Robert Yates

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A woman wearing a face mask campaigning for Medicare for All, near the Capitol in Washington D.C. (Photo by Probal Rashid/LightRocket via Getty Images).

Throughout recent history, even in the midst or aftermath of economic crises, political leaders have launched successful universal health reforms, bringing huge benefits to their populations and considerable political benefits for themselves.

New Chatham House research endorses the World Health Organization’s estimate that an additional one per cent of GDP for primary healthcare is a realistic target for countries aiming to launch universal health coverage (UHC) reforms. Today’s leaders, facing multiple troubles and in need of powerful political propositions, should take note.

Universal health coverage is achieved when everybody receives the health services they need without suffering financial hardship.

In reality, no country has reached this goal yet.…  Seguir leyendo »

Patients come to see Antoine Bissa, a nurse and the owner of a street pharmacy, in Bangui, Central African Republic, on 21 February 2022. Photo by BARBARA DEBOUT/AFP via Getty Images.

On the eve of the United Nations high-level meeting on universal health coverage (UHC), the World Bank and the World Health Organization (WHO) have published a sobering report which shows that the world is alarmingly off track to reaching the Sustainable Development Goal (SDG) target on achieving universal health coverage. The global UHC monitoring report highlights that 4.5 billion people – over half the world’s population – are not covered by essential health services and over 2 billion people suffer severe financial hardship when accessing health care.

Reforming health financing systems will play a vital role in improving these statistics and there is now a consensus among countries and global health agencies that public financing mechanisms are the best way to ensure that everyone can access and afford the health services they need.…  Seguir leyendo »

10 Downing Street in London, United Kingdom as seen on 05 September 2022 as Liz Truss was announced as the UK's next prime minister. Photo: Rasid Necati Aslim/Anadolu Agency/Getty Images.

It says something of the UK that the incoming prime minister has ordered a rewrite of British foreign policy barely 18 months after the last one was published.

Liz Truss, who has become the fourth prime minister in Downing Street in six turbulent years, is not prone to risk aversion or offering bland reassurances. She made clear during the campaign for the Conservative leadership that she wants the 2021 Integrated Review redrawn with a far greater focus on combating the ‘growing malign influence’ of Russia and China. She has also pledged to increase defence spending from its current 2.1 per cent of GDP, to 2.7 per cent, and then to 3 per cent by 2030, which will include more support for the intelligence services and cyber security, a further £10 billion overall at a time when public finances are in dire straits.…  Seguir leyendo »

UK prime minister Boris Johnson visits the Colosseum during the 2021 G20 summit in Rome, Italy. Photo by Jeff J Mitchell/Getty Images.

Success at Glasgow depends on bridging fault lines

Renata Dwan

The G20 summit’s lack of progress on climate highlights the scale of the challenge – and the stakes – for COP26.  The countries responsible for 80 per cent of global emissions recognized but failed to agree concrete action to limit global warming to 1.5C.

The leaders’ gathering reveals multilateralism’s fault lines. One is the tension between domestic politics and international priorities, reflected in the lack of ambition to reduce coal dependency.  The second is the tension between industrialized and developing states over responsibility for delivering global goods.

The G20 failed to endorse the G7’s pledge to achieve net zero emissions by 2050 or to accelerate the mobilization of previously agreed climate financing.…  Seguir leyendo »

Unloading a shipment of AstraZeneca COVID-19 vaccine in Abidjan, Ivory Coast sent using the COVAX global scheme to procure and distribute inoculations for free. Photo by SIA KAMBOU/AFP via Getty Images.

At the United Nations General Assembly (UNGA) in 2019 – practically on the eve of the COVID-19 pandemic – all countries committed themselves to the global development goal of universal health coverage (UHC), meaning all people across the world should receive health services according to their needs.

In the case of vaccines for infectious diseases, this should mean the most vulnerable – those most at risk of suffering serious adverse health impacts – would receive vaccines first, while those not needing vaccines urgently would go to the back of the queue. Little did the world then know that these principles of fairness and equity would be put to the test so quickly, or that the global community would fail so dismally in living up to them.…  Seguir leyendo »

The UK prime minister Boris Johnson receives his second jab of the Oxford/AstraZeneca COVID-19 vaccine. Photo by MATT DUNHAM/POOL/AFP via Getty Images.

The last time Boris Johnson held centre stage with the world’s media was when he was filmed trapped on that zip wire, waving union flags while promoting the London 2012 Olympics. That stunt and his rousing pre-games speech were generally deemed a public relations triumph, capturing the hopeful spirit of recovering from the global financial crash.

But the world is a very different place in 2021 – millions have died in the worst health crisis in more than a century, the global economy is in turmoil, and this year’s Olympics are still under question. So, as Boris Johnson welcomes G7 leaders to Cornwall, what the world needs now is not Flash Boris Johnson the showman, but instead Flash Boris Johnson the superhero who will help save the world.…  Seguir leyendo »

A street vendor arranging facemasks at his stall in Hyderabad, India. Photo by NOAH SEELAM/AFP via Getty Images.

What is causing this crisis in India?

Perhaps this is the first time in the pandemic we have seen a major health system close to collapsing under the strain of so many people requiring hospital care, although maybe Manaus in Brazil was a similar example. The accounts of people dying in queues as they try to access life-saving care or dying in hospitals which run out of oxygen is terrifying and extremely concerning. The response from the national and state governments has been very mixed.

In many respects, this is a consequence of India’s chronically under-funded health system with just over one per cent of GDP spent on public health financing.…  Seguir leyendo »

COVID-19 vaccination centre in Chertsey, England. Photo by Leon Neal/Getty Images.

As spring approaches in the northern hemisphere, there is growing anticipation 2021 will be the year the world conquers the coronavirus pandemic.

This optimism stems from the extraordinary collaborative efforts of scientists in discovering and testing six, safe and effective vaccines within a year of the first outbreak. But sadly, politics will be the biggest factor in determining whether and how vaccines are distributed around the world.

With new concerning variants of the coronavirus being reported on almost a weekly basis, the urgency to vaccinate as many of the world’s population is obvious and as pragmatic as it is altruistic.

But, despite the World Health Organisation (WHO) secretary-general Tedros Adhanom Ghebreyesus warning that 'no-one is safe until everyone is safe', most leaders are short-sightedly fixated on a race simply to cover their own populations first.…  Seguir leyendo »

Free healthcare initiative for pregnant women and children in Sierra Leone at Ola During Hospital, Freetown. Photo by Rob Yates.

COVID-19 is a universal threat against the health and wellbeing of all of us and therefore requires universal protective measures. Our best hope is to develop an effective vaccine, which logically should be given to everyone, to stop future outbreaks spreading and potentially eradicate the disease.

But, for the foreseeable future, as the virus spreads around the world and there is potential for people to be reinfected, this disease remains a threat to all of humanity. So, with such a deadly disease ever-present and able to flare up quickly, it is in all our interests that there is truly universal access to a full range of health services needed to tackle the disease.…  Seguir leyendo »

A "Big Insurance: Sick of It" rally in New York City. Photo by Mario Tama/Getty Images.

As the COVID-19 pandemic presents the greatest threat to human health in over a century, people turn to their states to resolve the crisis and protect their health, their livelihoods and their future well-being.

How leaders perform and respond to the pandemic is likely to define their premiership - and this therefore presents a tremendous opportunity to write themselves into the history books as a great leader, rescuing their people from a crisis. Just as Winston Churchill did in World War Two.

Following Churchill’s advice to “never let a good crisis go to waste”, if leaders take decisive action now, they may emerge from the COVID-19 crisis as a national hero.…  Seguir leyendo »

Builders work on an outside yard at the Nelson Mandela Children's Hospital in Johannesburg in 2016. Photo: Getty Images.

At the United Nations general assembly in September, all countries, including South Africa, reaffirmed their commitment to achieving universal health coverage by 2030. This is achieved when everybody accesses the health services they need without suffering financial hardship.

As governments outlined their universal health coverage plans, it was noticeable that some had made much faster progress than others, with some middle-income countries outperforming wealthier nations. For example, whereas Thailand, Ecuador and Georgia (with national incomes similar to South Africa) are covering their entire populations, in the United States, 30 million people still lack health insurance and expensive health bills are the biggest cause of personal bankruptcy.…  Seguir leyendo »

Despite protests and warnings of poor households not being able to access vital services, this policy was soon imposed across practically the whole of sub-Saharan Africa. But it was in Mali that a compromise was agreed on the charging of user fees, which perhaps had the biggest impact in ensuring it became standard practice across Africa. Called the Bamako Initiative, it argued that charging user fees could actually benefit the poor.

Laudable intentions failed miserably

The theory went that, if the local community had a role in setting fee rates and managing revolving drug funds (by patients being charged slightly above the wholesale price to maintain drug stocks) services would be affordable and quality maintained.…  Seguir leyendo »

Women admitted to the maternity ward at Roi Baudoin hospital in Kinshasa, DRC, are counselled by staff after having been detained for non-payment of medical fees. Photo: Getty Images.

Around the world, human-rights activists fight on behalf of people imprisoned in unsanitary jails and denied a fair trial. These victims often suffer the double indignity of being mistreated by their captors and deprived of basic services. In many countries, these abuses are not only taking places in prisons, but in hospitals, too.

A new Chatham House paper that I co-authored with Tom Brookes and Eloise Whitaker shows that up to hundreds of thousands of people are detained in hospitals against their will each year. Their crime? Being too poor to pay their medical bills. This phenomenon is particularly prevalent in several sub-Saharan African countries, notably Nigeria, Democratic Republic of Congo, Ghana, Cameroon, Zimbabwe, and Kenya, but there is also evidence of it in India and Indonesia.…  Seguir leyendo »

Most political leaders in high-income countries recognize that universal health coverage is popular. Photo by Getty Images.

In the extraordinary political battles in the UK and US in recent months, the issue of access to healthcare has been wielded to great effect. In the run-up to the UK’s 2015 general election, the Conservative government suddenly found £8 billion to inject into the nation’s beloved NHS. According to pro-Brexit campaigners, a year later, this would be dwarfed by the £350 million per week they claimed would be spent on the NHS were Britain to leave the EU. Meanwhile in the US, Senator Bernie Sanders’s extended campaign in the primaries was sustained by his commitment to bring healthcare to all Americans.…  Seguir leyendo »