Integration: build robust GHS capacities into comprehensive UHC systems Because national systems “lack interconnectivity”, decision makers and health experts struggle to work across the resulting “self-protecting silos” of health specialties, which are sometimes purposefully kept distinct to prioritise one area of the health system over another.55 Subsequently, poor communication and collaboration across institutions and national health systems means that unifying GHS and UHC policies at all levels of governance is a monumental challenge.
However, analyses offer important insights on where synergies might be possible. Both GHS and UHC mitigate risk, obligate states to realise a human right to health, can be supported through efforts to strengthen health systems, and overlap in their focus on health workforce, access to medicines, and financing or financial risk protection. It is well understood that the skills and infrastructure needed for the two systems are mutually reinforcing; an opportunity exists to re-examine obvious areas, such as fortifying the national surge capacity of the health workforce as a connection between prevention and health-care delivery or integrating emergency health information systems with routine surveillance networks and other national databases. Notably, countries with a poor track record of UHC, such as the USA and Ireland, have begun implementing UHC-style policies for outbreak response, including leveraging federal funds to provide COVID-19 testing that is universally free.
These actions also suggest that the crisis might offer an opportunity to embrace reforms for UHC as a foundation for health systems that are unified and sufficiently publicly funded. This opportunity reflects the WHO conceptual framework that portrays a cyclical relationship between quality UHC and GHS, with the pattern appearing to hold true during the ongoing COVID-19 response across low-income, middle-income, and high-income countries.
Source : Lancet