UN High-Level Meeting On Universal Health Coverage

• 25 Sep 2019

• On 23^rd September, 2019, the United Nations General Assembly held the first ever high-level meeting on Universal Health Coverage (UHC) under the theme- Universal Health Coverage: Moving Together to Build a Healthier World.

Aim

• The meeting aims at mobilizing the global community to secure political commitment from Heads of State and Government to accelerate progress toward achieving UHC by 2030.
• It aims to accelerate progress toward universal health coverage (UHC), including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

Background

• In 2015, Heads of States and Governments made a bold commitment to achieve universal health coverage by 2030.
• The September 23^rd, 2019 meeting was called for in December 2017 when the UN passed a resolution on global health and foreign policy, addressing the health of the most vulnerable for an inclusive society.

Source: ESMO

Key Outcomes

• The World Leaders adopted a high-level United Nations Political Declaration on universal health coverage (UHC).
• In adopting the declaration, U.N. Member States committed to advance towards UHC by investing in major areas around primary health care. These include mechanisms to ensure no one suffers financial hardship and implementing high-impact health interventions to combat diseases and protect women’s and children’s health.
• In addition, countries must strengthen health workforce and infrastructure and reinforce governance capacity.

Significance

• The declaration comes the day after the World Health Organization (WHO) and partners stressed the need to double health coverage between now and 2030 or leave up to 5 billion people unable to access health care.
• This declaration represents a landmark for global health and development. The world has 11 years left to make good on its sustainable development goals (SDGs) and universal health coverage is key to achieve within the given tine framework.

India’s Effort towards UHC

• Indian Prime Minister while addressing first ever high-level meeting on UHC stressed the importance of UHC as healthy life is every person’s right.
• He highlighted the bold steps taken by India to achieve UHC by adopting a holistic approach on four main pillars of healthcare which are:
  • Preventive Healthcare:
    • In order to promote preventive healthcare, special emphasis on Yoga, Ayurveda and Fitness and wellness centers have been made, helping in controlling life style diseases such as diabetes, blood pressure, depression etc.
    • Immunization campaigns and greater awareness through Clean India campaign have also contributed to health promotion.
  • Affordable Healthcare:
    • To ensure affordable healthcare, India has rolled out the world’s largest health insurance scheme - Ayushman Bharat Scheme.
  • Supply Side Improvement:
    • The government has taken several important steps for quality medical education and medical infrastructure development in the country.
  • Mission Mode Intervention:
    • Among mission mode interventions, the Poshan Abhiyan (National Nutrition Mission) has been launched to improve nutritional status of mother and child.

Recent Initiatives in UHC

National Digital Health Blueprint (NDHB)

• On 16th July, 2019, the government released the National Digital Health Blueprint (NDHB), bringing in the National Digital Health Eco-system (NDHE) that can ensure the availability of healthcare services on a wider scale.
• It encapsulates the goals of National Health Policy-2017 and aims to leapfrog to the digital age by providing a wide range of digital health services.
• It will support the quality of healthcare, universal health coverage (UHC) in an efficient, accessible, inclusive, affordable, timely and safe manner through the provision of a wide range of data, information, and infrastructure services

Ayushman Bharat (National Health Protection Mission)

• Launched in September, 2018, it is a national initiative as the part of National Health Policy 2017, in order to achieve the vision of Universal Health Coverage (UHC). This initiative has been designed on the lines as to meet SDG and its underlining commitment, which is “leave no one behind”.
• It comprises two inter-related components:
  • Establishment of Health and Wellness Centres: The first component, pertains to creation of 1,50,000 Health and Wellness Centres which will bring health care closer to the homes of the people.
  • Pradhan Mantri Jan Arogya Yojana (PM-JAY): It is one significant step towards achievement of Universal Health Coverage (UHC) and Sustainable Development Goal-3. It aims to provide health protection cover to poor and vulnerable families against financial risk arising out of catastrophic health episodes.

Poshan Abhiyan (National Nutrition Mission)

• Launched in March, 2018, it aims to improve nutritional outcomes for children, pregnant women and lactating mothers. The POSHAN (Prime Minister’s Overarching Scheme for Holistic Nutrition) Abhiyaan directs the attention of the country towards the problem of malnutrition and address it in a mission-mode.
• Four point strategy/pillars of the mission are:
  • Inter-sectoral convergence for better service delivery
  • Use of technology for real time growth monitoring and tracking of women and children
  • Intensified health and nutrition services for the first 1000 days
  • Jan Andolan

National Health Policy, 2017

• The policy envisages as its goal the attainment of the highest possible level of health and wellbeing for all at all ages, through a preventive and promotive health care orientation in all developmental policies, and universal access to good quality health care services across the country.

Challenges in Achieving Universal Health Coverage

• Disparity in Quality of Healthcare Services: Wide disparity in the quality of healthcare services in the public and private sector is prevalent as regulatory standards are neither established nor enforced properly by the Government of India.
• Lack of Medical Professionals: The issue of under trained and traditional healers treating patients at the grass-root level is a serious concern which reflects the poor availability of healthcare services and service providers in rural areas.
• Non-affordability of Health Services: Given the large number of people still living below the poverty line in India, the affordability of quality healthcare is a major problem across the country leading to serious health situations.
• Lack of Adequate Infrastructure: The existing healthcare centres especially in rural areas are under-financed, with below quality equipment, lack of beds, etc. which provide a major challenge towards delivering effective health care system.

Way Forward

• It is high time for India as well as other countries to acknowledge the need for redefining health in light of the SDGs. Universal health coverage should be designed based on the revised definition of health. That will lead to a better understanding, and attainment, of holistic health and well-being.
• Universal Health Care is expected to bridge inequalities relating to health and its access. As UHC evolves, it must take into consideration providing additional benefits to poor and vulnerable belts of people.