May 17, 2020

Universal Health Coverage Day: Poverty Should No Longer Mean Poor Health

Global healthcare
Universal Health Coverag
4 min
In the poorest parts of sub-Saharan Africa, half the population does not have regular access to basic health care, according to USAID. (Joint Learning Network photo)
A new global coalition of more than 500 leading health and development organizations worldwide is urging governments to accelerate reform that ensure ev...

A new global coalition of more than 500 leading health and development organizations worldwide is urging governments to accelerate reform that ensure everyone, everywhere, can access quality health services without being forced into poverty.

The first ever Universal Health Coverage Day marks the two-year anniversary of a United Nations resolution, unanimously passed on Dec. 12, 2012, endorsing universal health coverage as a pillar of sustainable development and global security.

Despite progress in combating global killers such as HIV/AIDS and vaccine-preventable diseases such as measles and tetanus, the global gap between those who can access needed health services without fear of financial hardship and those who cannot is widening.

According to the World Health Organization (WHO), each year 100 million people fall into poverty because they or a family member becomes ill and have to pay for care out of their own pocket. Around one billion people worldwide can’t even access the health care they need, according to WHO, which is paving the way for disease outbreaks such as Ebola to become catastrophic epidemics.

“Ebola is only the most recent example of why universal health coverage is the most powerful concept in public health,” said Dr. Marie-Paule Kieny, Assistant Director-General for Health Systems and Innovation at WHO. “Investing in strong, equitable health systems is the only way to truly protect and improve lives, particularly in the face of emerging threats like the global rise of non-communicable diseases and increasingly severe natural disasters.”

Why Strong Health Systems are the Real Disease Fighters

When it comes to prominent global health initiatives, many of their successes can be attributed to an overlying factor: a functioning health system with the right resources, staffing, infrastructure and supplies.

“The problem is, then, that today far too many countries still have health systems that are, at best, dangerously weak or cobbled together inefficiently,” states the international advocacy organization ONE. “We need to keep pushing for improved infrastructure, for increased skilled health workers, and for more supplies to create robust health systems that keep people safe and, indeed, healthy.”

In order to achieve this:

  • Supply chains that transport medicines and other health interventions to clinics need to be improved.
  • New health clinics must be built (and existing ones improved) from which patients can receive care and treatment without the risk that having to pay for a service will render them into poverty.
  • Information technology systems that track and monitor health needs must be updated and strengthened.
  • Health workers need to have enough protective masks, gloves and other protective gear.
  • Clinics must have enough disease-testing kits and life-saving medicines to treat patients.
  • Training systems need to increased and improved upon so that there are enough skilled health workers in each country to meet the demands and needs.

The dangers of fragile health systems can be seen during this year’s Ebola outbreak. The health systems in Guinea, Sierra Leone and Liberia were too weak to control the disease, as clinics ran out of supplies and the few skilled health workers in those countries became overwhelmed by the increasing number of cases.

WHO recommends 23 doctors, nurses and midwives for every 10,000 people but Guinea had just one doctor, nurse or midwife for every 10,000 people and the figures for Sierra Leone and Liberia were even lower.

The challenges posed by workforce, infrastructure and supply shortages leave countries not only unable to properly respond to an outbreak, but also unable to meet the basic day-to-day needs of citizens.

In the poorest parts of Asia and sub-Saharan Africa, where health systems are the weakest, USAID estimates up to half the population does not have regular access to basic care and treatment.

“Funding the fight against the world’s deadliest diseases is vital, but it is equally important to ensure citizens can access the care and treatment for those diseases in reliable, sustainable ways,” states ONE.

Health for All, Everywhere

In the past two decades, a number of lower- and middle-class income countries have successfully embraced reforms to make quality health care universally available. Countries as diverse as Brazil, Ghana, Mexico, Rwanda, Turkey and Thailand have made tremendous progress toward universal health coverage in recent years, according to WHO.

Today, the two most populous countries, India and China, are pursuing universal health coverage and more than 80 countries have asked WHO for implementation assistance.

“Putting people’s health needs ahead of their ability to pay stems poverty and stimulates growth,” said Dr. Tim Evans, Senior Director for the Health, Nutrition and Population Global Practice at the World Bank Group. “Universal health coverage is an essential ingredient to end extreme poverty and boost shared prosperity within a generation.”

“The need for equitable access to quality health care has never been greater, and there is unprecedented demand for universal health coverage around the world,” said Michael Myers, Managing Director of The Rockefeller Foundation, which is spearheading Universal Health Coverage Day. “Universal health coverage is an idea whose time has come – because health for all saves lives, strengthens nations and is achievable and affordable for every country.”

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Jun 13, 2021

How healthcare can safeguard itself against cyberthreats

Jonathan Miles
6 min
Jonathan Miles, Head of Strategic Intelligence and Security Research at Mimecast, tells us how the healthcare sector can protect itself from attacks

One of the most fundamental lessons from the COVID crisis is that health should always be a priority.  In a similar fashion to the human body that frequently fights off viruses and foreign invaders that intend to cause it harm, the sector itself is now a prime target for another type of external threat: cyberattacks.

The figures speak for themselves: between December and January this year, hospitals in the UK were at 89% capacity, with 7,000 fewer available beds than there usually are. As the pandemic increased pressure on hospitals, clinics, and research facilities to create a treatment for patients globally, it has left the sector exposed to hackers who, like a virus, have been targeting it relentlessly and evolving their tactics. 

From patient records being held ransom, to fake emails claiming to originate from the UN WHO, the NHS, or vaccine centres, through to attacks on the cold supply chain to find out the secret formula of the COVID vaccine, the healthcare industry is facing constant cyberattacks and struggling to cope. This threat is unlikely to go away anytime soon – and as such, the industry needs to take a proactive, preventative stance to stay safe in a dynamic digital world. 

Going digital 

The responsive nature of healthcare – particularly of hospitals – means that efficiency is crucial to the industry’s standard operations. To support this, the sector has been embracing technological advancements that can improve the quality of work, enabling staff to meet pressing deadlines, and enhancing patient care. For example, the industry has been digitising records and improving its ways of working through digital means over the past few years. 

This shift is critical to offer high quality patient care; yet, it also means the sector has become more dependent on IT, which can come with a risk if cybersecurity processes employed are deemed as inadequate. 

Without the correct security measures in place, the desired efficiency gains realised, can be easily lost in a heartbeat. Simply put, an elementary glitch in the system can have a tremendous ripple effect on many areas, from accessing patient records and conducting scans, to maintaining physical security and protecting the intellectual property of experimental treatment development.

To prevent this, healthcare organisations need to ensure they’re considering cybersecurity as part of their overall digital transformation strategy – and setting the right foundations to create a culture where safety goes hand in hand with patient care. 

Strengthening defences

Before implementing cybersecurity process, healthcare organisations need to assess the potential risks they face. Depending on how much confidential data the trust has, where it is stored, who has access to it and via which means, the cybersecurity strategy and associated solutions will change. 

It’s fair to say that a medical device start-up where all employees have a corporate-sanctioned laptop and access data via a VPN will have radically different needs to a large hospital with hundreds of frontline workers connecting to the hospital’s Wi-Fi using their personal device. 

These requirements will pale by comparison to a global pharmaceutical giant with offices in multiple locations, a large R&D department researching new treatments for complex diseases and a fully integrated supply chain. Considering the existing setup and what the organisations is looking to achieve with its digital transformation strategy will therefore have an immediate impact on the cybersecurity strategy.

Despite this, there are fundamentals that any organisation should implement: 
Review and test your back-up policy to ensure it is thorough and sufficient – By checking that the organisation’s back-up is running smoothly, IT teams can limit any risks of disruption in the midst of an incident and of losing data permanently.

In our recent State of Email Security report, we found that six out of ten organisations have been victims of ransomware in 2020. As a result, afflicted organisations have lost an average of six days to downtime. One third of organisations even admitted that they failed to get their data back, despite paying the ransom. In the healthcare industry, this could mean losing valuable patient records or data related to new treatments – two areas the sector cannot afford to be cavalier about.

Conduct due diligence across the organisation’s supply chain – Healthcare organisations should review their ways of working with partners, providers and regulatory institutions they work with in order to prevent any weak link in their cybersecurity chain. Without this due diligence, organisations leave themselves exposed to the risks of third party-led incidents. 

Roll out mandatory cybersecurity awareness training - Healthcare organisations shouldn’t neglect the training and awareness of their entire staff – including frontline workers who may not access the corporate network on a regular basis. According to our State of Email Security report, only one fifth of organisations carry out ongoing cyber awareness training.

This suggests it is not widely considered as a fundamental part of most organisations cyber-resilience strategy, despite the fact many employees rely on their organisation’s corporate network to work. By providing systematic training, healthcare organisations can help workers at all levels better understand the current cyberthreats they face, how they could impact their organisation, the role they play in defending the networks, and develop consistent, good cybersecurity hygiene habits to limit the risks of incidents. 
Consider a degree of separation – Information and Operational Technology (IT and OT) networks should be separated.

Although mutually supported and reliance on each other, employees shouldn’t be accessing one via the other. This should be complemented by a considered tried and tested contingency and resiliency plan that allows crucial services to function unabated should there be a compromise. Similarly, admin terminals should not have internet access to afford a degree of hardening and protection for these critical accounts.

As the sector becomes a common target for fraudulent and malicious activity, putting cybersecurity at the core of the organisation’s operations is critical. It will help limit the risks of disruption due to cyberattacks, reduce time spent by the cybersecurity team to resolve easily avoidable errors, and ensure that institutions can deliver patient care, safe in the knowledge that their networks are safe.  

Fighting future threats

With technology continuing to change the face of healthcare, the surface area and vectors available for attacks by malicious actors is constantly increasing. With the introduction of apps, networked monitoring devices, and a need for communication, the attack vector is ever expanding, a trend that needs to be monitored and secured against.

To prevent any damage to patients, staff, or the organisation they are responsible for, healthcare leaders must put security front and centre of their digital transformation strategy. Only then can the sector harness the full benefits of technology. Doing this should include implementing cybersecurity awareness training to challenge misconceptions around security, encourage conversation, and to ensure employee knowledge of the security basics and threats faced. 

This ultimately allows healthcare organisations to do what they do best: provide the highest standard of patient care, safe in the knowledge that their operations, patients, and data are safe.

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