I n t r o d u c t i o n The UN reports that 2.3 billion people have gained access to drinking water as a result of the Millennium Development Goals health technologies and medical products become available. People also tend to demand more and better services as they get richer, so demand rises as well as supply. Mostly these innovations come at higher cost. Population increases add to the pressures countries face to meet these demands. Ageing and the resulting epidemiological transition from communicable to non-communicable diseases and injuries exacerbate these tendencies. Low-income countries must now address the continued problems associated with the health MDGs as well as the increased burden of NCDs and injuries. The member states of the UN have recognised this by agreeing that five of the 13 targets under the health goal in the SDGs focus on NCDs and injuries, something they will further discuss and then vote on in the 2015 session of the United Nations General Assembly. To do this, low- and middle-income countries (LMICs) will need to focus their service delivery systems more heavily on NCDs and on integrated health services that address the multiple morbidities in older people. There is general agreement that much of the disability in older age is preventable or at least deferrable through a mix of health and social policies (Beard and Bloom, 2015; Mathers et al., 2015). This is important in all countries, but it is particularly important to address cost-effective means of health promotion and disease prevention in low-income settings before their still-developing health and health financing systems are overwhelmed by the burden of treating older people with NCDs and associated disabilities. Countries seeking to move more rapidly towards UHC or maintain their current achievements will face continuing demands to raise additional financial resources. They do this in the face of a slowdown in development assistance generally, and development assistance for health since the financial crisis hit the richer countries in 2009. Many have moved away from the target of 0.7 per cent of gross national income to be spent on development assistance. Universal health coverage UHC is now widely understood as the ambition to ensure that all people obtain the health services they need (promotion, prevention, treatment, rehabilitation and palliation) without suffering financial catastrophe or being impoverished because of the need to pay out of pocket at the time they receive them (WHO, 2010). Some countries will move faster than others and some are already closer to this ideal than others. However, it is a process of progressive realisation in which all countries, richer and poorer, can take steps to increase the number of people covered, expand the health services they obtain and/or strengthen the financial protection people receive, or at least ensure that they do not move backwards (ibid). 10 Commonwealth Health Partnerships 2015 Riccardo Mayer / Shutterstock.com
Commonwealth Health Partnerships 2015
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