WHO: Progress on Universal Health Coverage Lagging
According to a new report by the World Health Organization (WHO) progress on Universal Health Coverage (UHC) is still lagging. By 2030, 5 billion people would still be left without full access to healthcare, at the current rate of progress. The report also clearly outlines the role alcohol plays in burdening health systems and fueling health inequities.
The Universal Health Coverage Global Monitoring Report 2019 calls on governments to redouble the pace of expanding coverage, and commit to spending at least 1% of their GDP on primary health care.
The report contains the latest available data. Analysis shows an increase in the “UHC service coverage index” (SCI) measuring progress on SDG indicator 3.8.1 (financial protection and coverage of essential health services). The SCI rose from a global average of 45 (of 100) in 2000 to 66 in 2017. All regions and income groups recorded gains, according to the report.
Some of the notable findings of the report are as follows:
- Investing an additional US$ 200 billion a year on scaling up primary health care across low and middle-income countries would potentially save 60 million lives, increase average life expectancy by 3.7 years by 2030, and contribute significantly to socio-economic development.
- Progress has been greatest in lower income countries. But the poorest countries and those affected by conflict generally lag far behind.
- Based on current trends, by 2030 only 39% to 63% of the global population would be covered for essential health services.
- Out-of-pocket spending in proportion to household income, rose continuously from 2000 to 2015. Nearly a billion people spent more than 10% of household income on health in 2015, and over 200 million spent more than 25%.
Alcohol and Universal health coverage
The report covers several dimensions of how alcohol affects universal health coverage. For example, it highlights the heavy burden alcohol harm places on health systems and how alcohol taxation can help reduce this burden and at the same time help improve health system functioning.
The larger the share of the population that has established high health needs, the more limited the scope for pooling in health financing to redistribute from the healthy to the sick. There simply will not be enough healthy people in the population. Therefore, addressing these key risk factors today – particularly tobacco, alcohol and added sugar – is important not only to improve health but also to enable the capacity of health financing systems to sustain improvements in financial protection in the future.”
Furthermore, it addresses the link between harmful masculinities and “aggressive marketing of tobacco and alcohol” that increase men’s risk taking and reduce their willingness to use health services.
Tobacco and alcohol use are major risk factors for early death and disability among men. The alcohol and tobacco industries have historically targeted men, spending billions of dollars fostering the notion that smoking and [alcohol use] are markers of manliness.”
The report also outlines the vicious cycle of alcohol, gender-based violence and poor health outcomes for girls and women. Alcohol is a major risk factor for physical, sexual, intimate partner and domestic violence. The report emphasises that alcohol consumption by men is also a risk factor for women’s physical and mental health.
An estimated one in three women and adolescent girls experience physical or sexual violence by an intimate partner or non-partner sexual violence. Such violence starts early in the lives of women and girls, with 29% of adolescent girls (ages 15–19) experiencing intimate partner violence. Women who experience such violence are 4.5 times more likely to attempt suicide than other women; twice as likely to experience induced abortions, depression and alcohol use disorders; and 1.5 times more likely to get a sexually transmitted infection and, in some regions 1.5 times more likely to get HIV.”
The report also presents evidence that alcohol is fueling the burden on health systems from early years of life. Adolescent boys are particularly vulnerable to initiating unhealthy behaviours, increasing their risk of developing noncommunicable diseases later in life.
Many unhealthy behaviours such as tobacco and alcohol consumption are adopted in adolescence…
School surveys show that alcohol use starts early, before the age of 15: 50%–70% of 15-year-old boys had consumed alcohol in the last 30 days before the survey in many countries in the European Region and the Region of the Americas.”
The report was prepared by the WHO with contributions from the World Bank, the Organisation for Economic Co-operation and Development (OECD), the United Nations Population Fund, and UNICEF.
The report was released ahead of the UN High Level Meeting on UHC, at the 74th United Nations General Assembly.
This level of political commitment is more welcome than ever because it is essential on two fronts: first, to accelerate progress in areas where we have seen improvements; and second, to remove the barriers that are slowing down access to services in some countries and among certain populations,” said WHO Director General Tedros Adhanom Ghebreyesus said in the report, referring to the High Level Meeting on UHC, as per, Health Policy Watch.