Universal Health Coverage

by Arthur Loryoun

Editor's note: This post originally appeared on the Bill & Melinda Gates Foundation's blog, Impatient Optimists. Funded by the Gates Foundation and led by Management Sciences for Health (MSH), the Sustainable Drug Sellers Initiative (SDSI) project worked to ensure the sustainability of public-private drug seller initiatives in Tanzania and Uganda, and to roll-out the initiative in Liberia.

MSH's Douglas Keene, PharmD, MHS, Vice President, Pharmaceuticals & Health Technologies Group, was among the speakers at a recent event in Basel, Switzerland, hosted by Novartis, with representatives from NGOs, academia, and government discussing how to expand access to health in developing countries, including through the newly-launched program, Novartis Access.

MSH is partnering on Novartis Access to help empower governments of low- and lower-middle-income countries to provide access to health for chronic diseases patients who need it most. Ensuring affordable and equitable access to medicines is critical to achieving health for all -- and central to MSH's mission and health-systems strengthening approach.

December 12 marks the second annual global Universal Health Coverage (UHC) Day, and what a year it has been.

Through legal reform and new programs, many countries — like Burkina Faso and Iran — have made important progress on the path to UHC. The Sustainable Development Goals (SDGs) announced in September reinforced the world's commitment to UHC; the third SDG calls for "good health and well-being" and includes a target of achieving universal health coverage.

Now that goals and targets have been set, indicators to track progress are being agreed upon, and we must focus on the implementation, monitoring and accountability of these goals. Accountability — encompassing the interconnected functions of monitoring, review, and remedial action — is imperative to guiding implementation and accelerating progress across the SDGs.

As the world begins working toward the newly developed Sustainable Development Goals (SDGs), ensuring access to reproductive health supplies must be considered.

More than 100 countries are in the process of adopting or advancing universal health coverage (UHC) mechanisms to achieve the targets set for Goal 3, which calls for “good health and well-being.”

Despite the momentum, 400 million people lack access to at least one of seven life-saving health services. And in 2012, an estimated 222 million women lacked access to effective family planning. FP2020’s goal of enabling 120 million women and girls to use modern contraception requires countries to include sexual and reproductive health services and supplies when discussing health benefits packages under national insurance laws, policies, and other related UHC efforts. Moreover, marginalized populations should be prioritized for free or subsidized care.

The universal health coverage (UHC) movement has reached a turning point. With an unprecedented coalition of global partners rallying behind the UHC movement, the inclusion of UHC as a key aim of the newly launched sustainable development goals, and growing recognition of health as a human right, the real work of achieving UHC has begun – many countries are now grappling with the challenge of making UHC a reality.

As a key partner in bringing the UHC agenda to the forefront of the global community MSH is on the leading edge of translating this global momentum into tangible gains for women, children, and families at the country level. This UHC Day, MSH is working to advance #HealthforAll by recognizing that UHC means that people should have access to not only the health services they need, but also to the essential medicines and heath commodities that help to treat many of the most serious global health threats.

Ensuring equitable and affordable access to medicines is a key component of achieving UHC, but one that is often left out of the conversation. As many low- and middle-income countries start implementing a range of UHC policies, programs, and initiatives, MSH is taking steps to ensure that access to medicines remains on the agenda.

Tuberculosis (TB) is now the leading infectious cause of death worldwide -- ahead of HIV. While major advances in the diagnosis and treatment of TB have been made since 1990, children suffering from this disease have remained neglected and vulnerable. An estimated 1 million children become ill with TB each year, and at least 200 children die each day from TB around the world.

TB is curable and preventable, but we must recognize and treat it with the least possible delay. For children experiencing TB symptoms, the primary point of health care, often community-level facilities, is an important opportunity to identify and begin treatment. Symptoms such as a persistent cough, loss of appetite and high fevers must be recognized as possible signs of TB (not just of pneumonia, malaria, malnutrition, and other common illnesses among children), and health workers must be empowered to recognize and take appropriate action. Ensuring that children can access treatment close to home is a critical step towards eliminating preventable deaths from TB. 

This blog post is a web-formatted version of the Global Health Impact newsletter: Stronger Health Systems Stop TB and Save Lives (December 2015). (View or share the email version here.) We welcome your feedback and questions in the comments or email us. On social media, use hashtag #GlobalHealthImpact and tag @MSHHealthImpact.  Subscribe

This year, the theme of International Day of Persons with Disabilities is Inclusion matters: access and empowerment for people of all abilities. Far too often, people with disabilities face barriers to inclusion, and are not able to access transportation, employment, education, and other aspects of society.

In a world with a considerable unmet need for appropriate wheelchairs, enormous access challenges for those who do have a wheelchair, a glut of well-intentioned donations of inappropriate wheelchairs languishing in backrooms and landfills, where do you begin to help people who need wheelchairs? Over the last seven years, the World Health Organization (WHO)—with generous support from the US Agency for International Development (USAID)—has established guidelines for appropriate wheelchair provision, developed curricula for wheelchair professionals, and brought together a cadre of passionate supporters for appropriate wheelchair service provision in low resource settings. Training materials are now available, some in many languages including French, Spanish, Portuguese, Turkish, Romanian, Khmer, Thai, and Chinese.

This week, at the 46th Union World Conference on Lung Health (hashtag #WCLH2015), the US Agency for International Development (USAID)-funded and Management Sciences for Health (MSH)-led, Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program is launching a new tool to improve how the safety and effectiveness of medicines is monitored in low- and middle-income countries.

All medicines undergo rigorous clinical testing prior to being made publicly available. Continuing to monitor the safety and effectiveness of medicines in real world settings, also referred to as pharmacovigilance, is critically important to ensure that medicines can be used over a prolonged period of time, in conjunction with other medicines, among new patient populations, and in patients with multiple illnesses. 

Low- and middle-income countries, however, often lack the resources, capacity, and systems required to effectively implement pharmacovigilance activities. They often rely heavily on passive reporting methods which can underestimate potential medicines use issues.