Transcript Slide 1
A Wake-up Call Lessons from Ebola for the World’s Health Systems G7/G20 Parliamentarians‘ Conference, 17 April 2015 1 A Wake-up Call 1. Ebola - Learning the Lessons 2. 2015 Health Access Index - Prevention is Better than Cure 3. Universal Health Coverage - The Need to ‘Build Back Stronger’ 4. Recommendations 1. Ebola - Learning the Lessons “Had there been effective [health services] in the countries of origin of the disease, this problem could have been mitigated or even eliminated.” Amartya Sen Lesson: Importance of Health Systems Surge of measles in affected countries (rates 3 to 4 times higher*) 828 affected health workers, 499 reported deaths Ebola Spread Further weakening of health systems Weak health systems Limited access to health services Impact on health outcomes Half less pregnant women received prenatal care in Liberia* *between 2014 and 2015 (over 5 months) 4 State of Health Systems Before the Outbreak Critical shortages of health workers • 1 health worker/1,598 people in Guinea • 1 health worker/3,472 people in Liberia • 1 health worker/5,319 people in Sierra Leone Inadequate financing • Guinea $9 per person each year • Liberia $20 per person each year • Sierra Leone $16 per person each year Lack of access to medical products, vaccines & quality health services • Drastic shortages of medicines, inadequate knowledge of International Health Regulations Lesson: Cost of Ebola 3x Cost of Health System 6 2. 2015 Health Access Index Prevention is Better than Cure “The state of the health workforce and health systems [in Guinea, Liberia and Sierra Leone] has hampered the ability of these countries to respond to the Ebola epidemic – but these countries are hardly alone in having inadequate training, support and numbers of health workers.” Dr Ariel Pablos-Mendez, USAID’s Assistant Administrator for Global Health 2015 Health Access Index: Ranking Access and quality of health services 1 Brazil 19 Morocco 37 Myanmar 55 India 2 Kyrgyzstan 20 Philippines 38 Tanzania 56 Cameroon 3 Uzbekistan 21 Rwanda 39 Ghana 57 Pakistan 4 Azerbaijan 22 Iraq 40 Madagascar 58 Sudan 5 Egypt 23 Swaziland 41 Angola 59 Togo 6 South Africa 24 Bolivia 42 Côte d'Ivoire 60 Lao, PDR 7 Tajikistan 25 Cambodia 43 DRC 61 Mozambique 8 Turkmenistan 26 Uganda 44 Liberia 62 Guinea-Bissau 9 Gabon 27 Benin 45 Mauritania 63 Mali 10 Peru 28 Gambia 46 Sierra Leone 64 Niger 11 Solomon Islands 29 Malawi 47 Kenya 65 Guinea 12 China 30 Comoros 48 Lesotho 66 Central African Republic 13 Sao Tome and Principe 31 Equatorial Guinea 49 Nepal 67 Ethiopia 14 Viet Nam 32 Guatemala 50 Papua New Guinea 68 Haiti 15 Botswana 33 Senegal 51 Yemen 69 Afghanistan 16 Congo 34 Burkina Faso 52 Zambia 70 Nigeria 17 Indonesia 35 Burundi 53 Bangladesh 71 Chad 18 Mexico 36 Djibouti 54 Eritrea 72 Somalia 2015 Health Access Index: Risks for Outbreaks “The risk of new diseases quickly spreading worldwide has never been greater.” Judith Rodin, President of the Rockefeller Foundation • Estimations from the University of Washington: today, 51–81 million deaths globally might be caused by an influenza strain similar to Spanish flu of 1918-1920 • The 28 countries that fell below Liberia in the Index could account for more than 31 million deaths 2015 Health Access Index: Risk for Children and Women 17,000 children die every day New-born mortality rate remains high Unequal progresses towards MDG4 and MDG5 3. Universal Health Coverage - The Need to ‘Build Back Stronger’ “Well-functioning health systems are not a luxury. Well-functioning health systems are the cushion that keeps sudden shocks from reverberating throughout the fabric that holds societies together, ripping them apart.” Margaret Chan, World Health Organization Director-General, 2015 Universal Health Coverage: An Affordable Reality $86 per year per capita for essential services package delivery $101 billion additionally would be required annually for 75 countries with highest maternal and child mortality Increase health investments (to 15% of budget), increase health ODA (to 0.1% GNI) for 26 of 75 countries with highest child and maternal mortality 1 2 Universal Health Coverage: Best Investment into Child and Maternal Health Calling for: o 100% coverage of essential services o 100% financial protection from out-of-pocketpayments (OOPs) for health o for all people Best measure: o Skilled birth attendance for all segments of population (in particular poorest 1/5) Recommendations 1. Maintain the international response to help Guinea, Liberia and Sierra Leone achieve zero new Ebola cases 2. Political leaders in countries with low rates of health coverage should make public commitments and increase investment to 15% of budgets in comprehensive health services 3. International institutions and donors should ensure that aid and global support is increased to 0.1% GNI and better aligned to help build suitable and comprehensive health services 4. Civil society organisations should advocate for progressive tax reforms and increased transparency, more equitable revenue and health expenditure 5. The Sustainable Development Goals should commit the world to support universal health coverage and ending preventable maternal, newborn and child deaths, with no target met unless met for all German Government with G7 Presidency can set a clear signal during June Summit ahead of FFD and UNGA Thank you 15 Beyond Ebola: 2015 Health Access Index 1 7