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The Director in charge of Global Neglected Tropical Diseases (NTDs) Programme at the World Health Organisation (WHO), Dr Ibrahima Socé Fall, has described as “dramatic” the practice where patients are detained in health facilities for their inability to pay their medical bills after treatment.
For him, “This should never happen in any country," urging countries to consider real policy reforms to prevent such practices and establish more equitable payment plans, particularly for the poor.
He explained that detention of patients and family members for non-payment of medical bills is harmful to health and contrary to international law.
He was of the view that when countries achieve universal health coverage (UHC), it would help to prevent detainment of patients after treatment because it will do away with out-of-pocket payment for healthcare services.
Speaking in an interview with Graphic Online on this year’s World Health Day, which was facilitated by Speak Up Africa, a Dakar-based policy and advocacy action tank, on Friday, April 5, 2024, Dr Socé Fall, said UHC would ensure that patients do not need to pay out-of-pocket for healthcare.
"When you ask poor people to do out-of-pocket for healthcare, it will increase their level of poverty and expose them to more diseases," he noted.
For him, countries, particularly those in the developing world, should work more to minimise the practice of out-of-pocket payment for medical care, saying that there is an urgent need for solution to the problem of patient’s detention for non-payment of medical bills.
“This is not right. We need urgent solutions,” Dr Fall stated.
The WHO recommends that the practice of detaining patients, and the bodies of patients, for non-payment of bills be prohibited, noting that the practice “can also have serious health consequences as it may negatively impact on the physical or mental health of detainees, by exposing them to infection, by triggering psychological trauma, or by discouraging people from seeking much-needed healthcare.”
Dr Fall, who was speaking on the theme: “My health, my right” for this year’s World Health Day, said around the world, the right to health of millions is increasingly coming under threat.
He explained that political stability was a prerequisite element for ensuring right to health for all, noting that in Africa, for instance, about 100 million people still need humanitarian assistance, a situation he described, could ultimately affect right to health on the continent.
The WHO Council on the Economics of Health for All has found that at least 140 countries recognize health as a human right in their constitution. Yet countries are not passing and putting into practice laws to ensure their populations are entitled to access health services.
This underpins the fact that at least 4.5 billion people — more than half of the world’s population — were not fully covered by essential health services in 2021.
This year’s theme was chosen to champion the right of everyone, everywhere to have access to quality health services, education, and information, as well as safe drinking water, clean air, good nutrition, quality housing, decent working and environmental conditions, and freedom from discrimination.
The World Health Day is celebrated globally on April 7 each year to raise awareness about a specific health topic of global concern and to mobilise action to address health issues affecting people around the world.
Dr Fall indicated that health and human rights must always go hand in hand, stressing that people have a right to healthcare, and to be treated with dignity and respect when they access it.
For him, no one should be denied access to healthcare on the basis of the person’s race, ethnicity, sexual orientation or political affiliation.
He said right to health is fundamental human right that “requires attention from everybody.”
Dr Fall, who is known for his public health advocacy, noted that when health issues are not factored in policies, it makes it difficult for people, particularly vulnerable groups, to access healthcare.
“Neglecting this (right to health) can result in widespread health disparity that would lead to poor public health outcomes,” he observed, adding that neglecting right to health could even affect economic stability and societal wellbeing.
For him, there cannot be any development without health and also there cannot be productivity without health, saying "Without productivity, you cannot have sustained economic development."
Dr Fall, therefore, called for a multi-sectoral approaches in ensuring right to health, saying "We need government, civil society, and international organisations to collaborate to establish and enforce health related rights."
He was of the conviction that access to healthcare and access to quality healthcare "is critical" in the development of any society and that "health is a political choice."
He said to improve healthcare delivery in less developed countries, political leaders must show commitment to the cause.
Political commitment
“We need political commitment from political leaders to provide health infrastructure to aid quality healthcare delivery,” he stated.
Dr Fall also called for domestic financing for healthcare that would ensure that "people wherever they are, can access to health facilities and health workers."
Similarly, he urged African leaders to use the World Health Day as an opportunity to prioritise the health systems, invest in the sector and ensure the availability of medicines, vaccines as well as engage new technologies to improve healthcare delivery on the continent.
Dr Fall also stressed that African leaders should pay attention to preventive care and health promotion, explaining that "we don’t need to wait until people are sick before taking care of them. We need to respond to prevention."
For him, investing in preventive care and health promotion would lead to improved health outcomes, calling for the right foundations to be laid, in terms, of ensuring quality healthcare delivery on the continent.
He consequently called on African leaders to invest in human resources because without a well-developed human resource in the health sector, providing only facilities would lead to nothing.
He expressed the concern, for instance, that due to lack of appropriate facilities and logistics in the healthcare sector, many African health workers leave the continent to seek greener pastures in Europe, a situation, he noted, could have dire consequences on the continent’s healthcare delivery.
Dr Fall further observed that because the continent’s healthcare sector has not been well developed, many African leaders do not seek healthcare on the continent.
He was of the view that if political leaders in Africa also use the same health facilities just as the ordinary people do, "they will begin to improve the healthcare facilities” and also invest in healthcare workers.
