Modernising our health systems: Catering for an ageing population Joanna Nurse, Director, Health and Education Section, Commonwealth Secretariat Commonwealth Health Partnerships 2015 illustrates the multiple public health challenges we face across the Commonwealth and presents the case for a sustainable way forward. Although the Commonwealth has more than one billion young people, it also has an increasingly ageing population. This reflects the many improvements made by public health initiatives in reducing communicable diseases, however, as the population ages, we see a transition to increasing rates of non-communicable diseases. This is most marked in high- and middle-income countries, especially in some of our small island states; however, many parts of Africa and Asia experience a double burden, with high rates of both communicable and non-communicable diseases. As health needs change, our health systems need to adapt and modernise to reflect those changes. The post-2015 Sustainable Development Goals advocate universal health coverage (UHC) – to ensure equitable access to health services in order to improve health and support wider development outcomes. The vision for UHC is one that is supported globally and by the Commonwealth. However, the challenges for achieving this are multiple and complex – estimates show that the majority of countries, even high-income countries, cannot currently afford to implement UHC. This is further compounded by the increasing health care costs from an ageing population, as well as a lack of capacity in terms of human resources for health. We need to learn from the earlier successes of implementing universal education, which started its ambition at increasing attendance within primary schools, and is currently scaling this up to cover basic education and enhanced quality. Although we now have robust policy support for financing UHC, we need to start the process of supporting countries in developing sustainable policies for its implemention. The Commonwealth Secretariat, over the coming years, plans to develop policy frameworks and to build capacity to enable countries to strengthen their policies for UHC. In particular, the Commonwealth Secretariat will develop economic tools to provide countries with a framework to consider the most cost-effective approach to shape services, with a balance between prevention and promotion, as well as primary, secondary and tertiary health care. The aim of this framework is to enable the development of sustainable policy for UHC and to support planners in identifying areas that have a high health and cost impact, and approaches that are cost effective and bring good returns on investment. To complement this, assessment and planning tools will be developed to ensure priorities, services and workforce development reflect country-specific needs, rather than becoming supply driven. The health profiles included in this publication, along with the concurrent work on burden of disease being developed as part of the Health Hub, will provide Commonwealth member countries with data to help inform planning to shape policy for UHC. We also need to take advantage of working across sectors within the Commonwealth Secretariat, as well as with partners, in order to enhance our impact on addressing inequalities and the wider determinants of health. For example, many countries, especially those making rapid progress in development, are experiencing poor levels of urban air quality, which has a considerable impact on heart and respiratory disease. The Commonwealth will endeavour to support healthy cross-sector policy development in order to create healthy environments and communities that promote healthy living across the life course, including the needs of an increasingly ageing population. In doing so, the ambition of strengthening policy for UHC will enable countries to create communities, services, and the capacity for improved health and well-being across the Commonwealth in a sustainable way. Additionally, in order to ensure robust health security, comprehensive UHC also needs to include the strengthening of health protection services, so that we continue to address challenges from communicable diseases, as well as the increasing threats from climate change and natural disasters. By sharing evidence and good practice, and strengthening networks and regional responses via the Health Hub, we can scale up our response to building capacity for policy on UHC, including addressing non-communicable diseases. Moreover, the benefits of a healthy population support higher levels of educational outcomes, improve resilience, reduce crime and disorder, enhance productivity, and improve social and economic development. 8 Commonwealth Health Partnerships 2015
Commonwealth Health Partnerships 2015
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