Cost of healthcare

Prioritising cost-effective interventions to enhance healthcare delivery

Cost of healthcare


n World Health Day, we are reminded of the fundamental right to health, which serves as a cornerstone of human well-being and societal advancement. Established by the World Health Organisation in 1948, World Health Day holds global significance, urging us to recognise the paramount importance of health for all individuals, irrespective of their circumstances. This year’s theme, “My health, my right,” underscores the intrinsic connection between health and human rights, prompting us to evaluate the state of health rights, particularly in Pakistan.

Despite Pakistan’s longstanding membership in the WHO, the explicit inclusion of the right to health within the country’s constitution is conspicuously absent. Instead, health is indirectly addressed within the broader framework of the rights to life and dignity. This contrasts with approximately three-quarters of WHO Member States, where the right to health is explicitly recognised as a fundamental human right.

But what does the right to health entail? Why is it crucial? The WHO’s constitution defines health not merely as the absence of disease but as a state of complete physical, mental and social well-being. It proclaims health as a fundamental right of every human being, regardless of race, religion, or socioeconomic status. Nobel Laureate Amartya Sen’s ideas on human rights underscore that such rights are inherent to all individuals on ethical grounds, irrespective of legal structures. Therefore, the absence of explicit mention in Pakistan’s constitution does not negate the existence of these rights for its citizens.

Sen emphasises that human rights derive their significance from the freedoms they imply, encompassing both opportunities and processes. For instance, the ability to access healthcare services and the freedom to make informed decisions about one’s health are integral aspects of the right to health. This underscores the need for societal structures and policies that enable equitable access to healthcare and empower individuals to make choices concerning their well-being.

In Pakistan, ensuring the right to health necessitates that the state fulfill its obligation by providing at least essential healthcare goods and services for its citizens. Critics may raise concerns about the feasibility and economic implications of recognising health as a right, especially given economic constraints and resource limitations. However, creating conditions conducive to fulfilling the health rights of all Pakistanis is crucial for societal progress and well-being.

A notable recent initiative in Pakistan has been the Sehat Sahulat Programme, launched in 2015 by the provincial government of Khyber Pakhtunkhwa. This health insurance initiative aimed to uplift those below the poverty line, contributing to progress towards Universal Health Coverage. Despite its success in extending healthcare access to millions, uncertainty looms regarding how the current government will support the scale-up of UHC. Furthermore, the lack of adequate coverage for essential healthcare needs and the absence of mechanisms to address health inequalities pose significant challenges that need urgent attention and rectification.

To mitigate financial constraints and enhance healthcare delivery, revisiting the design of benefits package and prioritising cost-effective interventions is imperative. Governments should focus on expanding coverage of highly cost-effective interventions to maximise health gains, particularly during challenging economic times. There has been plenty of research on such programmes already. Initiatives to synthesise existing evidence and inform decision-making based on cost-effective health investments could be a game-changer.

However, realising the right to health requires not only governmental action but also societal commitment. Individuals and institutions must acknowledge their obligations to promote and safeguard health-related freedoms. The month of Ramazan, characterised by empathy and solidarity, underscores the importance of respecting and promoting access to essential healthcare for all Pakistanis.

The spirit of the late Abdul Sattar Edhi, whose humanitarian work continues to inspire, exemplifies the collective responsibility to support those endeavouring to meet the healthcare needs of fellow citizens effectively and efficiently, especially when the state fails to do so.

Our cultural wisdom underscores the significance of health in our lives. The proverb ‘Jaan hai tou jahan hai’ emphasises that life’s pleasures hold little value without good health. Therefore, upholding and promoting the right to health for all individuals is indispensable for societal progress and well-being in Pakistan.

The writer is a research affiliate at the University of Pennsylvania

Cost of healthcare