GHS and UHC tend to have different policies in practice athough not mutually exclusive . Thus far, countries with policies that are closely aligned with both frameworks have generally fared better and might be better equipped to recover after COVID-19 compared with nations with health systems that are not aligned to both frameworks, which could struggle to cope with challenges in the long term. Importantly, health systems that successfully integrated GHS core capacities with PHC services have been particularly effective at mitigating the effects of COVID-19.
For example, Veneto province, Italy, leveraged its UHC system while applying historical expertise in control of infectious diseases. Despite early community transmission, Veneto did substantially better in controlling the pandemic than did other regions of Italy, specifically Lombardy. This difference is most likely due to public health measures, such as extensive testing and proactive screening, and strong clinical measures, such as home diagnosis and care, supported front-line health workers, decreased fragmentation of privatised medical services, and robust coordination between decentralised PHC centres. Meanwhile, Taiwan, Vietnam, Hong Kong, South Korea, and Thailand instituted strict physical distancing and public health communications, and their roots in UHC have ensured swift control of the pandemic to date. Taiwan’s 99·9% coverage of national health insurance enabled comprehensive epidemic prevention, integrated medical data, unified information platforms, and safety nets for vulnerable populations.
Advancements in UHC helped Vietnam to safeguard the government– citizen cooperation that was needed to foster a culture of surveillance and comprehensive contact tracing where mass testing was improbable.39 Singapore leveraged public health infrastructure, innovative diagnostics, PHC physicians who were trained for outbreaks, and no-cost screening, testing, and treatment. In Kerala, India, over 30 000 health workers engaged effectively in the emergency response, including in early detection, expansive contact tracing, risk communication, and community engagement. To complement this engagement, Kerala’s commitment to broad social protection through investments in education and UHC included temporary shelters for stranded migrant workers, cooked meals for people in need, increased internet capacity, and advanced pensions. Finally, Costa Rica has been praised for initially having one of the lowest rates of COVID-19 case fatality in the the Americas, which was largely attributable to its robust universal health system, rapid response led by top national leaders, and strong institutional support from both public and private organisations.
Source : Lancet Publication