The future of healthcare (1)

QATAR has been in the news in recent times on issues surrounding its hosting of the World Cup football tournament in 2022.

However, what is not known is that Qatar is also undergoing an economic and social revolution that we could learn from as a country ourselves. It is a progressive Gulf State making major strides in the areas of Education and Healthcare.

The Emir of Qatar set up the Qatar Foundation a few years ago as an independent organisation. It was set up as a Foundation for Education, Science and Community Development.

The Foundation is a private, non-profit organisation that is supporting Qatar on its journey from a carbon economy to a knowledge economy by unlocking human potential for the benefit of not only Qatar but the world.

Founded in 1995 by his Highness Sheikh Hammad Bin Khalifa, Al Thani the Emir of Qatar, Qatar Foundation is chaired by Her Highness Sheikha Moza Bin Nasser. She established WISH – an acronym for World Innovation Summit for Healthcare.

Health services all over the world have to evolve to cope with changing demographics, in particular the ageing population, the growing burden of chronic diseases and economic pressures on states.

We, therefore, need creative ideas and answers to these problems but even more importantly, we need to develop means of disseminating these new ideas so they are taken up rapidly across the globe.

WISH was established to help the process of disseminating ideas and new ways of working rapidly and effectively by bringing together some of the world’s leading innovation experts and eminent figures from across the world.

I was invited to the second WISH summit in Doha, Qatar by the Qatar Foundation several weeks ago to represent Nigeria in this major global Healthcare Summit. The inaugural WISH summit was held in Doha in 2013. WISH 2015 was attended by over 1000 experts from around the world.

These included policy makers, academics and industry leaders. The future of healthcare is already here, it’s just unevenly distributed.

It is aimed that WISH will work alongside WHO (World Health Organisation) in helping to shape healthcare delivery across the world.

At this year’s summit were 30 Health Ministers from across the world, a couple of Heads of States, members of various Royal families and other leading government officials. This year’s meeting reviewed key reports from the summit of 2013.

It also focused on current and pressing global health problems facing humanity. As was agreed by the conference, the spread and devastation of the EBOLA virus as demonstrated over the past year, the case for strengthening global cooperation on health issues has never been stronger.

Ebola is just one of the alarming health challenges that humanity now faces. Such challenges threaten to outpace and overwhelm healthcare systems around the world, if not addressed in innovative global and collaborative ways. Education and communication are key components of such collaborations.

In this article I will go through some of the major highlights of the meeting and suggestions on various ways in which healthcare delivery can be improved around the world. The following were the main highlights of the 2015 summit.

Universal health coverage
It is interesting that the case for Universal Health Coverage (UHC) reared its head again at WISH 2015. Who can forget the big debate going on in the United States of America with President Barack Obama’s administration, with the president championing Universal Health Coverage (UHC) for Americans where around 40 million Americans have no health insurance coverage.

The summit reviewed the Universal Health Coverage report titled Delivering Universal Health Coverage – A Guide For Policy Makers. The report was presented by Professor David Nicholson, former Head of the National Health Service (NHS) in the UK.

The summit agreed that UHC is an idea whose time has come. Over one billion people worldwide still lack access to basic healthcare.

In response to this challenge, the United Nations General Assembly passed a resolution unanimously in December 2012. It called on all countries to plan or pursue the transition of their health systems toward universal coverage.

More recently, governments, the World Bank, the WHO and civil society organisations have been calling for UHC to be included in a post-2015 global sustainable development goal.

Universal Health Coverage is a simple idea. WHO defines its goal as: To ensure that all people obtain the health services they need without suffering financial hardship when paying for them. According to the WHO Director-General, UHC is the single most powerful concept that public health has to offer. Even the President of the World Bank has gone on record to say, “We must be the generation that delivers Universal Health Coverage”.

This consensus has arisen as a mounting body of evidence shows that UHC can deliver significant benefits for individuals in terms of health services and protection from financial ruin caused by ill-health; for countries as a whole in terms of population health and contribution to economic growth; and for politicians who successfully lead to its introduction. The main problem with UHC is how best to design and implement it as this is extremely difficult.

The report by Sir Nicholson summarises the evidence around some of the critical policy choices and issues related to UHC and addresses:

• What to cover: This refers to what aspects of health care do you cover for the general population. The choices and trade-offs policy makers, make between the dimensions of population coverage, service coverage and financial protection.

• How to pay for UHC: How does a state raise the necessary resources, then allocating and managing these resources efficiently and equitably.

• How to implement UHC: The issues that need to be addressed to implement UHC reforms successfully.

• The key policy recommendations of the report which I will suggest to Nigeria to adopt are as follows:

• Countries should give a high priority to achieving full population coverage of an affordable package of services rather than covering selected population groups with more generous packages of services and leaving some people relatively uncovered.

• It is only through publicly-governed mandatory financing mechanisms (general taxation and social health insurance contributions) that compel wealthier and healthier members of the society to subsidise the poor and the vulnerable. Financing systems dominated by private voluntary financing is very unlikely to help achieve UHC.

• The transition period towards UHC may well be faced with strong opposition from political opponents as has been witnessed in the USA. It requires the strong will of the head of state to see it through.

As for Nigeria, I will strongly suggest the government leads with this. It will require health economists and key members of the Health Care community to help implement it.

• To be continued.

• Izegbu is professor of urological surgery.