Proceedings of the 13th Meeting of the
COMCEC Poverty Alleviation Working Group
18
Dr. BOU HAKA began her presentation by mentioning 13th General Programme of Work
2019−2023 (GPW 13) of the World Health Organization (WHO). The Programme identifies for the
next five years three interconnected strategic priorities and ambitious goals related to the 2030
Agenda for Sustainable Development. This presentation covers mainly the strategic priority of
achieving universal health coverage (UHC) and its related goal: to ensure that 1 billion more people
benefit from UHC.
UHC cuts across the health-related SDGs and impacts on multiple other SDG targets. Progressively
advancing towards UHC is a political choice with important social and economic benefits. UHC has
three dimensions, Dr. BOU HAKA mentioned in her presentation; population coverage, service
coverage and financial protection. Important progress has been made in developing methods to
measure it, but there are still limitations. Currently, UHC measurement focuses on two SDG
indicators: 3.8.11 on service coverage and 3.8.22 on financial protection.
Dr. BOU HAKA continued her presentation with the development in the Eastern Mediterranean
Region (EMR). EMR is home to over 650 million people living in 22 countries with highly diverse
socioeconomic and geopolitical environments. In 2015, average gross domestic product (GDP) per
capita in the Region was US$ 12 120. The Region faces emergencies on an unprecedented scale, due
to political conflict as well its propensity to epidemic- and pandemic-prone diseases. Almost 30
million displaced persons - more than half of all displaced persons globally - originate from the
Region.
In EMR, while some countries have made remarkable progress in generating high-quality data,
there is a lack of reliable, timely and comparable information across countries. Challenges include
weak civil registration systems, limited population-based surveys, poor quality data from health
facilities, lack of disaggregated data, and fragmented data collection systems. Strengthening
national health information systems must therefore be a key aim in the context of the SDGs.
Progress in the region is demonstrated albeit with lots of variability and lack of consistency. Several
Member States have developed a national vision for UHC or necessary legislation and/or strategies.
Despite fiscal challenges, Member States are using public funds and developing prepayment
mechanisms towards UHC but the Region as a whole is a low investor in health, accounting for 1.9%
of global health expenditure for 8.6% of the world’s population in 2015. Insufficient public funding
for health, non-existent or dysfunctional prepayment mechanisms and inefficient use of scarce
financial resources continue to compromise health system performance in several countries. For
the past 15 years, around 40% of health spending in the Region has come from out-of-pocket
payments. As a result, around 55.5 million individuals face catastrophic health spending and 7.7
million are impoverished each year (2010).
She stated that the Member States have pursued diverse explicit/implicit service packages. Most
countries in emergencies have developed explicit minimum service packages that facilitate
resource mobilization. There is a growing understanding that improvements in access to health
services without commensurate attention to quality will not lead to the desired population health
outcomes. Challenges in improving quality and safety in the Region include insufficient leadership