The scientific & technological developments in the healthcare sector have significantly improved the quality of life across the world. However, several countries, especially the developing nations still face unprecedented healthcare challenges. Basic health services and essential medicines still fail to reach the majority of the global population. The prevalence of major diseases today, from the global AIDS pandemic to antibiotic-resistant tuberculosis, chronic disorders to lifestyle diseases, cuts across the healthcare, political, economic, and social disciplines. These diseases will continue to affect the world unless significant measures are taken to develop comprehensive prevention and treatment programs.
This article aims to capture the healthcare scenario in developed as well as developing nations across the world, with focus on challenges each nation faces while battling health crisis within.
Healthcare concerns in developed countries
Not only the developing countries, but even the developed nations have their own share of healthcare concerns. Also, finding effective ways to provide and pay for healthcare, in particular for medicines, is no longer a problem exclusive to the less developed countries but is a growing challenge in the world’s richest countries as well.
Healthcare is one of the top social & economic problems facing Americans today. During the past 20 years, there has been a dramatic increase in obesity in the US and rates continue to be high. Obesity is expanding, and childhood obesity is exploding in US. In 2009, the national prevalence of obesity among adults was 27%, almost two times higher than it was 25 years ago. Worse, nearly 17% of children aged 6-19 are obese. Also, chronic diseases such as heart disease, cancer, and diabetes—are the leading causes of death & disability in the US. Chronic diseases account for 70% of all deaths in the country, which is 1.7 million each year.
Adding to the woes, the inability to pay for necessary medical care is no longer a problem affecting only the uninsured, but is increasingly becoming a problem for those with health insurance as well. Thus, along with battling the rise in chronic & lifestyle disorders, the rising cost of medical care and health insurance is also impacting the livelihood of several in US.
In UK, government takes the burden of providing healthcare services through the world’s biggest healthcare workforce – National Health Service (NHS). Only 10% of the population has private insurance coverage. Lack of personalized services, insufficient funds and shortage of healthcare professionals are the key challenges leading to high waiting times for treatment in UK.
In Canada, waiting times, overall healthcare funding, and improvement of medical technology are key areas which need attention. Recently, WHO ranked France as a leading country for quality healthcare services, but high healthcare funding is a serious concern for the country. In Germany, quality of healthcare services is one of the best in the world. However, the German healthcare system suffers from shrinking revenue and an ageing population.
Coming to the Middle East, Healthcare in gulf countries has a higher demand than supply. Economic growth coupled with population growth is far higher than healthcare infrastructure growth. Currently, GCC (UAE, Oman, Saudi Arabia, Bahrain, Qatar and Kuwait) spent almost $ 12 billion on healthcare, which will increase to $ 60 billion in near future. Chronic and affluent disorders, along with genetic disorders are key challenges for the Arab world. Though GCC governments have initiated huge healthcare investments, lack of resources leads to lack of operational outcomes, which cause several GCC nationals to opt for healthcare services abroad.
Developing nations: Fighting the challenge of access to medical care
The developing countries face challenges in terms of access to medical care. Remarkable improvements have been made in health research worldwide over the last century, but these improvements have not been shared equally. The gap between rich and poor nations has widened, as have inequities within countries, between urban and rural. Those most vulnerable to existing and increasing health crises tend to be either below the poverty line or living in rural areas where healthcare is inaccessible. In many developing countries, a majority of the population in rural areas is barely able to afford two square meals daily, and thus, medicines and good healthcare remain out of reach for many of them.
Issues that need immediate attention in the developing nations include:
Maternal & child health issues
The number of infants in the developing world dying in their first month of life equals the total number born in US in a year. A woman in sub-Saharan Africa has a 1 in 16 chance of dying in childbirth, while a woman in North America has only a 1 in 3,700 chance of facing the same fate. Similarly, dismal comparisons abound for low birth weight in infants, mortality in children under 5, and children who are under weight for their age. Unfortunately, the majority of maternal and infant deaths occur in the poorest, most disadvantaged places, where health services are inaccessible or nonexistent, and food & transportation facilities are scarce.
Tuberculosis (TB), malaria, and HIV/AIDS together kill about 6 million people a year. As per the estimates, of the three, HIV is the most fatal, with 2.9 million people dying from AIDS-related causes in 2006, an alarming 2.1 million of them in sub-Saharan Africa. Even more alarmingly, an astounding 6% of all sub-Saharan adults are infected with HIV, making it the region with the world’s highest prevalence of the disease. The next closest is the Caribbean, with an adult prevalence rate of 1.2%.
The next dreadful disease is TB, one of the world’s leading infectious causes of death, killing about 2 million people a year. Poverty, lack of basic health services, poor nutrition, and inadequate living conditions all contribute to the spread of TB. In turn, illness and death from TB reinforces and deepens poverty in many communities. The regions most affected by TB include Southeast Asia, Eastern Europe, and some parts of Africa.
More than a million people die from malaria each year. This number is steadily increasing due to a variety of factors including deteriorating health systems, growing drug & insecticide resistance, climate change, etc. Growing resistance to the most affordable and available malaria drugs underscores the urgent need to scale up the research for effective drugs against malaria.
Ironically, while infectious diseases receive much of the attention, chronic diseases represent 60% of the global disease burden, with heart disease, diabetes, stroke, cancer, and other conditions on increase across the globe.
Health systems, and therefore health delivery around the world suffer from aggregate workforce shortages and inequitable distribution due to internal migration from rural areas to urban, international emigration to countries with better working conditions, loss of personnel from the public to the private sector, socio-economic barriers to medical education, among other factors. While many developed nations face their own shortages of health care workers, indisputably, this trend is highly visible in developing nations, which bear the brunt of professionals leaving their home countries in search of more safe, secure, and rewarding employment opportunities.
Low accreditation rate in hospitals is also the challenge for many developing nations. Accreditation is a highly specialized, knowledge and cost-intensive endeavor. Small healthcare set-ups struggle to keep pace with latest technology and investments required to maintain a benchmark.
Well planned infrastructure is another issue that needs to be handled. The overall healthcare expenses are increasing and insurance companies are under tremendous pressure to reduce claim ratio for which they end up passing on the cost burden to the healthcare organizations. Thus, funding for healthcare is another challenge the developing world is facing.
Solution for the world health woes
Of course, there cannot be a cookie cutter solution for complex healthcare problems existing across the globe. However, experts feel that following recommendations might help us address the challenges in the healthcare sector at least marginally in the beginning, if not end them completely.
Effectively handling non-communicable diseases
Chronic diseases including heart, lung, diabetes, obesity and cancer are emerging as a leading threat. Encouraging the use of modern technology, conducting workplace wellness programs and health education workshops to help treat and prevent these diseases would help resolve these issues to some extent. Each nation should also focus on prevention of ailments due to tobacco, alcohol, malnutrition etc. This again can be effectively managed by educating people through various mediums like media, workshops etc. One can also charge fine from people not amending to the rules set by the regulatory authority towards improved health environment.
Encourage the growth of advanced medical technology. Expand use of electronic medical records, mobile applications for health monitoring, advice & education, wireless devices and telemedicine for diagnosis & treatment, particularly in underserved areas in the developing world.
Vaccine preventable diseases
Create industry-sponsored purchase of vaccines and partner with host countries in building infrastructure needed to ensure vaccine delivery. This has the potential to eradicate certain diseases.
Halting the spread of global HIV/AIDS
Establish a PPP involving a consortium of multi-sector businesses, non-government organizations and the Government to apply scientifically proven interventions to slow and ultimately end the global HIV/AIDS pandemic. Strengthen sustainable health systems to improve access to preventive programs and pharmaceuticals.
To conclude, for the health crisis the world faces, finding comprehensive solution seems a distant possibility, but a feat definitely not impossible to achieve. The above recommendations from the experts if implemented and initiatives such as advance market commitments to improve vaccine availability; the Global Fund for AIDS, TB and Malaria; the work of foundations such as Bill & Melinda Gates Foundation; an increased focus on translational research, massive medical education programs in several countries; focus on personalized medicine and other cooperative undertakings, all show promise in turning the tide towards improved global health.