In the Asia-Pacific, like in many other regions, country governments are focused on achieving the United Nations’ Sustainable Development Goals (SDGs), particularly #3, which pertains to implementing Universal Healthcare Coverage (UHC) programs. This momentum accompanies a growing appreciation of the ‘health-to-wealth’ concept, by which a healthy population will help drive a country’s socio-economic growth.1
Unfortunately, due to the classic underfunding of health systems in the Asia-Pacific the UHC ambition alone represents a US$2 trillion investment.2 And we now have less than a decade to achieve the vision.
Yet, as our populations evolve, especially in a post-pandemic context, and health system structures become outdated, we wonder whether UHC alone is enough? The “S” in SDGs is hence key – ensuring that the decisions we make today for the design of health system financing and delivery are with a future generation in mind.
The gap is that many health reform initiatives focus solely on the demand side of things, often based on models from the west that were architected nearly a century ago. As average life expectancy has increased dramatically, pressure on national resources is being drained by increasingly older populations riddled with chronic disease, often in comorbid fashion. For instance, one can readily imagine the impact upon national health systems in some Pacific islands where diabetes prevalence is now as high as 40 percent.3 And, as COVID-19 has reminded us, we are certainly not out of the infectious disease trap either.
The paradox of advanced scientific knowledge, pitted against unattainable need, leaves healthcare as a primary driver of poverty. This is evident among those Asia-Pacific governments that now struggle to finance their healthcare systems, where it’s not uncommon to see citizens with out-of-pocket expenditures that represent 40% or more of the total healthcare costs.