Universal Health Coverage

Dr. Mark Dybul, MSH’s newest board member, has been a leader in global health policy as Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria during the Obama administration and as head of the US President's Emergency Plan for AIDS Relief (PEPFAR) during the Bush administration. Dybul is Professor of Medicine and Faculty Co-Director of the Center for Global Health and Quality at Georgetown University Medical Center. He brings tremendous experience and insight into MSH’s work to strengthen systems that improve the health of the world’s most vulnerable populations, including those living with HIV.

As we prepare for the 22nd International AIDS Conference, we sat down with Dybul to discuss the fight against HIV and AIDS, the need for strong systems to support a more effective and sustainable response, and how we must leverage those systems beyond HIV to improve health more broadly. 

Mark Dybul: Building Systems for Health to End HIV and AIDS

This interview was edited for length and clarity.

Is the world safer today from the threat of infectious diseases than it was a generation ago?

It is true that we have more tools at our disposal: better surveillance and diagnostic systems, stronger frameworks and regulations, such as the Global Health Security Agenda and Joint External Evaluations (JEE), and a deeper understanding of how diseases spread and what is needed to stop them. It is also true that climate change, deforestation, population growth, and our proximity to farm and wild animals are making the threat of epidemics greater than ever before. Although the challenge is great, we have the knowledge to solve it. So what do we need to do?

This story was originally published on Devex

The World Health Organization recently issued a statement calling on all countries to make three specific commitments to universal health coverage and be prepared to announce them at the World Health Assembly, which begins May 21.

UHC — the assertion that every person must have access to the health services they need, when and where they need them, without facing financial hardship — improves health. But that’s not all: It reduces poverty, creates jobs, drives economic growth, promotes gender equality, and prevents epidemics. It’s a momentous occasion and a great opportunity to start making real progress toward UHC.

But unless country commitments include efforts to strengthen pharmaceutical systems, communities will continue to struggle with inadequate health services and rising health costs that put their health and economic well-being in peril.

This story was originally published by Women Deliver.

In recent decades, a great deal of resources have been invested in the delivery of essential health services, especially through support to the six building blocks of strong health systems – health financing, health workforce, health information, health governance, medical products, and service delivery. These investments have been hugely important and effective in forming a foundation, supporting frontline health workers to save lives, and in securing unprecedented commitment to the common goal of achieving universal health coverage (UHC).

But the fact remains that over half the world’s population – women, children, and adolescents in particular - is still unable to access the high quality health services they need.

Women, children and adolescents remain underserved by health systems and suffer a disproportionate burden of morbidity and mortality, which endangers the broader well-being of the whole of society.

Tuberculosis remains the world’s leading infectious disease killer. Ending TB will require a comprehensive approach and targeted action, rapid innovation and proven interventions, bold leadership, and intensive community engagement.  

On this World TB Day, the global health community is calling for “Leaders for a TB-Free World” to work together, make history, and end TB once and for all.

The Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program helped make sure that some of the world’s most vulnerable people have timely access to safe, affordable medicines and to quality services to improve their health. Funded by USAID, the program worked for six years in 46 countries to comprehensively strengthen pharmaceutical systems by addressing five interrelated functions, with a focus on medical products—governance, human resources, information, financing, and service delivery. 

Each level of progress in pharmaceutical systems strengthening (PSS) sets the stage for further advances. Which areas need focused attention going forward so that progress continues? 

In recent years, global health stakeholders have begun to recognize the profound potential that drug shops have to advance public health goals, such as those related to malaria diagnosis and treatment, child health, and family planning. These outlets, for reasons of convenience and cost, are the first choice of care for millions of people - and until recently, they have largely been ignored.

“Drug shops and pharmacies are important sources of health care, particularly in rural areas or urban slums with few public clinics. They are often the first stop for women and men who seek FP information or services.”  - World Health Organization

This is why, in 2003, Management Sciences for Health (MSH) helped launch the Accredited Drug Dispensing Outlet (ADDO) Program in Tanzania to address the important role of these informal drug sellers by creating certain standards that, when met, increase the quality of medicines and services in the community. Tanzania’s successful ADDO Program provides a model that other countries in Africa—and now Asia—have adapted and made their own.