Primary healthcare matters as pandemic shockers abound

The reason Primary Health Care (PHC) is primary, is that it is closest to patients and caregivers and can provide comprehensive, holistic, and continuing care, which is especially critical in prevention and management of long-term conditions, and chronic diseases.

Whether mild or highly infectious, diseases such as Covid-19, Ebola, TB, or Malaria in the Ugandan best-case scenario have been recaptured by actors at the PHC level, in association with their communities, outlived the diseases, albeit with low welfare investments, save for social capital.

To that end, whenever a pandemic or epidemic accosts us, welfare concerns for health workers or Village Health Teams, occupational hazards, and workman’s Compensation come up and are fast forgotten thereafter.

As pandemics and epidemics abound, Ugandans with chronic conditions faced a ‘double threat’ because they were more vulnerable to complications.

Death from Covid 19 was eminent for patients with comorbidities, as it was for the urban poor and like rural areas’ counterparts where PHC services converged, experiencing indirect health effects from disruptions in essential care.

Uganda’s like other health systems that provided Cancer diagnoses, chemotherapy appointments, blood donation and transfusions, medical oxygen therapeutic, and ambulatory services decreased although doubled in healthcare costs for all patients regardless of connections or means. The media was awash with patients or dead body detentions for want of payment.

The centrality of PHC was underscored at the 77th session of the United Nations General Assembly (UNGA) by the WHO, UNICEF, and other intergovernmental agencies, and by civil society through the Open letter of the Allies improving PHC, signed by 75+ organizations.

The 77th session of the United Nations General Assembly (UNGA) opened on Tuesday, 13 September 2022 at the UN Headquarters in New York, in the first in-person format since the outbreak of the COVID-19 pandemic.

For more than 40 years, the world has made ambitious commitments to create a healthy future for all. Whether it is from the Declarations of Astana (2018) and Alma-Ata (1978) to the UN Sustainable Development Goals (SDGs) (2015) to the UHC Political Declaration (2019), which has been referred to as the most comprehensive set of health commitments ever adopted.

Along the way, global leaders have repeatedly recognized PHC as an approach that can reach every community and meet the vast majority of people’s health needs throughout their lives – as the foundation of strong health systems and the key to greater well-being, social and economic prosperity, and equity.

Yet in equal timelines, the reality of these commitments has fallen short of their promise. Instead of acting on lessons learned to build the health systems people want and need, they have kept retreating into patterns of crisis and inaction – leaving millions of lives and livelihoods in the balance.

The Covid-19 pandemic and other emerging health threats continue to test the resilience of health systems and prove that we still aren’t prepared to meet the challenge. As a result, additional negotiations have been launched to strengthen pandemic preparedness and response, including calls for a pandemic treaty, reform to the International Health Regulations, and a new fund to help prevent future health emergencies. Efforts are also underway to make up lost ground in the fight against leading infectious and non-communicable diseases.

However, without a strong foundation of primary health care to address growing gaps in essential health services, the most vulnerable communities will remain most susceptible to any threat – whether local or global in scale – to their health and well-being.

For every passing pandemic, PHC actors, Village Health Teams together with Nurses have been left behind. Therefore, prioritizing a PHC approach across the 2023 UN High-Level Meetings on Universal Health Coverage, Pandemic Prevention, Preparedness, and Response, and the 2023 midpoint of the Sustainable Development Goals,

The end game is financing PHC if Uganda must translate to a community of disease-free households so as to realize its needed human capital for development.

Mr Talibita is a lawyer and patient rights campaigner working with Uganda national health Consumers Organization

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