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The Director’s Corner

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Quality healthcare should be accessible to the many, not the few.

A message from José Luis Castro, Executive Director, The Union

Universal access to good quality, affordable healthcare is core to Goal 3 - ‘Good health and well-being’ - of the United Nations’ sustainable development agenda for 2030. This principle determines that everyone should receive the care they need, when they need it – and at a good quality standard. 

But estimates suggest that, in 2017 alone, 400 million* people around the world, will not have access to any healthcare whatsoever. In many countries, health services remain unaffordable, and what is available cannot be quality-assured. It is a sad fact that place of birth can severely diminish chances of accessing healthcare - which could be the difference between quality of life or no life at all. It is as stark as that.

But what does quality mean in the developing world and how can we ensure that healthcare systems adapt to changing priorities, new legislation and new treatment regimens – and that the healthcare workforce is supported in delivering services in a consistently changing environment? 

The newly-elected Director General of the World Health Organization, Dr Tedros Adhanom Ghebreyesus, has already been clear on his over-riding priority. He has said, “All roads lead to universal health coverage (UHC). For me, the key question of UHC is an ethical one. Do we want our fellow citizens to die because they are poor?”  

The Union works in some of the world’s poorest communities where issues of chaotic infrastructure, unstable economies and uneven healthcare services all impact negatively on the goal of UHC, showing that this is a pipedream for many. Through our work, we have seen instances where healthcare providers struggle to provide not just healthcare services, but the basics of sanitation, clean water supplies, consistent electricity (to power much-needed generators) and refrigeration systems for the storage of essential vaccines. Communication networks that we take for granted – landlines, mobile phones - are, for many people, simply unavailable.    

Strengthening healthcare systems requires a cohesive, partner-led approach from a collaboration of governmental and stakeholder policy and implementation – backed by protected funding that does not change year-on-year and is unaffected by fluctuating political administrations. 

Here are just three recommended actions which, if supported with appropriate and consistent levels of investment and resources, would positively impact global healthcare systems for all: 

  • The Union has long endorsed the qualities of operational research training – that is research into strategies, interventions, tools or knowledge - to enhance the effectiveness and performance of health systems. In practice this could mean supporting programme managers with the latest tools and training on new treatment regimens through to rebuilding healthcare systems that have been depleted through lack of resources or catastrophic epidemics.

Read two case studies that reflect both these subject areas:

The Union helps rebuild health systems in Ebola-affected countries through operational research

The Union’s new operational training course in Peru tackles critical updates in drug- resistant TB treatment and diagnosis

The Union’s latest training programmes can all be accessed via 

  • Prioritising the health workforce is central to strong healthcare systems. Well-trained and well-resourced staff across all disciplines from scientists and researchers through to frontline nurses and doctors are critical to ending TB. In low-resource settings particularly, nurses are frequently relied upon to deliver TB care and treatment – yet TB treatment is not generally part of nurse training. In accordance with the sustainable development goals, increased finance and investment must be prioritised to support the recruitment, training and retention of the health workforce in under-developed countries. The impact on healthcare systems would be profound. 

Case study: The vital role of nurses in TB care and treatment

  •  Exploiting digital technology and knowledge management techniques. Technological       advances are transforming health service delivery across the globe and should be considered a complementary strategy for strengthening health systems, especially in low- and middle-       income countries.  Mobile health (mHealth) initiatives such as toll-free telephone helplines       and electronic patient records (easily accessible and crucial for giving real-time information to   healthcare professionals) are mitigating against poor transport infrastructure, staffing      shortages and issues of treatment compliance (simple appointment reminders sent by text message for example) in vulnerable communities. 

Listen to the recording of our webinar on mHealth technologies in TB treatment: Can mobile health (mHealth) help accelerate progress towards ending TB


José Luis Castro
Executive Director
The Union 

*Statistics source from the World Health Organization