On Wednesday May 22 2019, the NCD Synergies team, in partnership with the Program in Global NCDs and Social Change and Program in Global Surgery and Social Change at Harvard Medical School, The Kletjian Foundation and the Leona M. & Harry B. Helmsley Charitable Trust, hosted a two-hour side-event during the 72nd World Health Assembly in Geneva, Switzerland. Over 140 people attended the event, including high-level participation from the Ministries of Health of Rwanda and Malawi, WHO, and a vast range of global health funders, academic partners and peer organizations.
The event focused on essential components of UHC delivery needed for the implementation of comprehensive care, many of which constitute some of the largest funding and delivery gaps currently in global health.
A full livestream of the event is available here:
We were fortunate to be joined by Dr. Gina Agiostradiou, Director of the Type 1 Diabetes Program at the Helmsley Charitable Trust and The Honorable Minister of State for Public Health and Primary Health Care of Rwanda Dr. Patrick Ndimubanzi. Both speakers called for decentralized and integrated delivery strategies that encompass the full extent of medical and surgical needs across the health system. The Honorable Minister shared formative lessons from Rwanda during the HIV/AIDS epidemic – in order to provide equitable care to everyone across all conditions, it is essential that the poorest and most vulnerable are prioritized.
The event then paused to share a video narrative of Dipesh Rai, a young man living in rural Nepal with rheumatic heart disease. Stories like Dipesh are the most instructive for our policy discussions on UHC, but he, and so many other patients, care providers and family members are not able to participate in global dialogues in Geneva due to structural and financial barriers. We need to make sure that those individuals from remote and lower-resource settings are included and heard in global advocacy discussions.
Next, Dr. Gene Bukhman, Director of the NCD Synergies Project and the Program in Global NCDs and Social Change at Harvard Medical School drew attention to gaps in prioritizing care for the poorest and most vulnerable in the NCD and UHC global agendas, leading into “Bridging the Gaps in UHC – Patient, Care Provider, and Health System Perspectives Discussion” moderated by Dr. Alishya Mayfield.
- Mr. Joab Wako, TransplantEd (Kenya)
- Dr. Maria Jose Pires Machai, FHI 360 (Mozambique)
- Mr. William Osseus, Zanmi Lasante/Partners In Health Haiti
- Ms. Marie Ketty Tout Puissant, Zamni Lasante/Partners In Health Haiti
- Dr. Jones Masiye, Ministry of Health, Malawi
- Dr. Teri Reynolds, World Health Organization
This panel deliberately highlighted a range of perspectives spanning the health care system, from patients, community health workers, clinicians, and national and global policy makers. Through rich discussion, panelists shared their experiences and presented their recommendations for achieving equitable care, especially regarding access to diagnostics, medicines, and treatment at a low-cost. Mr. Joab Wako, a patient advocate from Kenya living with chronic kidney disease, and Executive Director of TransplantEd Kenya, explained:
“Since my kidney transplant, it’s like day and night. Other patients who are stuck on dialysis deserve to feel like this. A transplant isn’t a cure, it’s a treatment – but everyone who needs it should have access to it. I wish everyone in the community had the same access to treatment that I had.”
Mr. William Osseus, a Community Health Worker supervisor and Ms. Marie Ketty Tout Puissant, a nurse leader joined us from Zanmi Lasante, PIH’s sister organization in Haiti boldly stating that delivery of care in possible and feasible. Mr. Osseus shared:
“Sometimes, I walk four hours each way to reach all of my patients. We work to bring healthcare to everyone no matter where they live.”
Dr. Jones Masiye, Deputy Director of Clinical Services at the Ministry of Health in Malawi, closed the discussion by sharing his key ask for UN/WHO community in the lead up to the HLM on UHC:
“If I had just one recommendation, it would be to invest in human resources for health. We must build up this capacity to bring care closer to where people live.”
Dr. John Meara, Director of the Program in Global Surgery and Social Change, provided closing remarks, thanked the panelists for their courage in sharing their personal stories and reiterated the need for a “social reconstruction in health care delivery.”
In featuring the voices of those directly affected by what member states and the global community are striving to achieve when it comes to ambitions around UHC, the discussion on Wednesday was a stark reality check on what is truly needed to achieve equitable care from the community to the hospital.