Public Health Emergencies as Catalyst for Financing UHC

Public Health Expert and the Executive Director, Centre for Universal Health, Chatham House, London, Rob Yates, at a recently held meet-and-greet with journalists in FCT Abuja, organised by the Nigerian Health Watch, NHW, has harped on the importance of using public health emergencies, such as the COVID-19 pandemic to catalyse financing of Universal Health Coverage, UHC, in Nigeria. Sunday Ehigiator reports

According to the World Health Organisation (WHO), universal health coverage means that all people have access to the health services they need, when and where they need them, without financial hardship. It includes the full range of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.

Achieving UHC by 2030 was one of the targets the nations of the world set when adopting the Sustainable Development Goals (SDGs) in 2015. To meet the health workforce requirements of the SDGs and UHC targets, over 18 million additional health workers are needed by 2030.

Gaps in the supply of and demand for health workers are concentrated in low- and lower-middle-income countries. The growing demand for health workers is projected to add an estimated 40 million health sector jobs to the global economy by 2030.

Investments are needed from both the public and private sectors in health worker education, as well as in the creation and filling of funded positions in the health sector and the health economy.

Currently, at least half of the people in the world do not receive the health services they need. About 100 million people are pushed into extreme poverty each year because of out-of-pocket spending on health.

The situation is similar in Nigeria if not worse. Nigeria faces challenges that delay progress toward the attainment of the national government’s declared goal of universal health coverage (UHC).

One such challenge is system-wide inequities resulting from the lack of financial protection for the healthcare needs of the vast majority of Nigerians. Only a small proportion of Nigerians have prepaid health care, others largely spend out-of-pocket.

Out-of-pocket health expenditures have become the order of the day and it is seemingly peaking at an overall of about 70 per cent of the total contribution for health, according to UHC 2030.

Financial difficulties when accessing health care services remain a major impasse for the Nigerian population, and vulnerable people are the worst hit.

Financing UHC through Health Emergencies

Against the above backdrop, Rob Yates harped on the importance of capitalising on public health emergencies such as the Coronavirus outbreak, monkeypox etc. as an avenue to seek financing towards achieving UHC.

According to him, universal health coverage means everybody gets quality health services without affecting their pocket. “You can only achieve that if the government or state has a great financing system policy directed towards UHC.

“One way to get the government involved and committed to UCH is by simply selling the importance of financing UHC to them when there is a public health emergency.

“These big decisions are mostly made during times of crises. For example, the UHC in the United Kingdom (UK) was influenced by the second world war (WW II).

“The crisis is a good argument to call for support from politically inclined people to finance UHC and not just those in power. By investing in UHC during public health crises, they get more political followership and recognition from the people, and this is one thing every politician needs.

“Public health emergencies are the best card to getting good financing for universal health coverage and also to achieving major health reforms in any country. This is because politicians want something that will give them more votes and make them feel good and popular to the public.

“And the best way to strike that cord within the populace is to take care of their health needs, especially during a public health emergency. It is all about the political marketing of public health reforms. And this was how many countries achieved UHC.

“Also, there should be tax-financed health programs instituted by the government for the benefit of the poor in society. While the rich can pay out of their pockets and get care at a higher cost, the money realised from them can then be channelled towards subsidizing healthcare for the poor.”

Yate noted that although the ministry of health may not be able to come up with enough money on its own, hence it should encourage wealthy people in the society to key into the sector so that the rest of the society can benefit from it.

He said Nigeria needs to have a system whereby the state controls the health financing system and encourages other stakeholders and individuals to partner with the state towards achieving the UHC.