Universal Healthcare Has Never Been More Important Than Today

The UN Resident Coordinator, Ms Nathalie Ndongo-Seh, writes about the SDG of the month of April; SDG3 - 'Good Health and Well-being'.

In 2015, World Leaders adopted the 2030 Agenda for Sustainable Development and its 17 Sustainable Development Goals (SDGs).  The 17 SDGs call for action by all countries to promote prosperity while maintaining peace, protecting the planet and the people, and building partnerships. With only ten years remaining to achieve these goals, countries are accelerating steps towards ending poverty, fighting inequalities, tackling climate change, and ensuring that no one is left behind.  Every month, the United Nations places one of the 17 SDGs under the spotlight, highlighting its purpose, targets, and criticality in advancing Agenda 2030. This month’s focus is SDG 3: Ensure healthy lives and promote well-being for all at all ages.


As the COVID-19 pandemic continues to cause great disruption and suffering across the world, we are reminded of the necessity to ensure good health and well-being for all. Reflected in Sustainable Development Goal (SDG) 3 - Ensure healthy lives and promote well-being for all at all ages -we cannot achieve Agenda 2030 and a prosperous world if Universal Health Coverage is not achieved.

COVID-19 continues to threaten to reverse decades of significant progress achieved in improving the health of millions of people while increasing life expectancy, reducing child and maternal mortality, and decreasing new HIV infections and AIDS-related deaths. Globally, 17,000 fewer children die each day from preventable diseases as compared to 1990. However, despite this progress, more than five million children continue to die before their fifth birthday each year. Four out of five child deaths occur in Sub-Saharan Africa and Southern Asia: a stark statistic.

In the Kingdom of Eswatini, the infant mortality rate was reduced from 80 per 1,000 live births in 2012 to 67 in 2014, largely through increased immunization coverage for children under the age of five, and the introduction of new vaccines.

Globally, the maternal mortality rate has fallen by 37 percent since 2000 while antenatal care offered to mothers in developing regions has increased from 65 percent in 1990 to 83 percent in 2012. However, shockingly, mothers in developing regions are still 14 times more likely to die from childbirth than mothers in developed countries. We cannot afford to leave mothers in developing regions behind.

Eswatini has made significant progress in this area, with the nation’s maternal mortality rate falling from 593 per 100,000 childbirths in 2012 to 474 per 100,000 childbirths in 2017. However, this remains extremely far from Agenda 2030’s target of 70 per 100,000 childbirths.

Since 2010, new HIV infections in Eswatini have declined by 23 percent and AIDS-related mortality has decreased by 39 percent. Nevertheless, the HIV/AIDS emergency is not over. In the past year, globally, 38 million people were living with HIV and a further 1.7 million people became newly infected with HIV. There is an urgent need to ensure that everyone has adequate access to treatment, prevention and information on HIV/AIDS.

In 2020, the Kingdom of Eswatini was celebrated as the only country worldwide to have achieved and surpassed the 2030 global HIV treatment targets. Indeed, by 2019, 96 percent of all people living with HIV knew their HIV status; 98 percent of all people diagnosed with HIV infection were on antiretroviral therapy; and 97 percent of all people receiving antiretroviral therapy were virally suppressed. Despite such impressive achievements, Eswatini remains the country with the highest HIV prevalence globally, with 27.3 percent of its population living with HIV. In addition, a major cause of concern is the estimated higher HIV prevalence among adolescents, especially among girls and young women.

As we endeavor, through the Decade of Action, to achieve the 2030 Agenda for Sustainable Development, bold and urgent action must be taken to ensure that those gains are not reversed.

Thus, a profound focus on providing more efficient funding to health systems, improving sanitation and hygiene, and increasing access to physicians, is needed to help save the lives of millions, according to the United Nations Secretary-General, Mr António Guterres.

As demonstrated by the outbreak of COVID-19, health emergencies are inevitable; accordingly, preparedness is critical. The coronavirus pandemic unveiled major disparities in countries’ abilities to cope with and recover from the crisis, as did it expose the many vulnerabilities across society.

The World Health Organization (WHO) has been leading the world’s health response to COVID-19, producing the Strategic Preparedness and Response Plan to assist countries in implementing appropriate public health measures to prepare for and respond to COVID-19. The Strategy Update of April 2020 provides further guidance at national and subnational levels in the public health response to COVID-19, highlighting the coordinated support required from the international community to overcome the coronavirus.

WHO, along with other partners of our global Organization, continue to provide essential guidance and advice on mental health care during the pandemic, particularly for healthcare workers, caretakers, persons in isolation, vulnerable communities, and the greater public. It is only in solidarity that the world will win this fierce battle against COVID-19.

However, and as we know by now, the pandemic is more than a health crisis: it requires a response by the entirety of Governments, development partners and society-at-large, upholding the same resolve, dedication and resilience demonstrated daily by our healthcare workers.

Globally, as of 25 April 2021, there have been 146,054,107 confirmed cases of COVID-19, including 3,092,410 deaths, reported to WHO. While a total of 899,936,102 vaccine doses have also been administered as of 22 April 2021, we cannot afford to lose momentum in our response and recovery from the coronavirus.

Significantly, a sense of hope has filtered across the globe as vaccinations against COVID-19 are gradually administered. In solidarity, scientists and research teams worked tirelessly to produce a selection of vaccines against COVID-19. As of April 2021, 778 million doses of the vaccine had been administered throughout the world, with 2.2 percent of the world’s population being fully vaccinated against the virus. This is an extraordinary feat, which provides a hopeful and encouraging a glimpse of the end of the pandemic.

However, there remains a stark contrast between vaccination programmes across the globe with some countries yet to administer a single dose. This trend needs to be changed as it is imperative that all countries have equitable access to vaccines.

So far, the Kingdom of Eswatini has secured 108,000 doses of the Oxford AstraZeneca vaccine through the COVAX Facility to be delivered within the first quarter, as well as 237,000 doses of Pfizer, Johnson and Johnson, and AstraZeneca vaccines through the African Union Vaccine Acquirement Facility, with delivery dates yet to be confirmed.

As of March 2021, Eswatini had received 32,000 doses of the AstraZeneca vaccine. Acting Prime Minister, H.E. Themba Masuku, launched the National COVID-19 Vaccination Campaign on the 24th of March 2021, urging the nation to continue adhering to all precautionary measures of washing hands, wearing facemasks and social distancing. COVID-19 vaccinations are being rolled-out in a three-phase approach, targeting: healthcare workers, the elderly and persons with comorbidities, vulnerable groups, and frontline workers, as well as the remainder of the population, respectively.

Clearly, Universal health Coverage has never been more urgent than today.

The United Nations continues to stand in solidarity with His Majesty’s Government and the people of Eswatini in the nation’s battle against COVID-19, working to deliver a people-centered response that addresses all health, socio-economic and humanitarian aspects of our recovery from the pandemic. In this last Decade of Action, we re-commit to taking bold and urgent action to achieve Agenda 2030 and, ultimately, ensure a “prosperous, just and resilient Eswatini in which no one is left behind.”

Written by
Nathalie Ndongo-Seh
Resident Coordinator
Nathalie Ndongo-Seh
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