ROME — All over the world, questions abound about who has access to healthcare, and how they pay for it. In the U.S., debt caused by healthcare costs contributes to 62 percent of personal bankruptcy cases. Globally, 100 million people slide into poverty as a result of essential medical care payments.
It’s worth remembering, however, that fully one third of the world’s population has no access to needed medicines to begin with.
In the case of the HIV/AIDS epidemic, which affects 25 million people in Africa, those who need treatment often have to pay 18 times more than in the United States because of the monopoly of pharmaceutical industries. Hepatitis C affects 1 in five people around the world, for most of whom it’s a death sentence because they can’t afford the medicines that would cure them in just eight weeks.
Life expectancy at birth in sub-Saharan Africa is 46 years, while in countries such as Italy it’s over 80. In the former, however, an estimated 6 million children last year didn’t reach the age of five.
These are some of the statistics given by Ghanaian Cardinal Peter Turkson, head of the Vatican’s office for Integral Human Development, and Beatrice Lorenzin, Italy’s Health Minister, at a healthcare summit taking place in Rome.
They were speaking on Thursday, in the opening session of a Nov. 16-18 conference titled “Addressing Global Health Inequalities,” taking place at the Vatican’s New Synod Hall. The gathering is organized by Turkson’s office and the International Confederation of Catholic Healthcare Institutions (CIISAC).
According to Italian Cardinal Pietro Parolin, the Vatican Secretary of State and Pope Francis’s right-hand man, this inequality in access to healthcare is “avoidable.” These disparities, he argued, “arise from inequalities within society and between different societies.”
They are a “regrettable” situation because they deny the “fundamental right” to access adequate health care. This is a right, Parolin said, which must be guaranteed to everyone, regardless of their economic, social, or cultural situation.
“Everywhere in the world there are serious examples of violations of the right to treatment,” Parolin said, adding that there’s a need for a “global agreement” illuminated by human rights, in a “spirit of solidarity and cooperation.”
For the Catholic Church, according to Parolin, promotion of the right to medical treatment has always been an “integral part of its mission.” The Church operates 116,000 hospitals and medical dispensaries around the world, in addition to religious orders dedicated to promoting, improving and guaranteeing medical assistance to the poor.
Parolin also said that the goal of the conference is to “contribute to improving universal access to healthcare, especially in the areas that are harder to reach.” The gathering, he said, should be a place to find solutions to promote healthcare for everyone, in an authentic spirit of justice and solidarity.
Hence the “precious” role of Catholic health institutions as a “tool to ensure integral assistance to every person.”
The Syrian case
It can be argued that Syria is in the top tier of countries where inequality in access to health care is both tangible and where the Catholic Church is adding its contribution.
“The sanitary sector is risking collapse,” said Cardinal Mario Zenari, papal representative in the country. “More than half of the hospitals and the centers of medical aid are unusable because of the fighting. Two thirds of the medical professionals have left the country [or been killed].”
Speaking with Crux, he said that before the war the country had a good pharmaceutical industry, but it’s been reduced by two thirds.
“It’s a situation that risks collapse,” he insisted.
It took Zenari 24 hours to get from Damascus to Rome, because there are no commercial flights in and out of the country. Yet he came, among other reasons, to have the opportunity to speak about the recently-launched “Open Hospitals” initiative, which he’ll do on Friday afternoon.
“We have three Catholic hospitals that have been operating in Syria for over 100 years,” he said. “They are in a grave crisis, because the people don’t have health insurance, and the hospitals can no longer sustain the enormous costs.”
As a result, all three are operating at half of their actual capabilities. But with the support of Francis and his closest contributors, Zenari said, Open Hospitals began to raise the funds so that all three can work as they should, focusing their efforts on the poor. The scope of the project is to guarantee they can cover the treatment of the patients who reach them but can’t afford to pay the bills.
According to the cardinal, the “very complicated job of finding the funds” has been fruitful so far.
Speaking more broadly about the situation in Syria, he said that the entire nation is suffering, and “everybody is on the same boat.”
“Each ethnic and religious group has seen their own [members] die, some call them their martyrs,” he said. “Every group has seen their homes destroyed, their sites of prayer destroyed, their ovens to make bread destroyed.”
Despite the fact that the suffering is “transversal,” minority groups are the weakest links, and in this sense, “Christians are the weakest of them all,” and the ones who are “most at risk.”
Regardless, he insisted, the suffering is universal, and “we have to be attentive to that.”
Though Francis is not scheduled to talk at the event, he did approach the issue of inequality in the access to healthcare on Thursday, in a message to European physicians.
He observed that many costly treatments and remedies are not available to all in the world, creating a “gap in healthcare possibilities” born from a blend between technological developments and economic interests.
Such a combination raises issues concerning the sustainability of health care delivery, the pope said, adding that it points to “what might be called a systemic tendency toward growing inequality in health care.”
“This tendency is clearly visible at a global level, particularly when different continents are compared,” he continued. “But it is also present within the more wealthy countries, where access to healthcare risks being more dependent on an individual’s economic resources than on their actual need for treatment.”
Call for a comprehensive, and global, healthcare reform
Francis also said that health care laws must take a “broad and comprehensive view of what most effectively promotes the common good” in each situation, including looking out for society’s most vulnerable people.
At the conference, Lorenzin, Italy’s health care minister, spoke of the “urgent need” to design health care systems that are economically sustainable. Otherwise, she said, “disparities will continue to grow globally, and we’ll have first class infirm, capable of accessing treatment and medicines, and second class infirm, who won’t be able to afford care.”
Though unbeknown to her, she echoed the pope, denouncing that the disparity won’t only grow between developed countries and developing, but within wealthy societies too.
“To respond to global challenges, we need a new model of governance of health services,” Lorenzin suggested. Said model would not only guarantee the right to access healthcare, but also to “ensure peace, to avoid millions of migrations and to rebuild global cohabitation.”
Though the minister didn’t put it in so many words, the reform to the global access to medical services has to include the Catholic Church. According to Cardinal Luis Antonio Tagle, of the Philippines, in some of the world’s poorest regions, such as sub-Saharan Africa, the Church-related institutions provide treatment to between 40 to 70 percent of the population.
For instance, the Catholic charitable agency Caritas Internationalis, which Tagle presides over, made 220,000 tests for HIV in Nigeria, and retro-viral treatment was given to 60,000 people.
In Rwanda, a network of 119 sanitary structures from the Church treat 50,000 people, and the bishops’ conference in Colombia has created a “medicine bank,” to provide medication at lower prices to those who can’t afford to pay for them.