Universal Health Coverage in Palliative Care: a long way to go in Latin America

(Credit: Unsplash)

This article was exclusively written for The European Sting by Mr. Sebastian Abanto-Urbano, a 5th year medical student at Universidad Nacional Federico Villarreal in Lima, Perú. He is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.


One of the biggest problems in public health is the inequity of access to health services. There are big differences in Latin America between the urban area, which has a greater number of complex health facilities, compared to the rural area. This problem is not only limited to the complexity of hospitals, it is also related to the expenditure on medicines by patients or their families, number of specialists, time from home to health centre, among others, constitute a concrete block on the road to Universal Health Coverage (UHC).

According to the WHO, the goal of UHC is that everyone should have access to the health services they need without incurring harmful financial costs, but with sufficient quality to be effective [1].

Today, there is a growing concern about providing equitable care for patients in need of palliative care. Recognized as a right, palliative care seeks to improve the lives of family members and patients facing incurable and progressive illnesses. The most prevalent diseases requiring palliative care are cardiovascular disease, cancer, chronic respiratory disease, AIDS and diabetes. It is estimated that 40 million people require palliative care and 78% of these people live in low- and middle-income countries [2]. Access to palliative care in resource-poor settings is described as a ‘chasm’. Although it is an element of the CSU, several obstacles explain this neglect (opioid phobia, the focus on curing and extending life, non-medical substance use, neglect of disease, etc.) [3].

Dr Tania Pastrana mentions that “unequal access to palliative care and pain treatment represents the greatest inequity in the world today”. In Latin America, only 4% of patients in need of palliative care have access to medicines to relieve symptoms and pain. [4]

Latin American health systems reforms produced a different approach to the CSU. Insurance coverage for the uninsured had to be expanded. On the demand side, determinants of health were identified by alleviating poverty and access to the most vulnerable. However, not all countries have an earmarked tax for each health system and limited funds are available [5]. So, are we on the right track?

Without a doubt, each country’s health system must be committed to providing and enforcing universal health care by including palliative care in national laws and programmes. In Latin America, emphasis should be placed on access to medicines, equipment and further research in universities and hospitals, especially to further strengthen the health system to achieve universal health care.

The work belongs to all of us, we must fight to achieve “equity”.

References:

[1] WHO. Universal Health Coverage [Internet]. 2020 [cited 2020 Dec 21]. Available from: https://www.who.int/healthsystems/universal_health_coverage/en/

[2] WHO. Palliative Care [Internet]. 2020 [cited 2020 Dec 21]. Available from: https://www.who.int/news-room/fact-sheets/detail/palliative-care

[3] Knaul FM, Farmer PE, Krakauer EL, De Lima L, Bhadelia A, Jiang Kwete X, et al. Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the Lancet Commission report. Lancet [Internet]. 2018 Apr 7;391(10128):1391–454.

[4] Infobae. Sólo el 4% de los pacientes que requieren cuidados paliativos acceden a ellos [Internet]. 2019 [cited 2020 Dec 21]. Available from: https://www.infobae.com/salud/2019/12/07/solo-el-4-de-los-pacientes-que-requieren-cuidados-paliativos-acceden-a-ellos/

[5] Atun R, De Andrade LOM, Almeida G, Cotlear D, Dmytraczenko T, Frenz P, et al. Health-system reform and universal health coverage in Latin America. Lancet. 2015 Mar 28;385(9974):1230–47.

About the author

Sebastian Abanto-Urbano is a 5th year medical student at Universidad Nacional Federico Villarreal in Lima, Perú. He is a member of IFMSA-Perú’s SCORE committee and currently LORE of the local association SOCEMVI. His major areas of interest are epidemiology, animal welfare and animal research.

the sting Milestones

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

UN chief welcomes South Sudan’s Unity government, lauds parties for ‘significant achievement’

With lifelong learning, you too can join the digital workplace

Legendary Harlem Globetrotters slam-dunk at the UN, with message that brings families, nations together

German stock market is not affected by the Greek debt revolution while Athens is running out of time

A Europe that delivers: EU citizens expect more EU level action in future

Ukraine: Temperatures plunge amid rising humanitarian needs

How to talk about climate change: 5 tips from the front lines

This Canadian start-up turns millions of chopsticks into sustainable furniture

OECD Secretary-General Gurría welcomes announcement of new trade agreement between the US, Mexico and Canada

How tech is helping the agriculture sector curb carbon emissions

2019 data on official development aid & online discussion of ODA’s role in the Covid-19 crisis

Spanish vote – bad luck for Greece: Does Iphigenia need to be sacrificed for favourable winds to blow in Eurozone?

How three US cities are using data to end homelessness

MEPs want to ensure sufficient funding for Connecting Europe’s future

Post-Brexit muddled times: the resignation of UK’s top ambassador and Theresa May’s vague plans

Re-open EU: Commission launches a website to safely resume travelling and tourism in the EU

How to make primary healthcare a favourable career choice for medical students: strategies and reflections

Eastern Partnership: Commission proposes new policy objectives for beyond 2020

What if big-tech companies became non-profits?

South Sudan: UN rights experts see little headway on peace deal amid spike in local-level violence

UN official sees ‘unprecedented opportunities’ to make progress on peace in Afghanistan

Commission supports reform projects in Member States for more jobs and sustainable growth

Polish de facto ban on abortion puts women’s lives at risk, says Parliament

Mobile health technology: Advances, Facilitations and Promotion of Autonomy

Road injuries leading cause of death for the young, despite safety gains: UN report

State aid: Commission approves up to €4 billion French measure to recapitalise Air France

Iran: UN rights chief ‘deeply disturbed’ by continuing executions of juvenile offenders

This afternoon Britain will be once more isolated from mainland Europe

MEPs want ambitious funding for cross-border projects to connect people

EU’s guidelines on net neutrality see the light although grey areas do remain

Why South Africa is on a path of economic renewal

Built by a woman: supporting the dreams of mum entrepreneurs

Texting is a daily source of stress for 1/3 of people – are you one of them?

Pandemic versus fear

A breath of fresh air: How three disused industrial areas became beautiful parks

Will the French let Macron destroy their party political system?

Pro-EU forces won a 70% triumph in the European elections

Norway has successfully enforced its foreign bribery laws but faces potential obstacles

EU is not only obsessed with Facebook but also blaims now innocent websites using social plugins to serve democratic dialogues?

Right-wing “sovranism” harm national identity

EU revengefully shows no mercy to Cameron by demanding a fast and sloppy Brexit now

What wealth managers can learn from family dynamics

How global food safety protects the planet and begins on the farm

OECD: Mind the financial gap that lies ahead

Why collaboration will be key to creating the workforce of the future

Green Deal: How MEPs wish to channel EU investment to sustainable activities

VW emissions scandal: While U.S. car owners are vindicated, Europe still unable to change its laws and protect its consumers

If on a summer’s night: is UK businesses’ “new deal” the only key to the “best of all worlds”?

The needs, challenges and power dynamics of refugee resettlement

A jingoistic Spanish ‘war’ from the past

Euro celebrates its 20th birthday

Students & Allies Unite Globally To Launch #Students_Against_COVID

This team of Saudi women designed an award-winning app to make the Hajj safer

Here’s how we get businesses to harmonize on climate change

Forty-two countries adopt new OECD Principles on Artificial Intelligence

No more lead in PVC to protect public health, say MEPs

‘Multiplicity’ of rights violations in Ukraine as fifth winter of conflict bites

5G: How a ‘legion of robots’ could help save the rhino

It’s Trump’s anti-globalization and inward-looking rhetoric that perturbs GOP and US

‘No shortcuts to a healthier world’: WHO chief sets out health priorities for the decade

More Stings?

Speak your Mind Here

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s