The World Bank and WHO have noted significant disparities in healthcare services globally
The World Bank and the World Health Organisation have highlighted significant disparities in health provision on a global scale in a new report. Titled Tracking Universal Health Coverage: 2017 Global Monitoring shows the significant proportion who lack access to essential healthcare services, which has risen to 50% of the worldwide population.
Utilising 16 essential health services as indicators of the level and equity of coverage in countries, the report has highlighted that up to 100mn citizens are pushed into poverty as a result of escalating healthcare costs, with 800mn people regularly spending 10% of their household budgets on health expenses.
This has left many citizens left to choose between affording everyday necessities, such as education and food, or pay extortionate healthcare fees, leaving poor income families to live on just $1.90 per day.
"It is completely unacceptable that half the world still lacks coverage for the most essential health services," said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. "It is unnecessary.
“A solution exists: universal health coverage (UHC) which allows everyone to obtain the health services they need, when and where they need them, without facing financial hardship."
The notion of UHC is a hot topic within the healthcare industry at present, with the UHC Forum currently underway in Tokyo, Japan and over 100 countries in attendance. A key supporter in the development of UHC, the Government of Japan has sponsored the event in partnership with the Japan International Corporation Agency.
"The report makes clear that if we are serious – not just about better health outcomes, but also about ending poverty – we must urgently scale up our efforts on universal health coverage," commented World Bank Group President Dr. Jim Yong Kim.
"We need a fundamental shift in the way we mobilise resources for health and human capital. We are working on many fronts to help countries spend more and more effectively on people, and increase their progress towards universal health coverage."
On a positive note, the report has shown that the 21st century has seen an increase in the number of people able to obtain key health services, such as immunisation and family planning, as well as antiretroviral treatment for HIV and insecticide-treated bed nets to prevent malaria.
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Wide gaps of available healthcare services have been flagged within Sub-Saharan Africa and Southern Asia. Lack of financial protection means an increase in financial distress for families as they pay for these services out of their own pockets.
This has been flagged as a challenge even in affluent regions, such as Eastern Asia, Latin America and Europe. Inequalities in health services are seen not just between, but also within countries: national averages can shield low levels of health service coverage in disadvantaged population groups.
Universal Healthcare Coverage (UHC)
Building a robust, universal healthcare system is now seen as paramount to counteract rising healthcare costs on a global scale and place increased emphasis on quality. The UHC Forum 2017 is presently underway in Tokyo, where the
The Government of Japan has announced that it will contributing US$50mn to the multi-stakeholder, Global Financing Facility (GFF) partnership in support of Every Woman Every Child.
Launched in 2015, the GFF will explore and improve the health of women, children and adolescents, providing greater impact within the health, nutrition and well-being of women, children and adolescents.
The GFF Trust Fund is supported by the governments of Canada, Japan, Norway and the United Kingdom; the Bill & Melinda Gates Foundation; and MSD for Mothers.
Japan has stated that it contributions to the GFF Trust Fund will help countries close the financing gap for reproductive, maternal, new-born, child and adolescent health and nutrition, accelerate progress on UHC, and reach the Sustainable Development Goals (SDGs) by 2030. Last month, the GFF expanded to over 25 countries.
“This contribution from the Government of Japan will help countries accelerate progress on universal health coverage,” explained GFF Director Mariam Claeson.
“We look forward to broadening our partnership and collaboration with the Government of Japan as we work with countries to expand access to quality health care and ensure that no one becomes poorer paying for needed prevention and care.”
Long haul Covid, the brain and digital therapies
It is estimated that around 10% of people who get Covid-19 develop long haul Covid, a debilitating condition that can last many months and cause breathlessness, exhaustion and pain.
Research is underway to find out who is more likely to get it and how to treat it. Here neuroplasticity expert and owner of Harley Street Solutions in London Ashok Gupta tells us how the condition affects the brain.
What is long Covid exactly?
Long Covid is when patients who have experienced Covid-19 go on to have continuing symptoms for weeks and months afterwards. These symptoms can include breathlessness, exhaustion, brain fog, gastric issues, pain, and post-exertional malaise. It is estimated that around 10% of Covid-19 infections may result in developing long haul symptoms, and in the USA, this may be affecting over 3 million people.
How does it affect the brain?
Here at our clinic, we hypothesise that it is due to a malfunction in the unconscious brain, creating a conditioned response that keeps the body in a hyper-aroused state of defensiveness. At the core of this hypothesis is the idea that we are here because our nervous system and immune system have evolved to survive. We are survival machines!
When we encounter something such as Covid-19, the brain perceives it as life threatening, and rightly so. And in the era of the pandemic, with more stress, anxiety and social isolation, our immunity may be compromised, and therefore it may take longer for the immune system to fight off the virus and recover.
If the brain makes the decision that this is potentially life threatening and we get to the stage where we’re overcoming the virus, a legacy is left in the brain; it keeps over-responding to anything that reminds us of the virus. Even if we’ve fought off the virus, the brain will react in a precautionary way to stimuli reminiscent of the virus.
The brain may get stuck in that overprotective response, and keeps stimulating our nervous system and our immune system, just in case the virus may still be present.
What symptoms does this cause?
These signals cause a cascade of symptoms including breathlessness, extreme fatigue, brain fog, loss of taste or smell, headaches, and many others. And these are caused by our own immunes system.
In the case of long-haul Covid, symptoms in the body get detected by a hypersensitive brain which thinks we’re still in danger. The brain then chronically stimulates the immune and nervous systems, and then we have a continuation of a chronic set of symptoms.
This isn’t unique to long-haul Covid. Many patients develop chronic fatigue syndrome, sometimes known as “ME”, for example, after the flu, a stomach bug, or respiratory illness. Covid-19 may be a severe trigger of a form of chronic fatigue syndrome or ME.
How does long-haul Covid affect mental health?
Anxiety is a very common symptom in long haulers. It can be frightening to wonder about what may be happening in your body, and what the prognosis is going to be for one’s long term health. Reaching out for support for mental health is crucial for long-haulers.
How does neuroplasticity treatment work for long-haul COVID patients?
We have been working with patients for two decades with a brain retraining programme using neuroplasticity or “limbic retraining.”
We believe that through neural rewiring, the brain can be “persuaded” that we are no longer in danger and to come back to homeostasis. But to be very clear, we are not saying it is psychological in any way, but we believe there are novel ways of accessing the unconscious brain.
We recently worked successfully with a 56-year-old male with long-haul Covid, who prior to contracting Covid-19 in March of 2020 was running half-marathons and cycling, but afterwards he struggled to get off the sofa for months. Within 3 months he’s now back to 100% and running half marathons again.
At our clinic, we train the patient to be able to recognise those subtle unconscious danger signals on the periphery of consciousness. This, coupled with supportive techniques and the natural hallmarks of good health such as sleep and diet help prepare the patient to respond to perceived threats that might trigger the response.
The natural state of our brain is to default to protection. The brain prioritises survival and passing on our genes to the next generation, over any other impulse. It cares more about that than you feeling healthy and well. Protective responses are evolutionary, and are the right thing for the brain to do – it’s survival.
What digital therapies or apps are proving effective at treating long-haul Covid?
It seems that long haul patients are availing themselves of many online therapies and services, including meditation apps and wellness websites. We have an online neuroplasticity “brain retraining” video course called the “Gupta Program” which hosts 15 interactive videos and many audio exercises. This is proving very popular with long haul patients, and we are currently conducting a trial to test the effectiveness of this therapy.
What is the danger of leaving long-haul Covid untreated?
The longer it goes untreated, we hypothesise that it may become more entrenched in the brain, and become chronic in the longer term. Therefore we advise all patients to get help and advice as soon as possible.