A medical officer at the Magomeni Health Center in Dar es Salaam, Tanzania examines a patient. © Arne Hoel/World Bank
When Cecilia Rodriguez was diagnosed with rheumatoid arthritis, an autoimmune disease that causes inflammation and pain in the joints, eight years ago, she had a major revelation. She realized that what she was promoting as director of a primary health care facility in Chile was very different than what she actually needed as a patient.
In response, she founded the nonprofit Fundación Me Muevo with her sister, who also has rheumatoid arthritis, to support people affected by the chronic condition. She also became a patient advocate -- Me Muevo is part of a growing movement of patient-led organizations in Chile. “Health care systems tend to be geared towards treating acute illnesses and are rarely organized to help patients with lifelong diseases,” Cecilia says. “We called the NGO Me Muevo (‘I move’) because we learned that with this condition you have to keep your body moving, but also because ‘I move’ means ‘I take action.’”
Cecilia is part of a large and growing global movement working to ensure that universal health coverage (UHC) becomes a reality. UHC is based on the simple idea that all people should be able to access the quality health services they need, without suffering financial hardship.
UHC Day, celebrated on December 12 every year, is a time to highlight the worldwide progress towards UHC. Thanks to strong national leadership and ambitious reforms, most parts of the world have seen an expansion in access to health services and action to ensure affordability. However, despite this, , according to recent research from the World Bank Group and World Health Organization (WHO).
It is also key to meeting the Bank Group’s twin goals of ending extreme poverty and increasing shared prosperity – these cannot be realized as long as millions are being impoverished by health expenses every year. , as data from 183 countries in the Bank Group’s 2018 Health Equity and Financial Protection Indicators (HEFPI) database indicates.
The cost of health care is a major financial burden on families. If these 800 million people lived in one country, they would make up the third biggest population in the world. This financial burden is seen in all regions of the world.
People spending ≥10% of household budget on health expenses. To view full infographic, click here.
Such large numbers can obscure the daily suffering individuals and families face when they can’t get the health care they need: the infant who isn’t immunized and dies from pneumonia; the stunted child whose school performance and learning is permanently impaired; the pregnant teenager who can’t secure family planning services and is forced to drop out of school; and the mother who is hemorrhaging post-partum without access to blood transfusions.
This denial of health care is not only unjust, it is also a waste of human potential and a country’s human capital. Human capital is the knowledge, skills and health that people accumulate over their lives, enabling them to realize their potential as productive members of society. A healthy, educated and resilient population is a must for countries to compete effectively in the global economy.
“The only way that we will actually bring health care to every person, everywhere in the world, is if we fundamentally change the system so that governments and people demand more investments in health,” says World Bank Group President Jim Yong Kim.
Each additional healthy year of life should be thought of as the fuel that makes economies grow, which is why UHC means investing across the life-course.
The path to UHC is different for each country, and the World Bank Group supports countries by providing financing, policy advice and technical assistance, generating research and knowledge and convening a range of stakeholders around shared goals. UHC is the driving force behind the Bank Group’s health, nutrition and population investments, which in FY18 totaled about US $14 billion.
Through its new Human Capital Project, an effort to accelerate more and better investments in people, the World Bank Group has committed to scaling up its investments in areas like health. The project’s Human Capital Index measures and ranks countries according to the amount of human capital a child born today can expect to attain by age 18 through investments in health and education—and shows how much income countries are foregoing because of human capital gaps. Country governments are the greatest drivers of change and investment in human capital, including health.
It will take effective leadership, the right policies and investments and an overarching commitment to “put the last mile first” and reach the most vulnerable. There is no time to waste.