Making Access Happen – the Key to Sustainable Global Healthcare for All (7 min read)
From a global perspective, people are living longer and healthier lives than at any time in history – but the global figures conceal huge inequalities, fresh challenges and a pressing need to act now to ensure access to healthcare for those who need it most.
One year ago (on September 25, 2015), member countries of the United Nations adopted a set of goals aimed at ending poverty, protecting the planet and ensuring healthier and more prosperous lives for all. The Sustainable Development Goals (SDGs) replace the Millennium Development Goals (MDGs) and represent a new global development agenda of unprecedented scope and ambition.
Margaret Chan, Director-General of the World Health Organization (WHO), wrote at that time: “We stand on the threshold of a new era.” She also added: “A great deal has been achieved since 2000. However, progress can easily be reversed if we do not maintain our commitment to making the world a better place for all, leaving no-one behind.” Referring to the health-specific goal (“Good Health and Wellbeing”), Dr. Chan stressed that universal healthcare coverage (UHC) should be seen as “the linchpin of the health development agenda.” UHC is defined as “including access to quality essential healthcare services and...affordable essential medicines and vaccines for all.”
Sustainable Development Goals (2015 - 2030)
Key areas outlined in the health SDGs:
reproductive, maternal, newborn, child and adolescent health;
infectious diseases including HIV, tuberculosis, malaria, hepatitis and neglected tropical diseases;
noncommunicable diseases (NCDs) including heart disease, cancer and diabetes;
mental health and substance use including narcotics and harmful use of alcohol;
injuries and violence; and
universal health coverage.
One year on from the launch of the SDGs, we at Sandoz are excited to launch this interactive online dialogue about why we believe access to healthcare is today’s single largest unmet medical need, and what we can all do to “make access happen.” The challenge as we see it is simple to define, while the solutions are complex, ambiguous and deeply interconnected – but absolutely achievable if everyone involved works together to do so. Let’s start by defining the challenge...
The last century has seen unprecedented medical progress, ranging from the landmark discoveries of penicillin and cortisone via the surgical “revolutions” in transplantation and intensive care through the curing of some forms of childhood cancer and the sequencing of the human genome. The last few decades have also seen impressive healthcare progress on many fronts, including reducing maternal/ child mortality rates and combatting infectious diseases (particularly HIV, TB and malaria), thanks to a broad coalition of governments, NGOs and private enterprise. These improvements have coincided to a large extent with broader progress on the full MDG agenda, including poverty reduction, education improvements and increased access to safe drinking water.
A counsellor sits outside a health clinic as Tuberculosis (TB) patients arrive in Tehkhand Slum, Delhi, India. Credit: Andrew Aitchison / Getty Images
However, a healthy life is still far from a given for many people. Overall, at least 400 million people worldwide still lack access to one or more essential healthcare services and more than two billion cannot access the medicines they need1. Even in the areas where the most progress was made, the global community still fell short of the – admittedly ambitious – MDG healthcare goals.
New Challenges on the Horizon
And historic challenges are being joined by new ones, not least the steady rise in global mortality rates due to noncommunicable diseases, or NCDs, the growing threat posed by antimicrobial resistance (AMR) and the increasing health impact of ongoing climate change. Bacterial resistance to antibiotics is increasing and could cause an additional 10 million deaths by 2050, while multi-drug resistant TB is also a growing phenomenon. At the same time, NCDs are now responsible for 28 million deaths per year in lower-income countries2 – 75 percent of the total global burden.
Surgeons perform an operation in Mbanza Ngungu, Congo. Some medical facilities, such as improvised lighting, are not ideal. Credit: Sven Torfinn/laif
Meanwhile, the global cost of healthcare continues to grow significantly more quickly than the global economy. In 2013, global healthcare spend reached USD 7.35 trillion, almost double the amount spent in 20003. To put that figure in perspective, it is equivalent to the total annual GDP of an economy the size of Italy.
The increased spend is driven in part by ongoing improvements in medical technology, as well as overall economic growth, but also by the steady increase in the global population (estimated to reach 8.5 billion by 2030) and the proportion of elderly people (an estimated 1.4 billion over-60s by 2030). If current trends continue, that number could double again within the next 10 years.3
Join the Discussion
In future articles, we’ll be looking more closely at some of these specific challenges to sustainable global healthcare systems and access for all, as well as encouraging readers to join the debate and share their views. But one thing we can be fairly sure of even now is that few of these global challenges will be successfully addressed unless everyone involved understands the extent to which all the SDGs are interconnected – and the need for joint action to achieve them.
Medical care in high-income nations covers basic needs, as well as specialist treatment. However, rising costs are a cause of concern.
While only one of the 17 SDGs is actually health-specific, it’s hard to see how many of them can be successfully addressed without simultaneously addressing healthcare-related issues. Healthy children are more likely to learn; healthy adults are more likely to earn. Gender equality contributes to better health for women and offers infants that all-important better start in life. Clean water, clean energy sources and adequate food supplies are a precondition for sustainable cities and communities.
Finally, it’s worth noting that the common thread running through all of the above is “access”: access to food, access to education and access to healthcare. We look forward to an engaging discussion about #MakingAccessHappen.