Regardless of our socio-economic background we all want and yearn for affordable health care.

In some developed countries health-care services are free and viewed as a human right. In such societies the citizenry have ready access to world-class health-care systems. However, in more developing countries one has to pay to access public health care and this is problematic and comes with a myriad problems. Some of the problems include long wait times for appointment dates for specialised health-care services, such as surgeries. It has become commonplace for persons to die while waiting on available appointment dates. The fact is: Most people cannot afford private health care.

World Health Day, which is observed on April 7, is a global health awareness day under the auspices of the World Health Organization (WHO). The day is set aside to draw attention to a specific health concern to people all over the world. The theme this year is ‘Health for all’.

April 7 also marks the 75th anniversary of the founding of the WHO in 1948. Since then the world has experienced public health challenges that have required everyone to work together to find solutions. The focus of the WHO is to promote health, keep the world safe, and serve the vulnerable so everyone everywhere can attain the highest level of health and well-being.

HEALTH CHALLENGES IN THE CARIBBEAN AND LATIN AMERICA

A recent report has revealed that the Caribbean needs to recalibrate its health-care priorities by securing more funding and learning how to spend resources better. The report is published by the Organization for Economic Co-operation and Development (OECD) and the World Bank and is titled ‘Health at a Glance: Latin America & the Caribbean 2020’, the first publication of the organisation that zeroes in on the region. It says that total health expenditure across Caribbean countries is on average 6.6 per cent of their gross domestic product (GDP). This is lower than the 8.8 per cent of other OECD countries. Spending varied from 1.1 per cent in Venezuela to up to 11.7 per cent in Cuba, and 9.2 per cent in Uruguay in 2017. The report also shows that health systems in the region heavily rely on out-of-pocket expenditures or supplemental private insurance from households. Countries that have the highest private spending are Honduras, Haiti, and Guatemala. Cuba and Costa Rica have the lowest.

Additionally, the Inter-American Development Bank states that Latin American and Caribbean countries will face significant increases in future health expenditures. A variety of factors are responsible: population growth and ageing, the epidemiological transition to non-communicable diseases (NCDs), and economic growth and technology, among others. Increasing health expenditures are particularly concerning to countries in Latin America and the Caribbean (LAC), given growing levels of debt, insufficient fiscal revenues, and high out-of-pocket payments. The projected average annual per capita growth rate from 2018-2050 is slightly higher in Latin American countries (3.2 per cent) than in the Caribbean (2.4 per cent).

PRIMARY HEALTH CARE

Primary Health Care (PHC) is rooted in a commitment to social justice, equity, solidarity, and participation. It is based on the recognition that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being, without distinction. For universal health coverage (UHC) to be truly universal, a shift is needed from health systems designed around diseases and institutions towards health systems designed for people, with people. PHC requires governments at all levels to underscore the importance of action beyond the health sector in order to pursue a whole-of government approach to health, including Health in All Policies, a strong focus on equity, and interventions that encompass the entire life course.

PHC addresses the broader determinants of health and focuses on the comprehensive and interrelated aspects of physical, mental, and social health and well-being. It provides whole-person care for health needs throughout the lifespan, not just for a set of specific diseases. Primary health care ensures people receive quality comprehensive care, ranging from promotion and prevention to treatment, rehabilitation and palliative care.

SUSTAINABLE DEVELOPMENT GOAL

The United Nations Sustainable Development Goal number three speaks to the promotion of good health and well-being for all. This goal is critical to sustainable development for all countries. Many people suffer across this planet due to a lack of universal health coverage or inadequate health insurance. Many of us have to choose which medication to buy when filling our prescriptions.

The COVID-19 pandemic has disproportionately impacted some vulnerable population groups in most, if not all, societies. Those living in deprived areas, migrants, and ethnic minorities oftentimes have limited access to health care and are most vulnerable to succumbing to preventable illnesses. According to the United Nations, by April 2022, the coronavirus causing COVID-19 had infected more than 500 million people and killed more than 6.2 million worldwide. However, the most recent estimates suggest that the global number of excess deaths directly and indirectly attributable to COVID-19 could be as high as three times this figure. The pandemic has severely disrupted essential health services, shortened life expectancy, and exacerbated inequities in access to basic health services between countries and people, threatening to undo years of progress in some areas. Furthermore, immunisation coverage dropped for the first time in 10 years and deaths from tuberculosis and malaria increased.

REPRODUCTIVE, MATERNAL, AND CHILD HEALTH

Based on data for the period 2015-2021, 84 per cent of births worldwide were assisted by skilled health professionals, including medical doctors, nurses, and midwives, an increase from 77 per cent between 2008 and 2014. In Sub-Saharan Africa, coverage is 20 percentage points lower. Available data do not reflect the impact of the COVID-19 pandemic on the disruption of services, which may reverse gains made over the past decades. The global under-5 mortality rate fell by 14 per cent, from 43 deaths per 1,000 live births in 2015 to 37 deaths per 1,000 live births in 2020, while the global neonatal mortality rate fell to 17 deaths per 1,000 live births in 2020 from 19 deaths per 1,000 live births in 2015, a 12 per cent reduction. Even with that progress, 5 million children died before reaching their fifth birthday in 2020 alone, down from 5.9 million in 2015. Almost half of those deaths, 2.4 million, occurred in the first month of life.

INFECTIOUS DISEASES

An estimated 1.5 million new HIV infections and 680,000 deaths from AIDS-related causes occurred in 2020. The incidence of HIV infections globally declined by 39 per cent between 2010 and 2020, far less than the 75 per cent target agreed by the UN General Assembly in 2016. Measures to slow the spread of the COVID-19 pandemic and the additional strain the new pandemic has placed on health systems have disrupted HIV-related services.

In 2020 an estimated 10 million people fell ill with tuberculosis worldwide. There was a rise in tuberculosis deaths for the first time in a decade, caused by the COVID-19 pandemic — from 1.2 million in 2019 to 1.3 million in 2020 (excluding tuberculosis deaths in people with HIV). Tuberculosis incidence has been falling at a rate of about 2 per cent per year, which is much slower than the 4-5 per cent annual decline which was required to achieve the 2020 milestones of the End Tuberculosis Strategy. Between 2018 and 2020 tuberculosis treatment reached 20 million people, only half of the global target. There were an estimated 241 million malaria cases and 627,000 malaria deaths worldwide in 2020. This represents about 14 million more cases in 2020 compared with 2019 and 69,000 more deaths. About two-thirds of the additional deaths were linked to disruptions in the provision of malaria services during the pandemic. Africa was home to 95 per cent of malaria cases and 96 per cent of malaria deaths.

NON-COMMUNICABLE DISEASES, MENTAL HEALTH, AND ENVIRONMENTAL RISKS

Globally, 74 per cent of all deaths in 2019 were caused by non-communicable diseases. The probability of dying from any of the four main non-communicable diseases (cardiovascular disease, cancer, diabetes, or chronic respiratory disease) between 30 and 70 years of age declined from 19.9 per cent in 2010 to 17.8 per cent in 2019. This rate of decline is insufficient to meet the UN Sustainable Development Goal target.

Tobacco use rates have declined in 150 countries, contributing to the decline of the global average prevalence rate from 24.4 per cent in 2015 to 22.3 per cent in 2020. In 15 countries tobacco-use rates are either steady or still going up. The global suicide death rate declined by 29 per cent from 13.0 deaths per 100,000 population in 2000 to 9.2 deaths per 100,000 in 2019. Although the available data do not show an increase in suicide rates during the first months of the COVID-19 crisis, the pandemic has had a severe impact on the mental health and well-being of people around the world. In 2020, there was a 25 per cent increase in the prevalence of anxiety and depression worldwide.

Wayne Campbell is an educator and social commentator with an interest in development policies as they affect culture and gender issues. Send comments to the Jamaica Observer or waykam@yahoo.com.