By Jaya Ramachandran

GENEVA | TOKYO (IDN) – Nearly half of the world’s population of 7.6 billion lacks access to essential health services at present and for almost 100 million people health expenses are high enough to push them into extreme poverty.

Against this perturbing backdrop, revealed by a recent report, a global Forum in Tokyo has underlined the need to extend by 2023 the health services coverage to 1 billion additional people and halve to 50 million the number of people being pushed into extreme poverty by health expenses.

The year 2023 is the midpoint towards 2030, the target date for achieving the Sustainable Development Goals (SDGs), says the ‘Tokyo Declaration on Universal Health Coverage’ emerging from the global Universal Health Coverage Forum 2017 from December 12-15.

A report tabled during the Forum warned that despite significant strides made in ensuring healthy lives and promoting the well-being for all, there is still a long way to go to achieving universal health coverage (UHC) by 2030 to which the international community has committed itself under the Sustainable Development Goals adopted in September 2015.

The report from the World Bank and the World Health Organization (WHO) emphasized that, while at least half of the world’s population is lacking access to essential health services, each year, large numbers of households are being pushed into poverty because they must pay for health care out of their own pockets.

Presently, 800 million people spend at least 10 percent of their household budgets on health expenses for themselves, a sick child or other family member. High expenses on health services are forcing almost 100 million to survive on just $1.90 or less a day. The findings, released on December 13 in Tracking Universal Health Coverage: 2017 Global Monitoring Report, have been simultaneously published in Lancet Global Health.

The report notes that the past 17 years have seen an increase in the number of people able to obtain key health services, such as immunization and family planning, as well as antiretroviral treatment for HIV and insecticide-treated bed nets to prevent malaria. In addition, fewer people are now being tipped into extreme poverty than at the turn of the century.

Progress, however, is very uneven, finds the report and points to wide gaps in the availability of services in Sub-Saharan Africa and Southern Asia. In other regions, basic health care services such as family planning and infant immunization are becoming more available, but lack of financial protection means increasing financial distress for families as they pay for these services out of their own pockets.

According to the report, it’s even a challenge in more affluent regions such as Eastern Asia, Latin America and Europe, where a growing number of people are spending at least 10 percent of their household budgets on out-of-pocket health expenses.

The report finds inequalities in health services not just between, but also within countries. For example, only 17 percent of mothers and children in the poorest fifth of households in low- and lower-middle income countries received at least six of seven basic maternal and child health interventions, compared to 74 percent for the wealthiest fifth of households.

The report was a key point of discussion at the global Universal Health Coverage Forum 2017. Convened by the Government of Japan, a leading supporter of UHC domestically and globally, the Forum is cosponsored by the Japan International Cooperation Agency (JICA), UHC2030, a multi-stakeholder platform to promote collaborative working in countries and globally on health systems strengthening, UNICEF, the World Bank, and WHO.

Participants included Japanese Prime Minister Shinzo Abe, UN Secretary-General Antonio Guterres, World Bank President Dr. Jim Yong Kim, WHO Director-General Dr. Tedros Adhanom Ghebreyesus and UNICEF Executive Director Anthony Lake, in addition to heads of state and ministers from over 30 countries.

Expressing the UN’s readiness to help countries move towards health coverage for all, Secretary-General António Guterres underlined that health is everyone’s right and a driver of economic development. “Our goal must be to protect and promote physical and mental well-being for all. Health is both an outcome and a driver of progress,” Guterres told the global Forum.

“It is at the centre of our vision of a more sustainable, inclusive and prosperous future […] When we invest in health – particularly of women and adolescents – we build more inclusive and resilient societies,” he added.

Commending Japanese Prime Minister Shinzo Abe’s announcement of U.S. $2.9 billion to fund universal health coverage programmes in developing countries, the UN chief acknowledged Japan for being one of the first countries to demonstrate the power of universal health coverage, achieving it in 1961 and unlocking economic growth for the decades that followed.

“It is completely unacceptable that half the world still lacks coverage for the most essential health services,” said WHO Director-General Tedros, adding: “And it is unnecessary. A solution exists: universal health coverage (UHC) allows everyone to obtain the health services they need, when and where they need them, without facing financial hardship.”

World Bank Group President Kim said: “The report makes clear that if we are serious – not just about better health outcomes, but also about ending poverty – we must urgently scale up our efforts on universal health coverage.”

He added: “Investments in health, and more generally investments in people, are critical to build human capital and enable sustainable and inclusive economic growth. But the system is broken: we need a fundamental shift in the way we mobilize resources for health and human capital, especially at the country level. We are working on many fronts to help countries spend more and more effectively on people, and increase their progress towards universal health coverage.”

“Past experiences taught us that designing a robust health financing mechanism that protects each individual vulnerable person from financial hardship, as well as developing health care facilities and a workforce including doctors to provide necessary health services wherever people live, are critically important in achieving ‘Health for All,’” said Mr. Katsunobu Kato, Minister of Health, Labour and Welfare, Japan. “I firmly believe that these early-stage investments for UHC by the whole government were an important enabling factor in Japan’s rapid economic development later on.”

“Without health care, how can children reach their full potential? And without a healthy, productive population, how can societies realize their aspirations?” said UNICEF Executive Director Anthony Lake. “Universal health coverage can help level the playing field for children today, in turn helping them break intergenerational cycles of poverty and poor health tomorrow.”

Building on the G7 Ise-Shima Summit in Japan in May 2016 and the Tokyo International Conference on African Development (TICAD-VI) Summit held in Nairobi, Kenya, in August 2016, both of which stress the need for UHC, the Forum in Tokyo was seen as a milestone for accelerating progress towards the target of UHC by 2030, a key part of the Sustainable Development Goals. Countries will then gear up for the next global moment: a high-level meeting of the UN General Assembly on UHC in 2019. [IDN-InDepthNews – 16 December 2017]

Photo: Secretary-General António Guterres addresses the global Universal Health Coverage Forum on December 14, in Tokyo, Japan. UN Photo/Curtis Christophersensik

IDN is the flagship agency of International Press Syndicate.

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