC makes health care accessible to everyone, no matter their circumstances. It delivers the full range of essential services, from prevention and treatment to palliative and rehabilitative to all people, not just those who can afford it.

The principles underlying UHC apply equally to protecting people against TB, NCDs, and promoting mental health. But while the urgent need for UHC is widely understood, real change will not happen without a greater commitment from the highest levels of government.

This means that presidents and prime ministers must become the champions of their people’s health. Only by ensuring a government-wide response can UHC be achieved, given that what drives good and bad health so often lies outside the remit of health ministries.

By highlighting the challenges posed by TB and NCDs, the UN is giving political leaders a unique chance to put the wellbeing of their citizens first. They should remember that promoting health pays dividends on many other fronts, too, from economic development to security.

So far, governments have already committed to achieving key global targets for TB and NCDs. With respect to TB, the world still needs to treat the 40 million people living with the disease, and provide preventive care to another 30 million, all by 2022. And to meet the UN Sustainable Development Goals (SDGs), we must end the epidemic by 2030. Countries can meet these targets by making investments geared specifically toward scaling up prevention, detection, treatment, and research.

As for NCDs, the SDGs commit governments to reduce premature deaths from these diseases by one-third. Progress toward this goal has not been fast enough to ensure that it is met before 2030.

Fortunately, there are low-cost ways for governments to meet these targets and save lives. Regulatory measures can protect people from exposure to the common causes of NCDs: tobacco, alcohol, physical inactivity, and foods and drinks high in trans-fats, salt, and sugar. Investments in health systems can improve disease detection and treatment for conditions like hypertension and diabetes. Vaccinating girls against the human papillomavirus (HPV), and screening women on a routine basis, can drastically reduce deaths from cervical cancer.

At meetings in Russia and Uruguay last year, health ministers from around the world committed to accelerating action against TB and NCDs. Now it is time to take the next step.

The UN General Assembly is a unique opportunity for world leaders to foster a true global good—better health for their citizens—by advancing universal coverage to end TB, beat NCDs, and promote better mental health.

Tedros Adhanom Ghebreyesus, former Minister of Foreign Affairs of Ethiopia, is director-general of the World Health Organization. 

Copyright: Project Syndicate, 2018.
www.project-syndicate.org

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