Obinna Nnewuihe | Nigeria

Universal Health Coverage

Peace

“We are determined to foster peaceful, just and inclusive societies which are free from fear and violence. There can be no sustainable development without peace, and no peace without sustainable development.”

Dear friends,

I am grateful for the privilege to speak at such a distinguished event. I’m humbled by the opportunity, not only to shape the world we have now, but to envision how the world could and should be. I want to extend my warm appreciation to the sponsors and organizers.

I will start by asking us to consider a few questions:

1. What is the value of life?

2. What is the value of your neighbor’s life?

3. What is the value of your own life?

In Nigeria my homeland, when a child develops a high fever and slips into a coma, the two commonest causes that readily come to mind are cerebral malaria or meningitis.

If the diagnosis is meningitis, the child will need a twice-daily dose of antibiotics that costs about eighty thousand naira (∼$220) to complete the regimen. Nigeria’s minimum wage currently stands at eighteen thousand naira monthly (∼$50). After parents are presented with the bill from the pharmacy, most of them return to me pleading, “Doctor, is there nothing else you can do apart from using these drugs? What if I can’t get it, what will happen? Is this how he will die?” These questions leave me troubled and I am not at peace within myself. At such times I ask the questions:

What is the value of life?

What is the value of the life of my neighbor?

If we think this challenge exists only with children and infectious diseases, we would have to think again. Very few things are able to tip one into a state of utter penury and a loss of independence in many African countries like being diagnosed with kidney disease, and the subsequent need for dialysis. I’m sure at some point this morning all of us have had to “tinkle” as we say in local parlance. This ability to pass urine, a seemingly simple human routine, is not the least simple for millions of patients globally.

Patients have to be connected to a machine to remove waste that would ordinarily be filtered out by our kidneys in urine. This procedure is carried out in 3-4 sessions/ week and costs about 100,000 naira weekly (∼$275). My monthly remuneration as a doctor in Nigeria is about one hundred and fifty thousand naira (∼$415). If today I come down with a kidney condition needing dialysis, I sadly would not be able to afford two weeks of care.

This also leaves me perturbed and begs the question: what is the value of my own life?

The awareness that no one has to suffer financial ruin when exposed to ill health or the notion that anyone is unable to afford life-saving care when in need lies at the heart of the model called Universal Health Coverage (UHC). UHC as a strategic tool for improving the health of populations has been proven to be highly efficient and cost effective.

So let’s ask ourselves, if something is so beneficial, why are we not doing it yet? For millions who are directly affected by rising cost of healthcare and its consequent unaffordability, UHC sits squarely at the nexus of social justice, equity and the time-honored principle of fraternity. It seeks to pool funds to guarantee risk coverage from ill health; bearing in mind that no one ever plans to fall ill; or enjoys it, to say the least. Ensuring people receive high quality care where they are and when needed, without being pushed into the poverty trap remains the lofty goal of Universal Health Coverage.

At the Commonwealth Youth Health Network, over the last one year, we have contributed to strategic global meetings representing the voices of millions of young people in negotiations on how UHC can and will be achieved across regions and countries. Most recently at this year’s UN General Assembly, in collaboration with the International Federation of Medical Students Association (IFMSA) the CYHN organized a side event on health equity and financing which brought together young people and top policy makers to capture youth perspectives on delivering UHC. We sought to understand strategic areas where the energy and passion of young people can be harnessed to guarantee better health outcomes, and how best to mobilize youths as advocates for more equitable health systems. This was immediately followed by a closed door meeting with the WHO DG Dr Tedros Adhanom, a fine man, who has committed to ensuring the realization of UHC as a core mandate of his leadership. In this meeting, we sought to institute a formalized engagement platform for young people at the WHO. Work on this is currently ongoing and I will do well to give regular feedback as we progress.

The 2030 agenda we dare to speak so boldly about is a future we are already inheriting as young people. It is a future we would live in, it’s a future that directly impacts how much of our potential we can fulfil.

Dear friends, the peace we so dearly seek is not a lone ranger. It walks steadily in concert with justice, equity and transparency. Achieving Universal Health Coverage for the millions of people currently exposed to financial risk, and who lack health insurance coverage or have minimal financial protection from their current insurance plans, is a steady, sure-fire route to building more peaceful, inclusive societies. Societies that capture the ideals of togetherness; and of fraternity as it should be! This is pertinent in our time.

Thank you so much for listening; it means a lot!