The COVID-19 pandemic focuses attention on the resilience of our health systems and challenges the health policies of our Member States and their effectiveness. In addition, doctors, health professionals and all care providers are under unprecedented pressure. Do we have sufficient medical facilities and supplies to respond to the emergency, even when strict containment measures are in place? Can the right of everyone to the enjoyment of the highest attainable standard of physical and mental health be realized in the current situation? Are caregivers sufficiently protected and can they bear the very heavy responsibility that falls on their shoulders? In the midst of this tragic pandemic, we cannot pretend to have all the answers to these existential questions. What we can do, however, is to remind us of some of the characteristics that a health system must have if it is to meet the needs of the entire population and maintain its capacity to deal with public health emergencies.
It is clear that everyone has the right to the protection of their health against a pandemic. The realization of this right requires universal health coverage. Broader social protection measures are needed to reduce persistent health inequalities. A special focus on gender contributes greatly to the effectiveness of responses. The creation of inclusive and resilient health systems, which is likely to take place in the context of a new period of austerity, should help to avoid the adverse effects on the right to health observed during the economic crisis of the previous decade.
Universal health coverage
The realization of the right to health is often seen as a question of access to health care. During my visit to Greece in 2018, I witnessed the negative impact of austerity measures administered over a long period of time on the accessibility and costs of care. I urged the authorities to remove obstacles to the implementation of universal medical coverage and to intensify their efforts to recruit medical staff. Achieving universal health coverage is one of the targets of United Nations Sustainable Development Goal 3 (enabling all people to live in good health and promoting the well-being of all people at all ages). According to the World Health Organization (WHO), universal health coverage is a situation in which all individuals and communities have access to the health services they need without facing financial hardship. It encompasses the full range of quality essential health services, including health promotion, prevention, treatment, rehabilitation and palliative care.
Efforts to achieve universal health coverage were given new impetus on 10 October 2019, when the United Nations General Assembly adopted a high-level political declaration entitled “Universal Health Coverage: Working Together for a Healthier World”, after it was endorsed by world leaders in September. The declaration recognizes that health contributes to the promotion and protection of human rights and commits states to ensure that an additional 1 billion people have access to quality essential health services by 2023, with a view to achieving universal coverage by 2030. The Declaration also emphasizes that strong and resilient health systems, capable of reaching people in vulnerable situations, ensure the necessary level of preparedness to respond to pandemics and provide effective care when needed.
It is important to note that the Declaration considers mental health and psychological well-being as an essential component of universal health coverage and stresses the need to fully respect the human rights of persons with mental health problems. Mental health professionals point out that the current pandemic is causing a parallel epidemic of fear, anxiety and depression. The environmental stress and containment measures necessitated by the pandemic are putting a strain on the mental health of the general population. People who were already experiencing mental health problems are at risk of worsening their condition, while opportunities to consult with ambulatory care specialists are increasingly limited. Patients in psychiatric hospitals are in a particularly vulnerable situation, caused by reduced access to care and increased risk of infection. Public Health England has issued detailed advice on how to protect mental health and well-being during the coronavirus outbreak.