NCDs, UHC, and MDGs

Universal health coverage has received a great deal of attention in the past few decades, arguably due to the rise of non-communicable diseases. As Maher and Sridhar point out, NCDs are no longer limited to wealthy populations; they have infiltrated previously unaffected portions of society and are rooted in social determinants of health. The insidious nature of NCDs complicates the fight against them; the effects of NCDs are not immediately observable, and are thus easily left untreated. Furthermore, the fact that ailments such as diabetes, heart disease, and obesity are wreaking havoc on impoverished populations poses another issue: many of the plagued individuals do not have access, or cannot afford to buy access, to the health care necessary for treatment.

                Not surprisingly, there has been a call for universal health coverage to combat this issue. Unfortunately, there has been limited success in mobilizing policy-makers and donors to allocate time and resources to NCDs. Millennium Development Goals, in this vein, have been unsuccessful, and indicative of the first world powers from which they originate. As long as wealthy nations have control within global organizations such as the WHO and IMF, NCDs will continue to fall to the wayside. Wealthy countries have dealt with such afflictions for years- the only difference being that for the most part, citizens of such nations can more easily afford individual treatment.

                Additionally obfuscating the plight against health disparity, rising NCDs, and health inequality and inequity is the simple fact that policy-makers have failed to construct clear guidelines for action. UHC is especially emblematic of this; the term universal technically means that there is a legal obligation of the state to provide health care to all its citizens. However, this definition does little to clarify what standard of health care this entails, or under which conditions. It also ignores individuals not belonging to a state, such as refugees. The MDGs are responsible for this confusion- according to O’Connell et al, the MDGs focused too much on national aggregates of health disparities, and this emphasis masked inequality. All in all, the MDGs are an extension of the United Nation’s failures; smaller states are ignored, and larger entities are put on a pedestal. As long as countries such as the US and other western powers are symbolically in control of the UN and other trans-lateral bodies, NCDs will continue to spread at an infectious rate, and health disparities will follow in suit with the rising wealth discrepancies that are observable globally.