Universal health coverage means that no one should suffer financial hardship when getting the promotive, preventive, curative, rehabilitative and palliative healthcare they need. UHC is not possible to achieve generally without meeting the specific needs of the hundreds of millions of people with hypertension and diabetes. This is not just about medicine supplies. For example, the cost of insulin is only about a quarter of the total cost of the entire essential care package for people with diabetes. Many hypertension medicines are already relatively inexpensive.
However, no country – rich or poor – has advanced UHC without public (i.e. government budgeted) financing. Estimates vary but for minimum essential UHC, a country needs to spend at least 5% of its GDP on health with a minimum of roughly US$80-90 per capita, That would achieve sufficient coverage and also reduce out-of-own-pocket expenditure to less than 20%. Hardly any low-income country has reached these benchmarks. Based on the historical experience of richer countries they would have to reach upper-middle income status to do so.
However, with the injection of new leadership from the WHO Director General Dr Tedros, more countries are embarking on the path to UHC. They are reforming their health financing policies. But as they increase coverage, there are inevitable gaps that will need external financing.
The Defeat-NCD Financing Facility is intended for least-developed and low-income countries to expand coverage of services for people with diabetes and hypertension. To be eligible for the Facility’s support, countries would have established diabetes and hypertension management policies as recommended by WHO and planned progressive multi-year provision for related services and supplies in their forward national health plans and budgets. Where they need assistance to do so, technical advice can be provided from the Partnership’s Capacity Development and Community Mobilisation Facility.
The Financing Facility is reliant, principally, on innovative sources of financing that expand the overall allocation of investments into provision for NCD services. As these methods are developed, initial set-up is resourced from donor governments, private sector, and philanthropic contributions. Donor government funds are intended to leverage some four times greater funding from private sector and other sources. Blended financing (a mix of grants and loan/equity investments from international financial institutions including the World Bank Group and perhaps Regional Development Banks) are explored as part of public-private partnerships.