Three Ways to Strengthen Healthcare Systems

By Jon Pender, GSK and Simon Wright, Save the Children UK

Three Ways to Strengthen Healthcare Systems

The Ebola outbreak exposed what we have all known for many years – healthcare systems in the poorest countries are chronically underfunded, under-resourced and fragmented. This leaves them ill-equipped to deal with everyday challenges like malaria and diarrhoea – that claim hundreds of thousands of children’s lives each year – let alone public health crises like Ebola.

As a report from Save the Children earlier this year pointed out, Ebola must be a wake-up call. All of us, be it governments, businesses or NGOs, must pull together to support universal health systems for good – to give children, families and societies the chance to thrive. These are the three ideas we believe could help deliver on that promise.

Universal healthcare coverage is not a fantasy

Some people say Universal Health Coverage (UHC) is a fantasy. But we don’t agree and made a short film to show this:

With 6 million children dying before the age of five in the last year, mainly from preventable causes like lack of healthcare for women giving birth, UHC needs to become a reality. In addition, growing non-communicable diseases like diabetes place an increasing burden on health services.

In essence, UHC means governments ensuring their health services are organised so that all people can access essential services without falling into financial hardship. It means governments providing health services fairly based on need and coming up with sustainable ways of financing healthcare so that, ideally, it is free at the point of use. It also means other sectors thinking hard about how they can support and enable this.

Rwanda is one country that has already proved this is possible, achieving 98% coverage of essential immunisation in 2010 and improving equity of access to skilled birth attendants. Here, UHC is making a real difference to the prospects of young children. No-one thinks that every country is able to afford every service, medicine and vaccine instantly. All countries, rich ones included, make decisions based on need, evidence, cost-effectiveness and available resources. But Rwanda shows it is not a dream and countries can do much more if they prioritise UHC in their health policies and budgets.

Get more feet on the ground

There are simply not enough health workers. For example in the Democratic Republic of Congo – where our organisations have just launched a programme to help reduce deaths among under-fives – there is one doctor for every 10,000 people. That compares to an average of 11 health workers per 10,000 people across Africa. If this is to change, we need to find innovative ways to swell the ranks of frontline staff and ensure that they can better provide the essential health education, medicines and services that people need.

One way GSK is helping is by reinvesting 20% of its profits from Least Developed Countries back into training 25,000 health workers so far in these countries – through partners including Save the Children. Our organisations are also embarking on a three-year programme in Nigeria to support the training of 5,000 health workers caring for mothers and children. Crucially, they will provide health education too, helping ensure the benefits of this programme endure. At the same time, GSK is partnering with Amref Health Africa and the One Million Community Health Workers Campaign to train health workers in Kenya and Ghana.

These kinds of programmes need to be catalytic, creating an evidence base for others to invest in and champion health workers. Governments must lead when it comes to funding and structuring healthcare systems. But the scale of the challenge demands multiple players. Enabling people to access the healthcare they need benefits all of us – it creates stronger, sustainable communities and economies – so all of us have a role in making it happen.

Innovation in the lab and beyond

Getting medicines, vaccines and other tools to those who need them is an integral element of stronger health systems – as is finding new interventions that can help people stay healthy. Healthcare companies like GSK are searching for fresh tools that could help tackle tenacious infectious diseases such as malaria; and are pursuing new ways to open up access to medicines and vaccines, such as focusing on lower prices and higher volumes. But there is further to go and we need to look beyond our own labs to tackle the toughest challenges.

Partnership is critical to stimulating ideas and making sure innovative products are affordable and accessible – nobody wants them left on the shelf. Working with Save the Children, drawing on their expertise in the field, is helping GSK progress development of an antiseptic gel which – if approved – could help prevent umbilical cord infection in newborns in developing countries. Through innovative market mechanisms, alliances like Gavi are helping vaccines reach the very poorest children.

Collaborations like this are not always straightforward – they require commitment and openness on all sides. But they are essential if we are to help create robust, resilient healthcare systems – underpinned by skilled staff and access to medicines for people who need them. Only then can we unlock human potential and achieve sustainable, inclusive development.

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