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Is universal health coverage possible in Bangladesh?

  • Published at 11:55 pm January 21st, 2019
Health is a right, not a privilege / <b>BIGSTOCK</b>
Health is a right, not a privilege / BIGSTOCK

No one should have to go bankrupt when they get sick

The United Nations adopted 17 Sustainable Development Goals for eliminating poverty and building a more resilient planet -- and one of those goals includes providing universal health coverage. 

The global coalition of leading health and development organizations worldwide is urging governments to accelerate reforms that ensure everyone, everywhere, can access quality health services without being forced into poverty. The coalition emphasizes the importance of universal access to health services for saving lives, ending extreme poverty, building resilience against the health effects of climate change, and ending deadly epidemics.

Every person should be able to access quality health services without suffering financial hardship. Aiming to achieve this vision of UHC by 2030 -- we need collective action -- prepare diverse stakeholders to call for stronger, more equitable health systems. It is an inherently political goal rooted in the human right to health. 

WHO’s constitution affirms that the enjoyment of the highest attainable standard of health is a fundamental human right. More than half of the world’s countries have included the right to health, public health, or medical care in their national constitutions. In recent years, the global UHC movement has gained momentum, with the World Health Assembly and the UN General Assembly calling on countries to “urgently and significantly scale up efforts to accelerate the transition towards universal access to affordable and quality healthcare services.”

There is a growing global consensus that UHC is a smart investment and an achievable goal everywhere. Lack of affordable, quality health care traps families and nations in poverty. More than 100 low and middle-income countries, home to almost 3/4th of the world’s population, have taken steps to deliver UHC. The emerging economies of Brazil, Russia, India, China, and South Africa (BRICS) -- representing almost half the world’s population -- are all taking steps toward UHC.

Countries implementing UHC are seeing the benefits -- healthier communities and stronger economies. Every $1 that a country invests in health today can produce up to $20 in full-income growth within a generation. When health care is accessible and affordable, families can send their children to school, start a business, and save for emergencies. UHC pays a resilience dividend. In times of distress, health minimizes the shock to lives and livelihoods. In times of calm, health promotes community cohesion and economic productivity. 

The poorest and most marginalized people bear the brunt of preventable maternal and child deaths, infectious and non-communicable diseases. In Bangladesh, traditional medicine can play an important role in ensuring health care of all if we can take necessary steps. WHO launched the Traditional Medicine Strategy 2014- 2023 for its academic promotion, quality production and mainstream integration into public health care to achieve universal health coverage. 

The inclusion of traditional medicine in the national health care system can play a complementary role to achieve the objectives of UHC. Its accessibility at the doorstep of marginalized people will be very cost-effective and worthy in regards to population coverage and reducing financial burden as well.

Since the beginning of human civilization, people have used various plants and minerals as medicine in order to protect from diseases. In the recent past, there has been a growing interest in traditional medicine/complementary and alternative medicine (TCAM) and their relevance to public health, both in developed and developing countries.

Diversity, flexibility, easy accessibility, broad continuing acceptance in developing countries and increasing popularity in developed countries, relatively low cost, low levels of technological input, relative low side effects and growing economic importance are some of the positive features of traditional medicine. 

In this context, there is a critical need to mainstream traditional medicine into our public health care to achieve the objectives of improved access to health care facilities. In countries such as Bangladesh, India, China, and many other parts of Asia, one can observe traditional medical knowledge in various forms such as codified medical systems, folk systems, allied disciplines, and new systems of knowledge.

In Bangladesh, Alternative Medicine Care (AMC) means Unani, Ayurvedic, and Homeopathic system of medicine. 

In India, AYUSH (Ayurveda, Yoga, Unani, and Sidhah) medical systems, or traditional Chinese medicine and acupuncture in China, have evolved in a historical period spanning over 3-4 millennia with their own unique worldviews, conceptual, theoretical frameworks, and elaborate codified literature. Such codified medical traditions have a unique understanding of physiology, pathogenesis, pharmacology, and pharmaceuticals -- different from Western biomedicine. 

These medical systems have been professionalized since the last millennia, and have been integrated into the national health programs. 

There are problems prevailing in our health sector, which are hampering our health services. There are many poor people who are unable to avail health services due to the financial constraints. 

There is an opportunity right now to work together for a movement that brings benefits to all people and patients, reduces poverty, and promotes inclusive growth. 

Dr Samir Kumar Saha is Executive Director of Public Health Foundation, Bangladesh & Founder President of AYUNS.