Siddhartha Yadav: Is it time for a global health service?

“I want to live”, read the caption to the life-size photograph of a young man attached to the dialysis machine. I had seen this photograph at a hospital gate in Nepal almost everyday for three months before I came to London two weeks ago, and it is likely that it is still there. Surprisingly, he is not asking anyone to donate him a kidney. He has already found a suitable donor. All he is asking for is money to cover the travel, transplantation and drug costs.

Organ transplantation is not available in Nepal. The nearest available option is in India. The cost for any organ transplantation, however, is so high that only a few from well-to-do Nepalese families can afford it. This is just one example among many other life saving treatments that Nepal doesn’t have or cannot afford to have. Our hospitals do not have facilities to provide essential diagnostic tests. We do not have well-qualified doctors in specialities such as neurosurgery. Among the services that are available, the government cannot afford to provide most of them for free. Many patients who cannot afford the cost of such treatments prefer to surrender themselves into the hands of fate, as they call it, rather than embark on a costly search for it inside or outside the country.

This is just a single story from a single nation. But there are millions of patients from hundreds of poor countries with similar stories. So, whose responsibility is it to help them? The answers can range from everybody’s to nobody’s. Everybody’s, if we believe in humanity and that every human life is worth the same. And if it is everybody’s responsibility, should not healthcare systems in all countries be sensitive to the needs of healthcare systems of poorer countries? Clearly, each nation’s individualistic approach to healthcare may have served their own needs but has failed to address the needs of millions of other fellow human beings living beyond their political boundaries. So, may be it is time that we scrap these individualistic approaches in favour of a single, free-to-all, comprehensive health service around the world: the global health service.

I call it the global health service because I am impressed by the UK’s model of healthcare: the National Health Service (NHS). In addition, I believe that the founding principles of NHS- universality, equity, free at the point of delivery, and central funding- can serve as the founding principles of a global health service. Such a service will cater solely on the basis of the needs of patients and will be able to easily transfer patients beyond political boundaries should the need arise. The benefits of having a single healthcare system around the world are too many to list. Most importantly, it will bring uniformity to the quality of care and medical recording around the world. Imagine conducting research using a global database consisting of millions of patients! There can be swift transfer of medical technology, information, and skills from one country to another.  The response to any disease outbreak will be more coordinated and the overall management of a disease well balanced. We will even be able to create a global organ bank consisting of potential donors from around the world.

As the UK’s NHS approaches its sixtieth anniversary, should we be thinking beyond national boundaries to the broader perspectives of the world? Of course, a global health service is still a far-fetched idea and a lot of things such as its management and financing will have to be worked out before its implementation. But it is worth discussing. What is your opinion?

Siddhartha Yadav is a medical student from Nepal and is currently working at the BMJ office as a Clegg Scholar.

  • shankar

    Yeah it is important concern in the developing countries like Nepal, with the use of on-counter antibiotics and a changing life patterns the incidence of Chronic kidney Disease is day by day increasing. The burden of dialyis to support the life of people with poor per capita income is hardly sustainable and next is the Transplantaion facility which is lagging in our part. Central level of National Health Sevice is yet to be properly estabished and implemented and different political downfalls the nation is facing is surely the one the major short comings and one of the key to support such country and their poor health facility is inturn to raise a global health concern. Global Health Facility may be a key to such problems and should be experimented.

  • pallavi yadav

    not just doctors even the patients feel the same…a little help does’nt hurt afterall.

  • Ha

    Yes. You are right. I am planing to open a website for health care education and information for Vietnamese people. I am looking for collaboration from individuals and organizations to make life better.

  • Rajeshwar Sharma

    It is a proud to Nepalese that you are trying to touch the sky in this stage of your career. Carry on. Nest of luck.
    Rajeshwar sharma

  • Uttam

    Ya ! It’s a novel idea .

    A wide-spread debate is possible on this idea . A pilot project may be taken to study it’s economic feasibiliy .

  • rajendra rajbhandari

    i think this will be a very good idea.carry on!

  • prerana

    ya,its a novel idea and a high time to think about it.

  • Namita

    Its a genuine idea.I think time demands a single health service around the world.Repeated dialysis in patients at times is not only frustating to patient and their families but also to doctors treating them because u know u can do lot of things but still u can do nothing because of limited resources available in developing countries like Nepal .Though there are some foundations helping patients suffering from kidney disease but a broader concept like Global health service will definitely be a good idea for better health care delivery to patients.

  • nagendra

    ya,this is a great idea.The idea of central funding with a global organ bank can help acheive the goal of global health service.there would be a day in near future when this could be accomplished.

  • shiva

    its really a good vision. to have global heath service in this modern age with modern technologoes is qite mentioned, the advantages in qualty medical services and research & development is more important fact associted in it. but the financial analysis can only make it feasible. so its nice effort to raise such an impotant issue in this localised national scenarios. wish it may come in life soon.

  • Roshen Mathew

    The idea of comprehensive global health care would be a great reform universally if it came into existence. Beside sharing health and technological resources for a better health infrastructure, it would even benefit developed countries like USA where uninsured population too suffer from the effects of not having health insurance. In a world where countries are struggling to provide health coverage to their citizens without having a hole in their coffers and GPA; this idea would be difficult to implicate, yet the idea seems so ideal and so humane if it came into practice. We already have an organization the World Health Organization (WHO) which could put this idea into practice if only countries would get together and work towards this distant goal. But who’s got the time?

  • Sanjeeta

    If really global health care could come into existence,it would be one of the greatest achivement for mankind.Besides acting directly to improve the health status in all the developing countries,it would be a great step forward to improve the quality of life.Its one of the most innovative ideas that should be acted upon.

  • Siddhartha Yadav

    Thank you for your comments on my blog. With so many of us already feeling the need for a global health services, I hope that it will come into existence sooner than I expect. I agree with Roshen’s idea that WHO, which has been working on the global stage, has potential to implement this. Thank you once again and I hope to keep on interacting with you all on health related issues in the future too.

  • Siddhartha’s visionary idea seems impossible to most of us, but this was probably the same for John Beller in 1710, when he proposed a European parliament and in 1714 when he published a plan for a national health service. This I learned from Wendy Moore’s short piece “230 Years before Beveridge” (BMJ 2008;337:a571). Three cheers for idealism and altruism in the inevitable trend of historical globalism.

  • ananta niraula

    Thinking of sharing global medical technologies is good, but I really want to draw your attention to creating an effective health care system at community level can have tremendous positive impact on people’s health. I have been reading and examining Nepal’s health care system . There are a lot that can be done and should be done at the community level. If you focus more on your commuinty that you live in and examine its medical needs, problems and possible solutions and act on it would probably be something that I would expect from you-the future doctor.


  • Keith

    I think it is a great idea in theory, and admire you for you optimism. Unfortunately, I believe the reality of a global health system would b an extremely long way off, due to the financial implications for the richer nations. At the end of the day, governments in those countries are not going to give an absurb amount of money to fund a global health service when they could have an arguably better national health service. Despite this, I can see a situation where an organ bank is set up globally, although this too has its downfalls. Keep up the good work, Keith

  • George

    Ananta, i have to agree with you on that. Preventative medicine as a concept deals with minimising risk of infection instead of treating symptoms of infection. To minimise the risks of infection they would have to look at the causes of infection and how to reduce/eliminate these causes. I think the concept of a worldwide health service would be excellent, however, the service would probably be limited in its usefulness due to different political agendas in different countries. For example, in the US, healthcare is not free, so, from a business point of view, why should doctors in the US have to treat foreign patients that give them no extra revenue. These are some of my thoughts.