Nach den MDGs: Universal Health Coverage als Schlüssel?

Ende 2015 laufen die Millenniumsentwicklungsziele (MDGs) aus. Ein fünfzehnjähriges, globales Engagement, um die Situation für die Ärmsten Menschen der Erde zu verbessern, läuft aus. Der Erfolg der MDGs ist weitgehend unbestritten – und so denkt die UNO darüber nach, dieses globale Engagement in irgendeiner Form weiterzuführen. Dieses Jahr hat der umfassende Konsultationsprozess dazu begonnen.

Die jetzt beginnende Debatte über die Nach-MDG-Ära bringt natürlich und richtigerweise die verschiedenen Interessengruppen ins Spiel – auch im Gesundheitsbereich. Soll ein neuer Fokus auf die Bekämpfung der chronischen Krankheiten gelegt werden, soll HIV weiter eine zentrale Rolle in der globalen Gesundheit spielen oder fokussieren wir uns künftig auf die Mutter-Kind-Gesundheit? Alles berechtigte Anliegen – nur leisten sie der weiteren Fragmentierung der globalen Gesundheit Vorschub.

Bereits vor zwei Jahren publizierte die WHO den Weltgesundheitsbericht zur Gesundheitsfinanzierung, in welchem sie das Konzept der „Universal Health Coverage“ (UHC) zu stärken versucht. In einem kürzliche publizierten Diskussionspapier bringt sie nun UHC ins Spiel, um die verschiedenen Interessen unter einem gemeinsamen Dach nach 2015 zu verankern.

UHC umfasst die Bereitstellung der notwendigen Gesundheitsinfrastruktur, den Zugang zu derselben wie auch die sozialen Sicherungs- und Finanzierungssysteme für die Nutzung der Gesundheitsversorgung. Nach der Definition der WHO-Mitgliedstaaten soll die „universal coverage“ allen Menschen den Zugang zu den benötigten Gesundheitsdiensten – Vorbeugung, Behandlung und Rehabilitation – garantieren, ohne dass dadurch jemand riskiert, finanziell an den Abgrund zu gelangen.

Das bestechende an diesem Konzept liegt darin, dass es sich um einen umfassenden Ansatz handelt und damit direkt an die Visionen von Alma Ata anknüpft, um die Basisgesundheitsversorgung zu stärken.

Martin Leschhorn Strebel
Mitglied der Geschäftsleitung

Focus: Universal Health Coverage
Network Health for All: What's up
Network MMS: News
International Health and more: Issues, Debates, Tools

Focus: Universal Health Coverage

Universal Health Coverage: Ensuring that all people have access to needed promotive, preventive, curative and rehabilitative health services
WHO on UHC
"Good health is essential to sustained economic and social development and poverty reduction. Access to needed health services is crucial for maintaining and improving health. At the same time, people need to be protected from being pushed into poverty because of the cost of health care. Universal health coverage is defined as ensuring that all people have access to needed promotive, preventive, curative and rehabilitative health services, of sufficient quality to be effective, while also ensuring that people do not suffer financial hardship when paying for these services. Universal health coverage has therefore become a major goal for health reform in many countries and a priority objective of WHO."
http://www.who.int/topics/universal_health_coverage/en/

Positioning Health in the Post-2015 Development Agenda
WHO discussion paper, October 2012
WHO | "This note is by the World Health Organization (WHO) is intended as a discussion paper on the position of health in the post-2015 agenda. This paper focuses on content, identifying a series of issues that need to be addressed in framing future health goals and discussing ways in which Universal Health Coverage might be used as a way of bringing all programmatic interests under an inclusive umbrella and explaining its relationship to the achievement of gains in healthy life expectancy. The purpose of these papers is to provoke discussion rather than present definitive positions. They will be revised and updated as the process evolves."
http://www.worldwewant2015.org/file/279357/download/302852

Health in the post-2015 UN development agenda
MMI's Thematic Guide
MMI | "In the current Millennium Development framework (MDGs) three out of the eight goals directly refer to health conditions (reduce child mortality; improve maternal health; combat HIV/AIDS, malaria, and other diseases). But what will be the role of health in the development agenda beyond 2015? This thematic guide - as part of our global health policy and governance guide - leads you to key institutions and resources involved in the development of a post MDG (health) agenda. This collection is still "under construction"."
http://bit.ly/Pm562K

Universal Health Coverage: a shared vision beyond 2015?
MMS | The existing fragmentation of the global health advocacy community is worrying. To overcome this situation people of the health community should agree on an overall understanding on what they want. Universal Health Coverage could work as a common, holistic concept for integrating the global movement for health, writes Thomas Schwarz in the MMS Bulletin.
http://bit.ly/QgXYEU

Network Health for All: What's up

MMS Symposium 2012: Mother and child health in developing countries
Basel, 6 November 2012
(E) MMS | Mother and child health is one of the factors that have a primary impact on social development in developing countries. Nevertheless, some 360,000 women still die every year during pregnancy or while giving birth. Furthermore, 7.6 million under-fives die every year too. In recent years, significant progress has been made in improving the health of mothers and children. Infant and maternal mortality have both fallen at global level. This year’s symposium organized by the Medicus Mundi Switzerland network will take a closer look. What is being done in international politics to further improve the situation? What strategies are effective? How can women and expectant mothers be given better access to healthcare provision?
http://www.medicusmundi.ch/mms-en/services/events/Symposium2012

75 Jahre medico international schweiz
Zürich, 17. November 2012
medico international schweiz | Wir laden ein zu einem Tag voller Erlebnisse und Begegnungen. Den Auftakt macht ein Konzert des Chors kreisch drei, weiter geht es mit einem Parcours durch Orte des solidarischen Handelns in Zürich, am Abend folgt eine Podiumsdiskussion und schliesslich ein Fest mit Fotoausstellung, Essen und Musik im Kulturmarkt. Eintritt frei, Kollekte.
http://medicointernational.ch/

A generation at risk: psychosocial support for Africa’s children
Basel, 4 December 2012
(E) Novartis Foundation | Over 16 million children worldwide have lost one or both parents to HIV and AIDS, and most of them live in sub-Saharan Africa. In addition to those affected by chronic illness and death, many other children are confronted by the challenges of poverty and conflict. These vulnerable children face material hardship, socio-economic disadvantage, social stigma, emotional isolation and psychological trauma. Such consequences carry far-reaching social effects for many countries, and pose a threat to longer-term development. We risk losing a generation of children made vulnerable by poverty, conflict, HIV and AIDS. This year’s Novartis Foundation Symposium invites esteemed speakers and experts to assess and discuss different psychosocial approaches. You can register now for free at:
http://www.novartisfoundation.org/symposium

aidsfocus.ch: The Global Fund and Civil Society
Bern, 12 December 2012
aidsfocus.ch | The Global Fund and Civil Society will be in the focus of the thematic part of the Annual Meeting 2012. Christoph Benn, Director, Resource Mobilization and Donor Relation Division, The Global Fund, accepted the invitation to share with us recent information on the Global Fund to Fight AIDS, TB and Malaria and to join in the discussion on the roles, opportunities and challenges of Civil Society in shaping the Global Fund. This will be a great opportunity for all of us to get first hand expert information from a high level official in the Global Fund and former Civil Society activist and a chance to ask questions, discuss and share ideas and concerns. Input and discussion with Dr Christoph Benn, Director, Resource Mobilization and Donor Relation Division, Global Fund, and Linda Mafu, Head of Political and Civil Society Advocacy, Global Fund (former Executive Director of World AIDS Campaign, and Treatment Action Campaign).
http://www.aidsfocus.ch/platform/Event.2012-09-24.3544

The 19th Swiss International Short Course on Travellers' Health
Basel, 28 January - 1 February 2013
Swiss TPH | "This 1-week course provides up-to-date information on tropical diseases and their medical treatment. It is mainly designed for participants from industrialised countries, who need to provide reliable information and advice for travellers, and to assess travel-related problems that occur in patients who have returned from tropical countries. The course is organised in collaboration with other Swiss and German institutes, under the patronage of the International Society of Travel Medicine, the WHO, and the Swiss Society for Tropical Medicine."
http://www.swisstph.ch/teaching/professional-postgraduate/travellers-health.html

Health Care and Management in Tropical Countries
Basel, 11 March - 14 June 2013
Swiss TPH | "This 3 months full time course aims at introducing participants to the fundamentals of international health with a range of skills and knowledge needed to work as a member of a district management team. The participatory course is designed for people who already have a first qualification in a health-related profession, and at least two years professional experience."
http://www.swisstph.ch/teaching/professional-postgraduate/hcmtc.html

How to plan successfully? A focus on priority setting, resource allocation and strategic planning
Basel, 17 June - 5 July 2013
Swiss TPH | This intense course aims on enabling the students to plan health projects and programmes, based on systematic analyses of the respective setting. It focuses on practical aspects of the planning and implementation process, using the techniques of a simulation exercise and computer based support. At the end a full project proposal is produced.
http://bit.ly/P60rX4

Network MMS: News

Jordanien: Vorbereitung der Winterhilfe für syrische Flüchtlinge
Schweizerisches Rotes Kreuz beteiligt sich an Hilfsprogramm
(D) SRK | Bereits sind schätzungsweise 200‘000 syrische Flüchtlinge in Jordanien eingetroffen und deren Zahl steigt täglich an. Logistiker des Schweizerischen Roten Kreuzes (SRK) bereiten eine Verteilaktion von Hilfsgütern vor. Dabei unterstützen sie den Jordanischen Roten Halbmond.
http://www.redcross.ch/activities/international/news/news-de.php?newsid=1607

"Good global health begins at home"
Federal Councillor Alain Berset in India
FDHA | "Health has never really known borders when it comes to infectious diseases. But at the same time, health care systems and health policy were for a long time largely national. Today, the markets for health goods and personnel have become largely globalized. This leads to the need for increased and improved international cooperation," said the Minister of Home Affairs, Federal Councillor Alain Berset in a speech he adressed to the "Public Health Foundation of India".
http://www.news.admin.ch/message/index.html?lang=de&msg-id=46184

FAIRMED: Gass folgt auf von Stamm
FAIRMED | Bei FAIRMED hat Thomas Gass am 1. Oktober 2012 die Nachfolge von Thomas von Stamm als Leiter des Bereichs Programme angetreten. FAIRMED unterstützt Gesundheitsprogramme in Indien, Sri Lanka, Nepal, Kamerun, Elfenbeinküste und Zentralafrikanische Republik. Kontakt:
mailto://thomas.gass@fairmed.ch

In the shadow of HIV: Tuberculosis
SolidarMed's Magazine in English
Lesotho SolidarMed | The donors magazine of SolidarMed is now also available in English. In the current issue is about the dual epidemic of TB and HIV in Lesotho. You will also find in it an interview on the subject with Dr. Nilaus Labhardt. (pdf)
http://bit.ly/SeyJUN

International Health and more: Issues, Debates, Tools

Strategies to improve health coverage and narrow the equity gap in child survival, health, and nutrition
The Lancet | "Implementation of innovative strategies to improve coverage of evidence-based interventions, especially in the most marginalised populations, is a key focus of policy makers and planners aiming to improve child survival, health, and nutrition. We present a three-step approach to improvement of the eff ective coverage of essential interventions. (...) Although knowledge gaps exist, several strategies show promise for improving coverage of effective interventions - and, in some cases, health outcomes in children - including expanded roles for lay health workers, task shifting, reduction of financial barriers, increases in human-resource availability and geographical access, and use of the private sector. Policy makers and planners should be informed of this evidence as they choose strategies in which to invest their scarce resources," write Mickey Chopas and colleagues in The Lancet.
http://bit.ly/OdLyC1

Polio Eradication – A Reflection on the Darfur Campaign
Challenges of an Immunization Campaign
Sudan IPS | "In June 2004, the Global Polio Eradication Initiative (GPEI) led by WHO, Rotary International, U.S. Centres for Disease Control and UNICEF warned that the polio virus was spreading at an alarming rate across West and Central Africa. In May 2004, it was confirmed that a child was paralysed by polio in Darfur. This was a complex emergency; a simmering conflict, combined with hunger, malnutrition, lack of access to clean water, sanitation, health and other basic services made survival itself a challenge. (...) The Global Polio Eradication Initiative (GPEI) had served as a bridge, an entry point and a disease control strategy for reaching the unreached and most vulnerable. The lesson learned is that it is possible to immunise children even in complex emergencies and conflict settings," writes Siddharth Chatterjee, International Federtion of Red Cross and Red Crescent Associations on IPS.
http://bit.ly/SDvGtS