Health for all

December 12 marks International Universal Health Coverage (UHC) Day, held annually since 2017. The day aims to raise awareness of the need for strong and resilient health systems and universal health coverage. As per the UN, UHC means everyone, everywhere, can access the health services they need without risk of financial hardship. This remains a rather lofty goal, even for the most developed countries. Perhaps one of the worst health systems anywhere is that of the US, the world’s largest economy. Even in certain EU countries with more extensive welfare systems, populations like migrants can still be left out of the loop. The situation is particularly dismal in the developing world, where the majority of the estimated 4.5 billion people without access to essential health services reside. Even when one does get access to these services, it can be tenuous at best. Many healthcare services are still not free, especially in poorer countries, with two billion people worldwide experiencing financial hardship and 1.3 billion people pushed into poverty due to health spending.

For many Pakistanis, experiencing a serious medical ailment or emergency is akin to a death sentence. This is both due to a lack of access to quality care in many parts of the country, particularly in the rural areas, and in inability to afford quality care where and when it is available. During a dialogue hosted by the the World Health Organisation (WHO) in Islamabad, the WHO representative in Pakistan called for stakeholders and donors to enhance their support for the government in providing UHC. He also noted how Pakistan had improved its UHC index from 40 per cent in 2015 to almost 53 per cent in 2022. Programmes like the Sehat Sahulat Programme (SSP) have helped advance UHC in Pakistan, with the SSP now providing health coverage to around 190 million Pakistanis. That being said, half of the population still lacks access to basic health services and the country has a lot of ground to cover. There is also the difference in the quality of health coverage available to different people depending on their socioeconomic status.

A big part of the problem is our high out-of-pocket spending on healthcare, accounting for around 55 per cent of our total current health expenditure as of 2020. This leaves the poor acutely vulnerable to sudden medical emergencies and this vulnerability has only been exacerbated by recent economic woes and the ensuing rise in the price of medicines. Government spending on healthcare still remains far too low despite a two fold increase in the budget allocation for healthcare for the current fiscal year. If this number does not go up, the country will continue to lag globally and in the region when it comes to healthcare outcomes. And it is not as though we need to reinvent the wheel in order to make a significant positive impact on our healthcare needs. In many cases, simply having more tests would make a huge impact. For example, one of the reasons Pakistan has the world’s highest burden of hepatitis C, with 10 million cases nationwide, is because many are simply unaware of their status. Simply giving all our citizens access to free checkups and screenings could save millions of people from unnecessary suffering. Unfortunately, as is the case with many of our other problems, doing the simple things often proves to be very hard.