OfMaria Giovanna Faiella
According to the World Health Organization, 4.5 billion people do not receive essential health services. The right to health is under threat all over the world. Also in Italy: from long waits in the public sector to lack of access to the new Lea services (essential levels of assistance)
All over the world the Right to health of millions of people is increasingly threatened. According to the World Health Organization (WHO), at least 140 states recognize health as a human right in their Constitution, however many they are not implementing the laws to guarantee everyone the right to access the health services they need and when they need them. And at least 4.5 billion people – more than half of the world's population – they did not receive essential health services in 2021. Hence the theme chosen by the WHO this year, on the occasion of the World Health Day, which occurs on April 7th, «My health, my right», to draw attention to the need, worldwide, for defend the right of everyone to have access to quality healthcare servicesas well as those life condition which contribute to having a good Health – understood by the WHO as a state of physical, mental and social well-being and not just the absence of disease – that is, access to safe drinking water, clean air, good nutrition, decent working and environmental conditions.
Health: do you know your rights?
Knowing your rights is the first step to having them respected, reiterates the WHO on the occasion of the world day. Every person has the right to access the necessary healthcare when and where he needs it without having to face financial difficulties as well to safe and quality care without discrimination, to privacyto have informations on the proposed treatment and be able to express informed consent.
In Italy it is a “fundamental” right
L'Italy is one of the countries where the Right to health And guaranteed by the Constitutionin article 32: «The Republic protects health as fundamental right of the individual and interest of the communityand guarantees free care for the poor. No one can be forced to undergo a specific health treatment except by law. The law cannot under any circumstances violate the limits imposed by respect for the human person.”
The expression «Right to health» contains a plurality of rights such as that ofphysical and psychological integrityto live in a healthy environmentto obtain the necessary health services when you need it (and don't wait months), to receive safe care i.e. a not suffer damage from medical errors or the inadequate functioning of health servicesas well as the right to not receive benefits other than those required by law to protect the individual and the community in exceptional situations (for example: vaccinations in the event of an epidemic).
In the wake of the Constitution, various laws have better defined the implementation methods of the right to health, first of all the Law no. 833 of 1978 who established the National Health Service (Ssn), a complex system of structures and services that must guarantee access to all, in conditions of equality to health services aimed not only at therapeutic treatments but also to prevention and to rehabilitation.
Essential levels of assistance (Lea), what you are entitled to
Health protection is matter of concurrent legislation between the State and the Regions, based on the art. 117 of the Constitution and the subsequent constitutional reform of 2001.
It is up to the State individuate the Lea, Essential levels of assistance that they must be guaranteed to everyone throughout the national territory. They were updated in 2017 but some new specialist outpatient and prosthetic care services they are not yet payable everywhere because of postponement of the entry into force of the respective tariffs on January 1, 2025 ed) ; is instead of competence of the Regions the organization and provision of healthcare in the respective territorial areas. The performances and services included in the Lea represent the “essential” level that the Regions must guarantee to all citizens. They include:
– the activities of individual and collective prevention (food safety, health protection in open and confined environments and in the workplace, veterinary healthcare, prophylaxis of infectious diseases, vaccinations and early diagnosis programmes, forensic medicine);
– L'district assistance that is, health and socio-health services spread across the territory (basic medicine, pharmaceutical, specialist and outpatient diagnostic assistance, home services, supply of prostheses and aids, mental health services, family consultancy, rehabilitation services, semi-residential and residential facilities for the elderly and people with disabilities etc.);
– L'hospital care (Emergency room, hospital admissions, rehabilitation facilities, post-acute long-term care facilities);
– L'socio-health assistance for particular categories.
There are still too many barriers in accessing public services
«As we celebrate World Health Day, the barriers to access health services public and the whole universalistic system of health protection in our country seems more than ever poised – comments Francesca Moccia, deputy general secretary of Cittadinanzattiva –. This is demonstrated by the many pieces of evidence we have, the official data on the treatments carried out and above all those on missed care of the many which is now there they give up. And this is also supported by one in three citizens who turned to Cittadinanzattiva in the last year, precisely to report too long waits, unsustainable costs and no guaranteein fact, to have the essential levels of assistance recognized in every corner of our country.”
How to overcome inequalities between citizens?
«The studies by Marmot and many experts also present in our country – reasons Moccia – have shown that to overcome health inequalitieswhose causes are attributable to many factors (income, education, work, lifestyle, context, relationships, access to prevention and treatment services), we need targeted public policies, multidimensional and universalistic interventions, which can reach even the most vulnerable, often “invisible”, in a widespread way. In particular, in the most disadvantaged areas interventions should strengthen primary carei territorial services and the General medicineto address the complexity of the problems more effectively in places close to the population.”
Mental health of children and young people in Europe
On the occasion of World Health Day, the SOS Children's Villages organization – also involved in Italy for over 60 years in the reception and support of children and young people without family care or at risk of losing it – launches an appeal for these to be implemented interventions in favor of the mental health of young people in vulnerable contexts (conflicts, situations of violence, forced displacements, disasters and health emergencies). According to recent Unicef data, only in the European Union more than 11 million children and young people they have problems related to mental health more likely to be exposed to anxiety and depression.
According to SOS Children's Villages, it should be the priority of every society to invest more and in the long term in prevention and psychological support services for kids who need it.
In Africa sub-Saharan iL 20% of all sick people in the world
In Africa, reports Amref Health Africa, the largest non-profit African health organisation, approximately 2 million healthcare professionals qualified (doctors, nurses, midwives) take care of a population of 1.2 billion people; only inSub-Saharan Africa resides on 20% of all sick people in the world and it occurs 50 percent of child deaths globally. «When someone gets sick he should be able to access the services that he needs regardless of how much he earnsthis is the true meaning of universal health coverage – says Githinji Gitahi, global director of Amref Health Africa –. In many of the areas where we operate, communities live more than 50 kilometers from a health facility, very often from reach on foot». Furthermore, in some areas, adds the deputy director of Amref Italia Roberta Rughetti, «the health situation is worsened by incessant conflicts and climate change which put them to the test already vulnerable health systems. For this reason, an essential element of Amref's work is training of health workers of communities, key figures in bringing assistance to the remote areas in which they live. In 2022 Amref trained beyond 48 thousand healthcare workers of community, also thanks to the use of online platforms».
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