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International Universal Health Coverage Day – 12 December

Figure 1

Building Back Better – what can we do?

Now that there is hope on the horizon for ending the pandemic through the emergence of effective vaccines we must seek to ensure that everyone everywhere has access to them. The WHO is seeking to do this through COVAX – the vaccine pillar of the ACT-Accelerator (Access to COVID-19 Tools). For an explanation about why this is essential see .

Equitable access to healthcare for all is more urgent than ever before. The inequalities are starkly illustrated by the COVID pandemic, both within and between countries, but have been well known for a long time. The tragedy is that we have not achieved universal health care in order to help minimise these differences. Can we raise awareness, advocate for and act through our projects to help achieve it?

WHO summarises the key facts as:

  • At least half of the world’s population still does not have full coverage of essential health services.
  • About 100 million people are still being pushed into extreme poverty (defined as living on 1.90 USD or less a day) because they have to pay for health care.
  • Over 930 million people (around 12% of the world’s population) spend at least 10% of their household budgets to pay for health care.
  • All UN Member States have agreed to try to achieve universal health coverage (UHC) by 2030, as part of the Sustainable Development Goals.

A measure of the health of a nation is the wellbeing of its young children – from birth to age 5 years. The range across countries in SIGBI is shown in Figure 2 below.

Figure 2 Childhood mortality across SIGBI

At the other end of the age range is how long we can expect to live when we are born and when we reach ‘the grand old age of 60years’ – see Figure 3 below.

Figure 3 Life expectance at birth and aged 60 years

The old adage that wealth equals health should read equitable wealth distribution equals good health. The World Bank and WHO have been working together on this:

‘Health is also an essential part of the Sustainable Development Goals (SDGs). For example, the SDG 3.8 target aims to “achieve universal health coverage, including financial risk protection, access to (high) quality essential health care services, and access to safe, effective, (high) quality, and affordable essential medicines and vaccines for all.” In addition, SDG 1, which calls to “end poverty in all its forms everywhere” could be in peril without Universal Health Care, as almost 90 million people are impoverished by health expenses every year.

Furthermore, The World Bank concludes that:

  • More than 1 billion people still live in destitution. At the same time, inequality is rising in many developing nations.
  • The World Bank wants to galvanize international and national support around two goals: to virtually end extreme poverty in a generation and to push for greater equity.”

Many people live on less than 1.9$ per day with the majority going on food, followed by fuel meaning that half the world lacks access to essential health services. Unless we help all to have access to vaccination and treatment for COVID the spread of the virus will continue, largely unabated. Now is the time for Universal Health Coverage.

Climate Change and Health

With COP26 in Glasgow (1-12 November 2021) the synergy between climate and health comes even more into focus. This is through direct effects such as increased communicable disease transmission and heat related through, for example, dehydration as well as indirect effects on food production, drought and increased migration.

Air pollution lessened during the initial phases of COVID but this is being reversed as lockdown provisions are decreased and people become less observant of the advice to maintain at least 1 metre distance between themselves and other people.  Wearing a face mask when close to others in closed or crowded spaces and in close contact is advised. However, poor mask construction and usage as well as poor general hygiene might help to spread the disease. For clear advice watch the videos on these links:

Fabric masks –

Medical and fabric masks –

The Way Forward

What is needed and what can we do?

WHO has just established a Council on the Economics of Health for All so that we can move towards  “…  a new narrative that sees health not as a cost, but an investment that is the foundation of productive, resilient and stable economies,”

This means that those of us who can afford access to high standards in health and care services must help those unable to do so for themselves. Will you help us to do so?

Kay Richmond
SIGBI Director of Programme