September 28, 2023
International Safe Abortion Day: Progress in Mexico, setbacks in the USA
This week on September 21, the UN General Assembly in New York City will be hosting a high-level meeting for countries and stakeholders to discuss the advancement of Universal Health Coverage, a topic that impacts us all. This High-Level Meeting presents an opportunity to the international community to renew efforts and accelerate progress toward achieving health for all.
With the introduction of the Sustainable Development Goals (SDGs) in 2015, all United Nations (UN) member states adopted a new approach to global healthcare: the commitment to Universal Health Coverage (UHC) by 2030, which is defined as: “all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.” UHC, in fewer words, argues that no one should be left behind when it comes to healthcare, nor should they suffer financial hardship when it comes to acquiring care.
However, the goal to reach global commitment to UHC by 2030 is still far from being achieved. Over 2 billion people are facing catastrophic or impoverishing health spending globally. While 3.5 billion are unable to access health services that they desperately need. These numbers have dramatically worsened since the COVID-19 pandemic. The pandemic further demonstrated why UHC is so crucial: globalization has ensured that any outbreak can hop borders and continents with frightening ease.
The High-Level Meeting comes at a critical moment as the world recovers from the COVID-19 pandemic, confronted with multiple humanitarian and climate crises. Developing more concrete policies and goals will help us prepare for future health-related disasters whether it’s a pandemic or environmental catastrophe.
Doctors of the World (DotW) will be attending the High-Level Meeting on UHC this week. Ensuring universal access to healthcare and healthy living conditions lies at the core of DotW’s mission and work. DotW works directly with people who are marginalized and who lack access to health services around the world.
At Doctors of the World, we have a unique perspective on the realities of access to healthcare and its costs so that we may provide evidence that can help verify the reports that Member States make to the UN. Afterall, DotW works with people who continue to lack access in countries that have formally declared achievement of UHC. France, Colombia and Georgia are just a few of the countries where we work that declared achievement of UHC, however many marginalized populations fall through the cracks: indigenous people, migrants, women, sex-workers, LGBTQ+, and drug-users are just a few to name.
Because of this discrepancy between what is reported and the actual state of affairs on the ground, we feel that UHC is simply not a sufficient measure of actual access. Stronger language and actionable commitments are needed to make countries accountable and move forward. Ensuring that no one is left behind requires that more data collection and analysis is needed to identify gaps in the healthcare system and apply evidence-based solutions.
While the move towards UHC is important, we urge the UN GA to progress to a rights-based approach to health. A rights-based approach asserts health as a fundamental human right, underscoring that everyone has the right to the highest attainable standard of physical and mental health. It ensures that healthcare encompasses all, regardless of class, race, origin, documentation, gender or orientation. With this approach, we can ensure that with UHC, no one is left behind.
A rights-based approach recognizes the essential role of the State in building an inclusive and equitable public health system. Each State has a duty to respect, protect and promote every person’s right to health, even if they may be a migrant, refugee or asylum-seeker. It also recognizes that high-income countries should maintain and improve their health and development policies to strengthen support of health systems in low and middle income countries so that they can ensure the right to health for all.
Through our programs we notice that one group is frequently ignored, under-represented and left behind: women and girls. Sexual and Reproductive Health and Rights (SRHR) should also be included within UHC. Especially since there is no specific mention of this right in the WHO Constitution. Nearly every woman (around 4.3 billion) will not have access to (at least) 1 essential reproductive health intervention during their lifetime. Now, more than ever, it is important that we recognize internationally women’s rights to access care tailored to them. Especially as we see more policies and laws coming into effect to police and control women’s bodies and their choices.
Universal Health Coverage is a target that Doctors of the World fully supports, as long as it can ensure that no one is left behind. We are excited to participate in the meeting this week to argue the points mentioned above and we are hopeful that progress will be made for everyone. Healthcare is a fundamental human-right, and must be recognized globally by all.
© Michele Lapini