Tangcharoensathien Viroj, Mills Anne, Palu Toomas
International Health Policy Program, Ministry of Public Health, Tivanond Road, Nonthaburi, 11000, Thailand.
London School of Hygiene and Tropical Medicines, Keppel Street, London, WC1E7HT, UK.
BMC Med. 2015 Apr 29;13:101. doi: 10.1186/s12916-015-0342-3.
The Sustainable Development Goals (SDGs), to be committed to by Heads of State at the upcoming 2015 United Nations General Assembly, have set much higher and more ambitious health-related goals and targets than did the Millennium Development Goals (MDGs). The main challenge among MDG off-track countries is the failure to provide and sustain financial access to quality services by communities, especially the poor. Universal health coverage (UHC), one of the SDG health targets indispensable to achieving an improved level and distribution of health, requires a significant increase in government investment in strengthening primary healthcare - the close-to-client service which can result in equitable access. Given the trend of increased fiscal capacity in most developing countries, aiming at long-term progress toward UHC is feasible, if there is political commitment and if focused, effective policies are in place. Trends in high income countries, including an aging population which increases demand for health workers, continue to trigger international migration of health personnel from low and middle income countries. The inspirational SDGs must be matched with redoubled government efforts to strengthen health delivery systems, produce and retain more and relevant health workers, and progressively realize UHC.
各国元首将在即将召开的2015年联合国大会上承诺推行的可持续发展目标(SDGs),设定了比千年发展目标(MDGs)更高且更具雄心的与健康相关的目标。千年发展目标未达标的国家面临的主要挑战在于,社区,尤其是贫困人口,无法获得并持续获得优质服务的资金支持。全民健康覆盖(UHC)是可持续发展目标中健康领域的一项指标,对于提升健康水平和实现健康公平分配不可或缺。这需要政府大幅增加投资,以加强初级医疗保健——一种贴近民众的服务,它能够实现公平可及。鉴于大多数发展中国家财政能力增强的趋势,如果有政治承诺且实施重点突出、行之有效的政策,朝着全民健康覆盖取得长期进展是可行的。高收入国家的趋势,包括人口老龄化导致对卫生工作者需求增加,继续引发卫生人员从低收入和中等收入国家的国际迁移。鼓舞人心的可持续发展目标必须与政府加倍努力相匹配,以加强卫生服务体系,培养和留住更多相关卫生工作者,并逐步实现全民健康覆盖。