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We need stronger universal health coverage after pandemic
Global health security is centered on preventing, detecting and responding to public health threats, particularly by protecting people from infectious disease threats.
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Health for all: A mother brings her child to a community health center (Puskesmas) in Dago, Bandung, West Java, on Nov. 21, 2022 for a polio vaccination. The government has declared an “extraordinary occurrence” of polio after the discovery of cases in Aceh. (Antara/Raisan Al Farisi)
T
he COVID-19 pandemic is the worst health crisis in recent history. It has killed more than 6 million people, pushed an estimated 150 million into extreme poverty, and left around a billion undernourished.
Even before the pandemic, half of the world’s population had no access to the health services they deserved. The disproportionate and unequal impact of the COVID-19 pandemic on the population has brought attention to inequalities. One of the greatest inequalities globally is the disparity and inequity in access to safe, effective and timely health care.
Through the National Health Insurance (JKN), Indonesia aims to achieve Universal Health Coverage (UHC). From 2014 to 2019, JKN coverage expanded to reach 83 percent of the population and reduced individual out-of-pocket expenditures from 47 percent to 32 percent of their spending on health care.
Health is a fundamental human right, and UHC is critical in achieving that right. UHC is driving the global health agenda. It is embedded in the Sustainable Development Goals (SDGs) and now is designated by an official United Nations UHC Day on Dec. 12.
SDG 3.8 sets a target to achieve UHC, including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
Although coordination has been explored between UHC and global health security, primary health care and health systems, how UHC relates to public health has come under less consideration. Most efforts and resources to date have focused more on the provision of personal health services and less on public health. This situation is concerning because public health interventions offer better value for money than curative services, and can result in increased equitable health benefits.
Achieving UHC requires governments to make complex political and policy choices about how to use limited resources. Increasing the coverage of public health services will also involve allocating resources beyond the remit of the traditional health sector. Without robust public health interventions, healthcare reform will not decrease health inequity.
