The dream of universal health care can be realized

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The dream of universal health care can be realized

Friday, 07 April 2023 | Sudha Sharma

On the occasion of World Health Day today, we must renew our pledge for ‘Health For All’ and find the missing link to ‘good health’

World Health Day, 7th April, is celebrated as the World Health Organisation (WHO) was established on this day 75 years ago. Among its many public health achievements is the eradication of Smallpox, eradication of Polio, Cervical cancer vaccine, malaria vaccine and helping global community tackle newer health problems and pandemics like SARS, Swine flu, Ebola, Covid-19 and others with 'Science, Solution and Solidarity'.

The theme for this year's World health day is 'Health for All'. Universal health care (UHC) means everyone must have access to health care when they need it, where they need it and without financial hardship. Health emergencies like the Covid-19 pandemic, climatic crises, economic constraints and wars have made action for UHC an urgent need. Is this an achievable dream, given that 30% of the global population does not have access to essential services and more than 2 billion people are facing catastrophic health expenditure?

According to WHO, primary health care approach to give essential services is the most cost-effective approach. Our country has a strong infrastructure of District level hospitals to CHCs, PHCs and sub centres. These sub centres have been upgraded to HWCs- Health and Wellness centres. All facilities are trained to give promotive, preventive and curative services for all groups of diseases infectious diseases and non-communicable diseases. Along with the Government sector, the Private sector, NGOs, charitable institutions and public-private partnership ventures shoulder the responsibility of providing quality healthcare to the community. But we are still facing so many diseases!!

Where is the missing link?

Life has become EASIER but not HEALTHIER. Amid these diseases threatening us, the show stoppers are Non-communicable diseases like hypertension, diabetes, obesity, heart disease, stroke..the so-called lifestyle diseases and COPD and cancers. These are the cause of 61.8% of deaths in our country. We are the diabetes capital of the world. Other  alarming figures point to the fact that a lot needs to be done at the individual and community levels.

In all types of diseases, there is a 'host -agent-environment interaction' required to produce disease. So the good news is, agents alone cannot cause diseases. Changes in the host, the person(us), and the domestic environment can modify these risk factors and can benefit us in many ways. Living a healthy 'life in style' can not only protect, prevent and control NCDs but also set an example for others to follow...So, what are these steps that can make our homes a wellness centre?

Like all the best things in life, these too are very simple and inexpensive. As recommended by WHO, the best buys for reducing NCDs are having a balanced nutritious diet with fresh fruits and vegetables, giving up tobacco, giving up alcohol, daily physical activity, salt restriction, reduction of refined sugar consumption. To the list, one could add curtailing fat consumption especially trans fats,  and regulating excessive use of mobile phones.

Don’t underestimate the power of these simple interventions:

They can create wonders for you if followed regularly. Another paradigm shift we need is to assess the ' *health affordability* ' of our choices, not the financial affordability.

A last word of advice for those suffering: Regular medications and lifestyle changes will keep complications at bay and significantly improve your quality of life. Investing in strong health systems is critical for a prosperous society but there needs to be a major shift from economies driven by profit and pollution to economies driven by fairness and well-being and economies driven by sustainable and need-based development.

Universal health coverage is a political and social choice. We need strong political leadership and public demand. This public demand should be towards the Governments for services, legislations and insurance schemes but our role to change ourselves and our environments to transform our lives should not be ignored. So, the next time you have to choose between driving your children to the mall or cycling to a nearby park.

Make a wise healthy choice:

Let us pause on this world health day and check which roadblocks are preventing aur progress on this road to health. And you would find that there are many which would require a simple change of habits and thought patterns. Like in all aspects of life, in health too, there are two solutions to any problem. We can either wait for others like Governments (by banning fast food and cold drinks) and friends and family to make healthy choices for us, or we can use our self-determination and willpower to make healthy choices and be role models for others. Our active participation will be a game changer in realizing the dream of universal health coverage. Let us on this day promise Good health to ourselves and pledge to ensure 'Health For All’.

(The writer is a health expert, MD in Community Medicine, MLB. Medical College, Jhansi)

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