In these difficult times, we wonder how countries can be prepared against current and future pandemics, protect their citizens and respond to their growing needs for health services at all stages of life.
The answer always includes making universal coverage effective and strengthening health systems in each and every corner of the world.
With good reason, on December 12, International Universal Health Coverage Day, the World Health Organization (WHO) insisted on the motto: "Leave no one behind: invest in health systems for all". According to this organization, each year, 100 million people are pushed into poverty because the cost of medical care is much higher than they can afford. Not to mention that more than half of the world's population does not have access to medical coverage, nor access to the knowledge and technology necessary to respond to their needs.
Since 2020, the UN has incorporated another decisive date into the calendar, December 27, International Pandemic Preparedness Day, after the global alert caused by covid-19, and the need for international collaboration to provide the best response. to this type of crisis.
As Dr. Tedros Adhanom Ghebreyesus, Director General of the WHO, rightly says, universal coverage and global health security are two sides of the same coin.
But where do we start?
What do countries need to respond effectively to the diseases that threaten us?
I am referring not only to the preparation for dramatic crises such as the one caused by the new coronavirus, but also to the countless threats to our body and the thousands of diseases that will appear, sooner or later, in the course of our lives.
Below are some proposals.
We cannot run the risk of focusing only on covid-19 and losing the momentum to achieve universal health coverage at all levels
Both primary care centres, emergencies and hospital consultations, including the most distant and peripheral ones, must be able to adequately and timely diagnose each of the ailments presented by the people who come to them. For this they need diagnostic means; an information system that produces reliable data at all levels of care and the ability to analyze it in hospitals and outpatient clinics.
The resulting data must be able to be transferred in time to the Ministries and regional institutions of the branch so that they can act accordingly and promote the appropriate preventive Public Health measures.
In addition, it must have the capacity to be able to transfer patients between the different levels of care and provide an adequate response in complex cases, in specialized services accessible to all.
For all this, it is necessary to have a sufficient number of adequately trained, managed, motivated professionals who apply existing scientific knowledge in their daily practice and work in adequate infrastructures with all the basic tools: medicines, equipment, consumables, necessary medical items for your clinical practice…
The preparation and response to pandemics and other threats requires the construction of robust health systems and their proper functioning. These are the fundamental foundation for preparing for pandemics, as well as for maintaining and expanding access to essential, indivisible, public health, primary care and specialized hospital care services.
Since 2020, COVID-19 has exacerbated inequalities in access to health services around the world, especially in low- and middle-income countries. If before the priority objective was to achieve universal coverage and guarantee well-being for all through the strengthening of health care systems; The need to provide an immediate response to the crisis caused by SARS-Cov-2 has made this need even more evident, if possible. However, we cannot run the risk of focusing only on this virus and losing the momentum to achieve coverage at all levels. We must take advantage of the knowledge derived from the latest experience to find the collective certainty of the importance of having robust public systems.
We must be aware of the great effort made by the majority of low-income states and the progressive increase they devote to their small budgets
It is true that investing in health infrastructure raises the question of its financing and the percentage of a country's GDP that should be allocated to it and to the protection of its citizens.
For this reason, we must be aware of the great effort made by most low-income States and the progressive increase they devote to their small budgets, which is always insufficient, and which the international community must complement.
Likewise, we must support and strengthen those with middle income so that they progressively strengthen their health systems at all levels.
It is necessary to leave behind the risk of proposing a global response to the covid-19 crisis focused solely on specific aspects of Pandemic Preparedness and Response, in a global space concerned about the security of international health.
Effectively and pragmatically supporting the efforts of middle-income economies, and especially the least developed ones, should be included in any future International Agreement for Pandemic Preparedness.
And it must be a priority on the global and collective agenda of the main donors, without giving room for fatigue because, to be effective, efforts must be constant and long-term, including international financial support for it.
Time is pressing, because the goals of the Sustainable Development Goals in 2030 are inexorable, and new emergencies appear at every step that distract us from the struggle to achieve this essential goal.
This will make an essential contribution to making future pandemic preparedness and international health security a reality.
María Cruz Ciria
is head of the Health Area of the Sectoral Cooperation Department of the Spanish Agency for International Development Cooperation (AECID).
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