Thanks to technology and inexpensive travel options, national boundaries form less of a barrier for than ever. While this is brilliant news for clinical research, allowing us to conduct orphan trials and compare global populations with ease, it also means that illnesses spread quickly, threatening larger populations than ever before.
No longer are preventable infectious diseases confined to the one billion people living in poverty in developing countries. Recent outbreaks of Ebola have proven that healthcare is more of a global responsibility than ever before. To address health on a global scale, first world countries need to consider innovative solutions to treating and preventing illness - both in their own economies and cultures, and in vastly different cultures.
Why globalise Universal Healthcare?
The World Bank shows that Sub-Saharan Africa only receives 1% of all global health expenditure, despite those countries accounting for 24% of all global disease across 11% of the world’s population. In order to meet the growing health demands of an increasingly global population, we need to consider the demands of our most developing countries.
To realistically meet healthcare needs in Sub-Saharan Africa alone, governments will need an estimated $25 billion to $30 billion in investment - and an accelerated programme of innovations to change the way we think about globalising universal healthcare.
Since 2010, over 80 countries have approached the World Health organisation for support in moving toward Universal Healthcare. From India and China to Brazil and South Africa, emerging economies representing half the world’s population are taking significant steps toward adopting Universal Healthcare protocols.
In December 2012, the World Bank Group identified Universal Healthcare as a top priority for sustainable economic development, giving developing and emerging countries more motivation to offer free and affordable healthcare for all than ever before. However, the reality of approaching and implementing global Universal Healthcare is far more complex than the ideal, with countries across the globe taking many different pathways depending on their own cultures and economies.
Even the most financially stable countries face challenges when it comes to their healthcare models. With the USA seeking a functional system to replace the Affordable Care Act, we’re more aware than ever of the difficulties governments face in deciding how to provide for their populations.
Instead of looking for the perfect existing model to base an overarching global healthcare system on, we need to first understand the unique challenges facing each population, and the progress that each government has already made in addressing those challenges.
For example, both Thailand and Sri Lanka have made significant progress toward universal health care over the past years, but both based on very different models. While Thailand has taken a slow-and-steady approach toward a Primary Health Care model, cutting infant mortality by 80% in 30 years and involving Buddhist monks in health education and promotion, Sri Lanka has firmly placed its focus on a mixed health market, offering access to free healthcare via collaboration between the public and private sectors.
Ghana’s healthcare model is a work in progress, but is based around a national-level risk pool, in which the healthier and wealthier subsidise care for the poorest and sickest members of the population. This was trialled on a community level, and has gone on to form the basis of sustainable healthcare purchases on a national level.
What works for one population won’t always work for another, and while we can hope for a global means of funding and researching healthcare, we may need to accept that the delivery of that care might differ dramatically on a country-by-country basis.
Invest in disease prevention
Global health isn’t just about hospitals, clinics and insurance. It’s also a matter of safe and sanitary housing, progressive education, and civic welfare. Rather than focusing on treating ill people on a global scale, we need to take a step back and consider preventing those illnesses in the first place.
From educating vulnerable young women and their families about the risks of early pregnancy, to ensuring that parents can find enough work to pay for a safe, clean home for their families, healthcare is a far-reaching issue that will require constant reassessment between global governments and NGOs alike.
It can be hard to convince public and private policy makers of the value of prevention activities, as their effects can’t be effectively measured in the way that treatments are. Many confounding variables could all play a role in the steady improvement of a population’s health, and it’s hard to single out a single campaign as the root cause. Furthermore, while drugs and treatments can be patented and charged for, preventative measures remain solely in the public domain, meaning that it’s unlikely that private funders will see any short-term benefit.
However, in the longer term prevention is often the most cost-effective way to combat disease. By investing in sanitation, housing and education at an early stage, governments will reduce the need for costly medication later down the line.
A paradigm change
While pushing for global Universal Healthcare will call for an ongoing and often difficult dialogue between developing, emerging and developed countries, the benefits are evident: healthcare improvements drove a quarter of full income growth in developing countries between 2000 and 2011.
In order to transfer this benefit to all citizens, however, we will need to change the way we think about healthcare models, examining the specific needs of each population, adapting existing infrastructures, and prioritising the very poorest around the globe.