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Opinion

World must work together to bring universal health coverage by 2030

Countries need to match good will with money, strategy and follow-through

Thailand's successive governments have focused on improving health infrastructures.   © Reuters

From the fightback against HIV/Aids to the rapid decline in child mortality, nations around the world have made great strides in health care in recent decades. Yet at least half the world's population lacks access to essential health care.

Reaching the U.N.'s target of universal health coverage -- providing equitable access to health care services, medicines and vaccines without pushing millions of vulnerable households into extreme poverty -- has rightly become a political priority. We can see welcome signs of momentum from governments around the globe.

But there is a catch: political commitment is not always matched by the deployment of domestic financial resources, while donor funding is often aimed at programs targeting individual diseases, rather than working in a coordinated approach to strengthen a country's entire health care system.

As heads of government, civil society groups and NGOs gather in Japan this month for the Tokyo International Conference on African Development -- where I will be speaking about the private sector's role in achieving UHC -- it is clear what the right approach must be.

Take Indonesia, which is rolling out the world's biggest national health insurance program but is struggling to bridge the gap between health care spending and income from contributions paid by its people.

For many countries, achieving affordable health care for all by the target date of 2030 remains a distant hope, especially when slowing global growth is putting greater pressure on aid budgets and health care spending.

Meanwhile, the impact of noncommunicable diseases, or NCDs, such as cancer, diabetes and mental health conditions is placing strain on stretched health care systems. It is a challenge that will only intensify.

About 70% of deaths from cancer occur in low to middle income countries, according to the WHO, and globally cancer cases are projected to rise from 18 million last year to 24 million by 2030, estimates from the Global Cancer Observatory show.

An Indonesian cancer patient sits outside at the shelter cancer center in Jakarta: about 70% of deaths from cancer occur in low to middle income countries.   © NurPhoto/Getty Images

There is growing public awareness of this challenge. In July, a series of high-profile cancer deaths, including that of Bob Collymore, chief executive of Kenya's biggest mobile operator Safaricom, prompted protests on the streets of Nairobi

NCDs represent the new frontier of access to health care. They are complex and patients require support across the spectrum -- from screening, diagnosis and treatment to aftercare. They cannot be tackled through the provision of medicines alone.

We need to move faster on implementation, with an emphasis on building up the whole health care system and prioritizing primary health care. While people prefer to be treated locally, confidence in primary health care services is often low, with the result that patients head directly to tertiary health centers and hospitals at a late stage in the progression of their disease.

This challenge must be tackled by improving local services and supporting family physicians, nurses and community health workers so that patients are screened and diagnosed at a sufficiently early stage for effective treatment. They should also be guided to better health and steered away from misinformation.

Thailand, which is a model of achieving UHC, has done exactly this, with successive governments having focused on improving health infrastructures at both the district and subdistrict levels.

The private sector has a crucial role to play in helping to accelerate progress in achieving UHC.

But industry cannot work in isolation. In the past, some well-intentioned interventions led by the private sector have backfired because they have tried to work around health care systems rather than strengthen and build them from within.

Led by governments, partnerships of NGOs and businesses can hold each other accountable and ensure that all our resources and efforts are accurately targeted to serve patients better.

This is a social challenge that cannot be solved through science alone. That is why we at Takeda have designed an initiative piloted in Kenya's Meru county -- an area of small towns, villages, farmland and forest -- that aims to identify and bridge some of the gaps in access to health care.

The Blueprint for Innovative Access is unique in its partnership approach -- led by local and national government, with strong accountability across all partners, including Takeda and expert NGOs, and tackling specific barriers to treatment for a range of NCDs. This strengthens the existing health care system.

The early signs are promising. In the first quarter of 2019, over 500 community health workers were trained to educate local households on NCDs. Our interventions have taken NCD screening where it is needed, reaching people in accessible venues such as a community sports center.

Crucially, we are following diagnosis with treatment, demonstrating to patients that there is a value in being screened. Over 2,500 women and men were screened for cancers, and more than 95 people are receiving treatment.

Solving this complex challenge requires a collective effort -- maximizing the expertise of the private sector and the passion of NGOs, under the leadership of government. The progress we have made in health care has already transformed thousands of lives, but millions more are at stake. We do not have the luxury of time.

Dr. Susanne Weissbaecker, MD, is global head of access to medicines at Takeda.

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