Saima Wazed calls for ensuring universal access to quality healthcare

Regional Director of WHO South-East Asia Region Saima Wazed has said that to fulfil the right to health, both health services and the underlying determinants should be available, accessible, acceptable, and of adequate quality.

“Realizing the right to health for all means creating conditions where everyone, everywhere, can access high-quality health facilities, services, and goods that prioritize people’s needs, understanding, and dignity,” she said in a statement ahead of World Health Day.

It also means a full set of rights that enable people to live healthily, such as education, safe water and food, nutritious food, adequate housing, good working conditions, environmental conditions, and information—or the underlying determinants of health, Saima said.

The right to the highest attainable standard of mental and physical health—or the right to health—has been core to WHO’s mission, globally and in the region. It is enshrined in the WHO's constitution, according to a message received from New Delhi on Wednesday.

On World Health Day, celebrated on April 7 to mark the foundation of the World Health Organization, the spotlight this year is on ‘My Health, My Right’, as in a world witnessing multiple crises, from diseases to disasters to conflicts and climate change, realizing people’s right to health is now more important than ever.

As WHO marks its seventy-sixth year on April 7, the Southeast Asia region has seen many gains and has much to celebrate with regard to the right to health. 

The Universal Health Coverage Service coverage index has improved from 47 in 2010 to 62 in 2021. 

The average density of medical doctors, nurses, and midwives in the region stands at 28.05 per 10,000 population, up by 30.5% since 2015. 

The region achieved a 68.5% reduction in the maternal mortality ratio between 2000 and 2020. The under-five mortality rate declined significantly from 84 per 1000 live births in 2000 to 29 per 1000 live births in 2021, and the neonatal mortality rate declined from 41 per 1000 live births in 2000 to 17 per 1000 live births in 2021. Between 2015 and 2021, new HIV infections declined by 25% and malaria incidence by 62%.

“However, despite progress, we still have a considerable way to go to make the right to health a reality for all in the WHO South-East Asia Region,” the regional director said.

Despite global commitments to the right to health, nearly 40% of the region’s people lack coverage of essential health services. Investment in health by national governments, which is the foundation of advancing the right to health, is unacceptably low, which has resulted in high out-of-pocket expenditures. 

The proportion of households experiencing financial hardship in accessing basic health care has been rising.

The TB mortality rate in the region increased by 8.6% in 2021 compared to 2015. 

The probability of death between the ages of 30 and 70 from four major diseases—cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases—is still unacceptably high at 21.6%.

The poorest and groups with vulnerabilities face the greatest barriers to accessing needed healthcare, often with catastrophic consequences for their health and wellbeing. 

Poor quality care accounts for more diseases and deaths than lack of access to care.

The regional director said gender inequality affects equitable access to diagnosis and treatment of non-communicable health conditions. 

For example, compared with men, a higher proportion of women with raised blood glucose go untreated. This diagnosis and treatment gap is also seen for hypertension.

Violence against women and girls—a violation of their human rights and a priority public health issue—remains pervasive. 

More than one in every three women in the region has experienced intimate partner violence at least once in their lifetime, with rural and uneducated women and those from the poorest households facing a significantly higher risk, she said.

Too many still face stigma related to certain health conditions, such as TB, HIV/AIDS, disability, or mental illness. 

They also face discrimination in the health system based on their gender, class, ethnicity, religion, sexual orientation, or other characteristics, she said.

Equality and non-discrimination are core to a human rights-based approach to health. 

A human rights-based approach also entails adherence to the principle of participation, for example, by ensuring that those most affected by certain health conditions or health policies and decisions have a say in how these decisions are made, Saima said.

Accountability is also integral to a human rights-based approach: for example, reporting back to affected groups and communities about the performance of the health system or health programs to address their needs, she said.

All governments and other duty-bearers have the obligation to respect, protect, and fulfil the right to health and other human rights and to ensure their progressive realization. 

Governments need to increase investments in health—especially to advance universal health coverage grounded in the primary healthcare approach, she said. 

Good laws can lay the foundation for more effective tobacco control, environmental protection, better nutrition, the control of obesity and cardiovascular diseases, fair and equal working conditions, and much more. Health services need to be made more available, accessible, acceptable, and of better quality for all, Saima said.

WHO is committed to advancing the right to health and other human rights. “Let’s make the right to health a reality for all,” the regional director said.

Source: UNB