Global health protection crisis leaves 40% without coverage

A new study by the International Labour Organization (ILO), has revealed that global health protection crisis leaves almost 40 per cent of the world’s population without any coverage.

It shows large health coverage gaps, including West African countries, where 80 per cent had no coverage.

The study which was made available to the Ghana News Agency on Tuesday, shows that 80 per cent of the population across 44 countries are without any health protection, and are therefore deprived of the right to health; these countries include Burkina Faso, Cameroon, Guinea and Sierra Leone.

The study dubbed “Addressing the Global Health Crisis: Universal Health Protection Policies,” said that similar major gaps also exist in Asia.

It said, in India for example, more than 80 per cent of people lack health protection coverage. Other countries showing substantial coverage gaps, include Azerbaijan, Bangladesh, Haiti, Honduras, and Nepal.

The report was issued to coincide with the Universal Health Coverage Day, which falls on December 12.

“Universal health protection is key to fighting poverty, reducing inequity, and nurturing economic growth.

Sustainable development with decent jobs for all requires investment in health protection – these linkages cannot be ignored in policy development,” said ILO Director-General Guy Ryder ahead of the Universal Day.

The ILO study points to high impoverishment due to private health spending, as a barrier for accessing health care. In many countries, such as Sierra Leone, 75 per cent of total health expenditure comes from private resources in the form of out-of-pocket payments, which has led to deep impoverishment.

According to the study, the extent of impoverishing out-of-pocket payments in a country increases with the level of the population living below the poverty line.

“Thus, it is the poorest with the highest needs who suffer the most from having to pay out-of-pocket healthcare expenses,” explained Xenia Scheil-Adlung, Health Policy Coordinator at the ILO.

It said another major factor leading to the global health crisis concerns the shortage of health workers, who were often poorly paid.

Globally, the ILO estimates that 10.3 million additional health workers were needed to close the current gaps, and ensure the delivery of universal health care.

It said in countries such as Haiti, Niger, Senegal and Sierra Leone, as many as 10,000 people have to rely on services provided by five or fewer health workers, whereas in a high-income country like Finland, there are 269 health workers available for 10,000 people.

The study shows that 56 per cent of the global population living in rural areas do not have health protection coverage, compared to 22 per cent of the urban population.

“For decades, public health systems were underfunded and could not properly develop in middle and low income countries. Quick fixes like small vertical programmes – for example, immunization -- are insufficient. Countries need investments in universal health systems,” said Isabel Ortiz, Director of the ILO Social Protection Department.

The study noted that the highest inequities and disparities in coverage between rural and urban areas were found in Africa, Asia and the Pacific.

It said rural populations were also most affected by the lack of health workers; adding that seven million out of the total 10.3 million health workers who were missing globally were needed in these areas.

It said since 2010, fiscal consolidation policies had stalled, or even reversed steps towards universal health coverage by increasing the financial burden on private households, cutting back health services and cutting/capping wages of the health workforce.

The study explains that overcoming the current global health crisis, requires a policy shift towards universal health protection and points to ILO Recommendation 202 concerning national floors of social protection as a useful tool for achieving that goal.

It said investment in health systems leads to sustained economic growth, increased productivity and well-being for populations, a reason why countries like Benin, Gabon, China, the Philippines or the United States, had expanded health coverage in recent years.

It pointed out that in Thailand, the introduction of universal health protection had led to economic gains of as much as 1.2 times the original investment.

The ILO study shows that irrespective of a country’s level of income, it was possible to move towards universal health protection.

It said, a precondition for such a move was that, countries were committed to fully implementing rights to health, minimizing impoverishing out-of-pocket payments, and ensuring sufficient numbers of skilled, decently paid health workers.