Is universal health coverage the key to unlocking the potential of countries like Nigeria, to bring equality, health and wealth for all?
As the Universal Health Coverage Forum convenes in Tokyo this week, coinciding with Universal Health Coverage Day, sub-Saharan Africa finds itself in the midst of a healthcare crisis. Life expectancy remains drastically lower than in any other region, and a susceptibility to deadly diseases - such as TB, HIV and Ebola - has consolidated its reputation as the weakest link in healthcare advancement globally. One major factor is the startling lack of universal health coverage.
Universal health coverage (UHC) is defined as people and communities being able to use the health services they need without incurring financial hardship. In Africa, just a handful of governments have implemented it. It is time that we open our eyes to the critical role that UHC can play in drastically improving health outcomes as well as reducing poverty, driving economic growth and promoting gender equality.
Every year healthcare expenses push an estimated 100 million people into poverty around the world, as a result of just 20% of the world's population having access to social security protection. In my native Nigeria, where average life expectancy is 53 years old, and nearly two thirds of the population lives in poverty, the onset of unexpected illness often cannot be met without the family incurring significant sacrifice. The solution lies in a government-coordinated, public-private collaboration in the provision of healthcare.
Of Nigeria's 190 million population, just 5% is covered by health insurance, with over 90% of healthcare paid for privately. Illness creates huge burden on these people who the lack social protection to support them in times of need.
The impact of absent universal care trickles down to all levels of society. Starting at an individual level, many forego treatment due to an inability to pay for it. Of the families that do pay for healthcare when in need, many are forced to sacrifice other basic necessities, such as food and education for their children, under the financial strain imposed by healthcare.
The lack of UHC also has broader economic repercussions - improved health directly correlates with economic growth, providing reason to prioritise UHC.
There have been some signs of optimism regarding UHC this year.
In Nigeria, the media has driven the issue of UHC more than ever before, and there are signs of political will and concrete progress. In July, the Senate President launched the Legislative Network for Universal Health Coverage to address the issue of financing healthcare to reach all Nigerians, marking a step towards achieving UHC. The Senate has also made tracks in urging the Federal Government to increase spending to the Ministry of Health and to fully implement the National Health Act of 2014. The motivation is there. Now what is needed is funding.
The WHO estimates that 85% of the costs of meeting the SDG health targets - including UHC - can be met through domestic resources. But resources must be maximised and utilised effectively. In Nigeria, for every 1 Nigerian Naira that the government spends on health, 2.5 Naira is spent on defence. In 2015 alone, malaria killed 182,284 people in Nigeria; diarrheal diseases killed 143,880; and 212,557 women and children died during pregnancy and childbirth. The situation needs action, and it is time for the government to tackle healthcare with the same vigour as demonstrated in its approach to managing national security threats.
UHC can liberate impoverished people from the constraints of poverty, and carries vast potential to free millions of people from the burden of involuntarily financing private healthcare. Perhaps it is the key to unlocking the potential of countries like Nigeria, to bring equality, health and wealth for all.
Toyin Ojora Saraki is the Founder and President of the Wellbeing Foundation Africa, a pan-African maternal health and gender rights organisation, headquartered in Nigeria. The Wellbeing Foundation Africa has trained thousands of midwives across West Africa, and provides basic education to expectant mothers via its Mamacare programme. Mrs. Saraki is a longstanding advocate for gender equality, and has dedicated much of her life to improving maternal outcomes in Africa. Any views expressed in this article are those of the author and not of Thomson Reuters Foundation.