19 Jun, 08 | by BMJ Group
“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.