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The case for universal health coverage, and the critical role for the private sector

While universal health coverage is essential, the implementation of such a system is complex and the private sector has a pivotal role to play in leading the charge

Co-authored by Dr. Githinji Gitahi, Group CEO Amref Health Africa and Dr. Susanne Weissbaecker, Global Head of Access to Medicines, Takeda

Dramatic advances in healthcare and medicine over recent decades have helped increase humanity's average life expectancy, but the underlying reality today is that access to these innovations is far from equitable. Many people around the world still lack even basic access to care, innovative medicines and medical resources, especially in the evolving healthcare systems of low- to middle-income countries.

In these countries, patients are often excluded from existing healthcare systems or only have access to sub-standard care because they are required to pay "out of pocket" but lack the means to afford it. A 2017 joint report by the World Health Organisation (WHO) and the World Bank Group stated that more than half of the world's 7.3 billion people do not receive all the essential services they need[1].

Patients also usually spend too great a proportion of their household budget on healthcare and are pushed into poverty, which compounds the problem further. The joint report found that over 800 million people spend at least 10 per cent of their household budgets on healthcare, and approximately 100 million of them are pushed into extreme poverty due to health expenses.

At the 2015 United Nations General Assembly, all Member States created a shared blueprint to achieve a better and more sustainable future for all. The core of this plan was a list of 17 Sustainable Development Goals. Goal number three is focused on ensuring healthy lives and promoting the well-being for all, at all ages. Under this Goal, one of the targets is to achieve universal health coverage (UHC) by 2030[2].

As countries develop and healthcare systems evolve, they naturally aim to achieve UHC to ensure that all people obtain the health services they need without suffering financial hardship when paying for them. Investing in UHC also leads to faster and more inclusive growth for economies.

However, a successful UHC system cannot be achieved alone. Knowledge, expertise, and financial responsibilities must be pooled. Non-siloed partnerships, complementary infrastructure, capacity and funding, buy-in from all stakeholders, including government authorities (health and financial), civil society, patient groups, healthcare professionals and private sector partners are all paramount.

Public debate has shown that there are strong views on whether the state or private sector funds UHC systems. Critics have said that private funding of a UHC system would likely lead to spiralling healthcare costs.

This prompts a critical question: what role should the private sector play?

At Takeda, we believe that the private sector, particularly the pharmaceutical industry, plays an essential role in this complex journey. Beyond opportunities to bring stakeholders together to facilitate dialogue and align efforts, the private sector can do many things. This includes partnering with government and civil society to enhance access to high quality and innovative medicines by contributing towards the building and broadening of capacity in local health systems.

Technology is also an enabler for accelerating UHC. As the private sector has strong research and development capabilities, there is scope for technological disruption to help local health systems overcome existing barriers.

Convening partners to
synchronise efforts along the continuum of care

An example of how Takeda has sought to build these essential partnerships was in September 2018 where we supported a high-level consultation on Equitable Access to Healthcare in Asia and Africa, hosted by Amref Health Africa and UHC 2030 alongside the 73rd Session of the UNGA. The event brought together prominent health leaders including ministers of health, representatives of major foundations, NGOs, UN agencies and private sector players to engage in a dialogue on critical drivers of UHC in Africa and Asia. The event showcased examples of progress towards the achievement of UHC in Africa and Asia, and shared some of the solutions, innovations and ideas that can make UHC a reality in the two continents by 2030. 

UNGA side event 2018: From l-r Tim Evans, World Bank, Dr Naveen Rao, Rockefeller, Dr Girija Vaidyanathan, Ministry of Health India (Tamil Nash), H.E. Sicily Kariuki, Ministry of Health Kenya, Dr Suwit Wibulpolprasert, Ministry of Public Health, Thailand.