User fees for health care are a life or death issue for millions of people in poor countries. Too poor to pay, women and children are paying with their lives. For those who do pay, over 100 million are pushed into poverty each year. This month will witness a global opportunity for world leaders to really make a difference to poor people by backing the expansion of free health care in a number of countries. The opportunity marks a true test of leaders’ commitment to save lives and accelerate progress towards health care for all in our lifetime. The question is, will they pass it?
On 23 September 2009 leaders will meet at the United Nations General Assembly in New York for a high-level event on health. On the table is a proposal to support at least seven developing countries to fully implement free care for women and children or to expand free health services to all. The seven countries are Burundi, Ghana, Liberia, Malawi, Mozambique, Nepal, and Sierra Leone. The need to make health care free and expand access in these and other countries is beyond question, but to do so successfully requires high-level political commitment and sustained additional financial and technical support. Leaders in the North and South must back this proposal on 23 September and announce the additional support they will provide over the coming years to make it a success.
Key recommendations involve high-level commitment from the governments of Burundi, Ghana, Liberia, Malawi, Mozambique, Nepal, and Sierra Leone to:
- Introduce free health care for women and children and/or fully implement and expand free health care for all.
- Increase government spending on health to at least 15 per cent of the national budget to pay for increased demand, especially for health workers and medicines.
- Advocating for the creation of a space for civil-society engagement in the planning and decision-making processes concerning the health-care reforms.
High-level commitment from rich country donors and multilateral aid agencies is also needed to:
- Provide the additional long-term and predictable funding necessary to successfully implement free health care in all seven countries.
- Officially extend the offer of financial and technical support for free health care to all poor countries who wish to remove fees and to make this event a global turning point in the fight to make health care free for all.