Universal health coverage is not an option – but a reality

The Sierra Leone Telegraph: 3 July 2013

“Poverty still remains a major barrier to healthcare access in Africa”, says Dr. Agnes Soucat, the Director of the Human Development Department of the African Development Bank (AfDB).

This statement set the tone for the Africa-Asia dialogue on achieving Universal Health Coverage in Africa, which took place in Lusaka, Zambia last week. The AfDB facilitates Africa-Asia knowledge exchange on Universal Health Coverage

During this rich 4-day experience, participants benefited from lessons learnt on health financing reforms in Cape Verde, China, Ethiopia, Ghana, India, Malaysia, Mongolia, the Philippines, Senegal, Singapore, South Africa and Thailand.

The Africa-Asia Dialogue brought together some 50 participants from Ministries of Finance and Health, national health insurance authorities, academia, of both African and Asian countries as well as development partners.

The purpose of the dialogue was to strengthen the delivery and financing of health services in Africa, by helping countries build coherent, efficient, equitable and sustainable health financing systems based on prepayment, pooling and strategic spending for progressively achieving Universal Health Coverage.

‘Universal health coverage is not an option, but a reality’, said the Honorable Joseph Kasonde, Minister of Health, Zambia.

“The forum created a revolution by enabling the Ministries of Health and Finance to sit together and dialogue”, he added.

Malaysia continues to make remarkable progress in providing health care for the poorest. Universal health coverage was made possible through a tax-funded health financing system in Malaysia – said Dr. Davis Johnraj, Senior Assistant Director, Malaysian Ministry of Health.

Thailand attributed its achievements to a unified health insurance model.  Ghana, on the other hand, shared its progress towards universal coverage through a tax-based health insurance system.

Mr. Sylvester Mensah, CEO of the Ghana National Health Insurance Authority (NHIA) advised African countries to avoid difficulties faced by Ghana, in particular in the design of the benefits package which is ambitious and difficult to sustain.

Senegal, South Africa and Ethiopia essentially shared their current reform pathway as it is still work in progress and tried to test their reform propositions.

Cape Verde suggested ways to hold dialogue with the Ministry of Finance to draw innovative tax resources into the health sector.

Four main outcomes were realized at the end of the conference for each of the participating countries:

•          Understanding of the key factors behind successes and failures as well as limitations of different health financing approaches.

•          Identification of strategic options in designing, redesigning and strengthening health financing reforms aimed at universal health coverage.

•          Prioritization of critical areas of need to undertake health financing reform requiring          Bank and other donor support.

•          Development of partnerships among various key development partners in lending support to African countries

Group work sessions formed the backbone of the dialogue, where country experiences were applied to the respective African country settings to test their applicability.

Areas requiring immediate attention in each participating country were highlighted and discussed alongside possible solutions.

The event was hosted by the Human Development Department of the African Development Bank, in collaboration with the Zambian Ministry of Health, the German International Cooperation (GIZ), the International Labour Organization (ILO), the World Health Organization (WHO), Providing for Health (P4H) and the World Bank,

Countries from the Southern Africa region identified evidence-based policy development, knowledge exchange, skills development and capacity development as the major areas requiring immediate attention and donor support.

The African Development Bank through its newly approved Strategy for 2013-2022 will support countries in building safety net programs and creating economic opportunities.