EU development days: Sirpa Pietikäinen and Indu Capoor

The EU must use its financial and political influence to deliver universal heath coverage, write Sirpa Pietikäinen and Indu Capoor

In 2010, 287,000 mothers died during and following pregnancy and childbirth, and in 2011, 19,000 children were still dying every day, according to the World Health Organisation. Most of those deaths occurred in low-income countries where millions do not have access to adequate healthcare.

Despite important economic growth, middle-income countries like India experience huge inequalities between rich and poor, between men and women, between rural and urban areas and due to religion and caste. More vulnerable groups, such as women and children and people living with HIV, including sex workers and men having sex with men are often excluded from essential (public) services such as healthcare, primary education or sexual and reproductive health. Under an EU-funded project on sexual and reproductive health and rights implemented by the international Aids alliance and the centre for health education, training and nutrition awareness (CHETNA) in India, a baseline study has discovered that women experienced severe human rights breaches, particularly those living with HIV who are advised not to have babies because of their status.

However, every person has the right to health, and every government the responsibility to move towards universal health coverage (UHC) and ensure human rights based approaches in their programmes. As a major donor of aid, the member states and the EU institutions have a responsibility to continue supporting lower and middle-income countries in achieving this. We last met in early 2011 at the European parliament event ‘Child marriage and early pregnancy: the EU’s role in the protection of vulnerable girls in developing countries’, where we learned that we share a passion for ensuring access to healthcare.

CHETNA has helped women and children in India, including people living with HIV, to address their health needs for the past 30 years. India is still ranked 134 among 187 nations on the human development index (2011), and the country’s maternal and child mortality rates reflect the deprived status of women and children and the continued need for investment in health.

The Indian government has a responsibility to ensure its people have better access to healthcare. It has made huge steps in the past three decades, introducing simple health insurance schemes for the poor in 2003 and more recently devising a five-year plan which has included the development of the UHC framework. CHETNA took part in the government’s public debate for ‘faster, sustainable and inclusive growth’ and advocated for convergence of health, nutrition and other development programmes, women’s access to maternal health entitlements and the need for a continuum of care across time and place.

CHETNA is delighted to have been invited by Marie Stopes International, countdown 2015 Europe, Action for global health, Stop Aids alliance, the Red Cross EU office, Oxfam international, IPPF EN and UNAIDS to take part in a high-level panel at the European development days entitled ‘Building a social contract for health’. The debate will look at financing for universal health coverage and realising the right to health and will include key actors such as the European commission and WHO.

As the European Union is considering its next budget for 2014-2020 and the world is looking towards the post-millennium development goals era, the EU must show political leadership to ensure that health is kept firmly on the global development agenda and that its aid goes to those with greatest need. We ask that the EU continues to support people in lower and middle-income countries, and uses its financial and political influence to help deliver universal health coverage for all.

Sirpa Pietikäinen is director of the centre for health, education, training and nutrition awareness

Indu Capoor is co-chair of parliament's working group on reproductive health; HIV and development