Delegate: Spain
Committee: World Health Organization (WHO)
School: Kennedy Middle School
Delegation Policy:
Located in southwestern Europe, bordering the Mediterranean Sea, North Atlantic Ocean, Bay of Biscay, Pyrenees Mountains, and southwest of France, Spain has a rich infrastructure, economy, as well as a profitable trading structure. The Kingdom of Spain, a sovereign country ruled by King Felipe VI, is the largest country in Southern Europe at 195,364 mi². There are three different climate zones in Spain, due to its large size. Generally, Spain expects a Mediterranean climate, consists of hot, dry summers and mild, rainy winters. The extensive central plateau has a more continental influenced climate with hot, dry summers and cold winters. Spain is part of the Iberian Peninsula. Major landforms consists of the Andalusian Plain, Cantabrian Mountains, the Pyrenees, Maseta Central Plateau, Sistema Central Mountains, the Sierra de Guadalupe Mountains, and the Canary Islands. Trade is vital to Spain’s economy, displayed by the value of exports and imports simultaneously equal 64 percent of GDP. The average applied tax rate is 1.5%. Foreign and domestic investors are treated equally under the law, and most divisions of the economy are open to foreign investment. The financial sector continues to progress, with the banking division regaining stability.
Spain is a parliamentary monarchy, with the current prime minister and head of the government Mariano Rajoy Brey. The present supreme law is the Constitution of 1978. It was legislated after the country's 1978 constitutional referendum, progressing towards the Spanish transition to democracy.The constitution focused on fundamental rights and public liberties, the citizens’ obligation, principles of social and economic policy, and the anatomy of the constitutional monarchy and parliament. Spain enforces pure laws through courts records of investigation and prosecution cases of corruption.
Spain's healthcare system is commonly evaluated among the world’s best, guaranteeing universal coverage and no direct expenses from patients apart, from paying a proportion of prescription charges. Spain spends about 10% of its GDP on healthcare, and is ranked sixth in the EU for the number of doctors with around four doctors per 1,000 people. A 2015 World Health Organisation survey showed that Spanish women outlive all other nationalities living to 85.5 years. Spanish healthcare consists of both private and public healthcare, with some hospitals and healthcare centres offering both private and state healthcare services. Private health insurance to get medical treatment in Spain is not needed, but it usually allows you to get faster treatment for non-emergency procedures, diagnosis tests, and specialist consultancies. Around 90 percent of Spaniards use the public healthcare system, with some 19 percent signed up to some sort of private healthcare scheme in order to combine the best of both systems. In total, 98.7 percent of the population are insured for Spanish healthcare. However, healthcare expenditures have been decreasing in recent years, and waiting times can be long. For example, the waiting time for operations in Spain has increased over the past few years, averaging 89 days in 2016 (a 13-day increase since 2012). In May 2016, there were nearly 550,000 patients waiting for a non-urgent procedure. Meanwhile, the number of people in Spain with private health insurance has grown in the last five years to 500,000 people, a 5 percent increase. The state system is funded by social security contributions, with each region of Spain taking individual responsibility for a health budget assigned by central government.
Although Spain has one of the best healthcare rates universally, there are still some minor controversies in their healthcare system, the first being service to immigrants. Spain has strict rules that are applied to their both illegal and legal immigrants. Immigrants are not provided with non-emergency health care and will be only treated in cases of emergencies. This could possible cause problems in the very near future; the 873,000 non-registered immigrants are currently not treated unless the situation at hand is an emergency and in need of immediate treatment. Although this is a rule, in a percentage of immigrant emergencies, doctors will turn away the patient for any treatment merely due to their background.
Article 46 of the Ley General de Sanidad establishes the fundamental characteristics of Spain’s health system. The extension of health services is available to the entire population. The system provides adequate organization to provide comprehensive health care, including promotion of health, prevention of disease, treatment and rehabilitation. The coordination and integration of all public health resources is instilled in a single system. Financing of the obligations derived from this law will be met by resources of public administration, contributions and fees for the provision of certain services. The provision of a comprehensive health care, seeking high standards, should be properly evaluated and controlled. The Spanish Constitution, whose articles 43 and 49 establish the right of all citizens to protection of their health, recognizes a right to health services for all citizens and for foreigners resident in Spain called the General Health Law. The autonomous communities have first-order importance in this area, and the law permits decentralization of these functions from the central government to the autonomous communities, in order to provide a health care system sufficient for the needs of their respective jurisdictions. Article 149.1.16 from the Constitution, establishes meaningful principles that allow general and common attribute to be consistent throughout the new system, providing a common basis for health services throughout Spain. In each autonomous community, authorities are adequately equipped with necessary territorial perspective, so that the benefits of autonomy do not conflict with the needs of management efficiency. The National Health System is thus conceived as the set of health services of the Autonomous Communities properly coordinated. Thus, the different health services fall under the responsibility of their autonomous communities, but also under basic coordination by the central state. The General Health Law was complemented in 2003 by the Law of Cohesion and Quality of the National Health System, which preserved the basic lines of the General Health Law, but modified the diction of that law to reflect the political aspect. By 2003, all of the autonomous communities had gradually assumed purview in matters of health and had established stable models. The 2003 law establishes coordination and cooperation of public health authorities as a means to ensure citizens the right to health protection, with the common goal of ensuring equity, quality and social participation National Health System. The law defines a core set of functions common to all of the autonomous health services. Without interfering with the diversity of forms of organization, management and services inherent in a decentralized system, it attempts to establish certain basic, common safeguards throughout the country. This law attempts to establish collaboration of public health authorities with respect to benefits provided, pharmacy, health professionals, research, health information systems, and the overall quality of the health system.
Toward these ends, the law created or empowered several specialized organs and agencies, all of which are open to the participation of the autonomous communities. Among these are the Agency of Evaluation of Technologies, Spanish Agency of Medicines and Medical Products, the Human Resources Committee, the Committee to Assess Health Research, the Charles III Institute of Health, the Institute of Health Information, the Quality Agency of the National Health System and the Observatory of the National Health System.
The Royal Decree-Law 16/2012 was introduced on April 20, 2012. The law made a refusal to give assistance to unregistered foreigners, increase the percentage of medicines paid by the user, seniors needed to pay 10% for medicine, workers now payed depending on their wage. Article 41 of the General Health Law establishes that the autonomous communities exercise the notion assumed in their statutes and those that the state transfers to them or, as appropriate, delegates to them. The public policies and actions foreseen in this Act which are not expressly reserved for the state will be deemed to have been delegated to the autonomous communities.The State finances, through general taxes, all health benefits and a percentage of pharmaceutical benefits. This tax is shared among the several autonomous communities according to various sharing criteria now that the communities are responsible for health in their respective territories. Each year the CISNS, after deliberation, establishes the portfolio of services covered by the National Health System, which is published by a Royal Decree of the Ministry of Health. Each autonomous community then establishes its respective portfolio of services, which includes at least the service portfolio of the National Health System.
Ineffective health care is provoked mainly in locations of lower poverty and poor health cares to start with. Minor governments without the affordability to have effective healthcare are the ones with bad health care systems universally. These health care systems do not have the accommodations for various types of injuries and health issues such as essential emergency care and non-emergency coverages. In the Democratic Republic of Congo is ranked the third worst health care system in the world, with outbreaks and poor conditions of living. Fewer than a quarter of people have proper sanitation facilities and fewer than half access to clean water. This means water-borne diseases such as diarrhoea, bilharzia/schistosomiasis and cholera are common. Outbreaks of cholera occur every year and around 3% of those who contract the disease die because of lack of treatment. However, the greatest threat to health is malaria. In 2009, there were over 6.7 million cases of malaria. Two out of every five deaths among young children are caused by malaria (WHO). Around 55% of people live below the poverty line, living on less than a dollar each day. Areas with the greatest number of poor are particularly in the east of the country, where conflict continues. Fighting and the lack of roads make it difficult for aid and help to be provided to certain regions. Malnutrition is widespread. Without a proper diet, nearly two-thirds of children lack Vitamin A (which allows the immune system to develop) and half suffer from a deficiency of other essential nutrients such as iron, Vitamin E and zinc. With families struggling to survive and the high number of orphans created by war and disease (an estimated 4 million), there are many street children in the DR Congo. The capital, Kinshasa, contains around 20-25,000 children who sleep rough and survive by begging. Most hospitals and health centres across the DR Congo are poorly staffed and equipped. This is because the healthcare system collapsed during the years of conflict. Health professionals have not received a wage from the government for many years. This means they have either gone private, emigrated or become an employee of one of the foreign non-governmental organizations (NGOs) providing healthcare support.
Central African Republic, the second worst health care system in the nation, also faces similar situations to the Democratic Republic of Congo. With one of the lowest life expectancies of 52.80 years, a raging civil war involving the government, rebels from the Séléka coalition and the Anti-balaka militias, and Central African Republic just like its neighboring countries is blessed with abundance of natural resources such as diamond, uranium, timber, gold, oil, and hydropower. However, despite the abundance of natural resources, Central African Republic remains one of the poorest countries in the world today and among the 10 poorest countries in Africa. Central African Republic like so many poor countries in Africa today, faces so many challenges including extreme poverty and hunger, poor education ( high illiteracy rate especially among girls), the deadly HIV/AIDS, natural hazards such as floods and desertification.
Central African Republic has a literacy rate of 56.6% for the total population which implies about 56.6% of all Central Africans above the age 15 can at least read and write. Although this literacy rate isn't the worst in Africa, this literacy rate falls far below expectation in Africa today. The female literacy rate is even worse. Central African Republic has female literacy rate of just 44.2% which is one of the worst literacy rates in Africa today. Central African Republic has lost its reputation as one of the last great wildlife refuges in the world due mainly to poaching and deforestation. Poaching, deforestation, overgrazing, etc. remain some of the major environmental issues facing Central African Republic today. Central African Republic remains one of the HIV/AIDS killing zones in Africa with an HIV/AIDS Adult prevalence rate of 4.7%. More than 130000 were living with HIV/AIDS in 2012 with about 11,000 deaths recorded within the same year. In addition to HIV/AIDS, other deadly diseases such as Malaria (One of Malaria killing zones), bacterial and protozoal diarrhea, hepatitis A and E, dengue fever, rabies, typhoid fever, schistosomiasis, etc. continue to tear the country into pieces.
Just like in most other African countries, most of the leaders and political figures in Central African Republic today are very corrupt and inexperienced. Corruption levels remains at all time high while poor governance continues to tear the beautiful country of Central African Republic into pieces. Central African Republic remains one of the conflict prone zones in Africa with several clashes every now and then. Political conflicts especially between the Government of the Central African Republic and the Séléka (which means "Union" in the Sango language), a coalition of rebel groups, many of whom were previously involved in the Central African Republic Bush War. The rebels accused the government of President François Bozizé of failing to abide by peace agreements signed in 2007 and 2011.
The WHO and medical NGOs are doing their best to deal with a number of public health challenges. For example, the UN Children’s Fund (UNICEF) has been running immunization programmes against measles and polio. WHO devoted much of its resources to the fight against the major communicable diseases. Mass campaigns were waged against malaria, trachoma, yaws, and typhus, among others. Malaria turned out to be a more complex problem than anticipated, and early efforts at eradication had to be scaled back to the level of control. Efforts to improve maternal and child health services included the training of traditional birth attendants—an approach advocated by UNICEF, WHO's close partner in all child-health projects—to reduce infant and maternal deaths. WHO also followed up on the work done by its predecessor organizations on sanitary conventions. It adopted, in 1951, the International Sanitary Regulations, later (in 1971) renamed the International Health Regulations.
Beginning in the 1960s, WHO began an effort to extend health services to rural populations. In 1974, recognizing the underutilization of existing technologies to fight childhood diseases, WHO launched an expanded immunization program against polio, measles, diphtheria, whooping cough, tetanus, and tuberculosis. In 1990, WHO joined with UNICEF in urging the UN Summit for Children to set Year 2000 goals. These goals included increased immunization rates; reduction of infant, under five, and maternal mortality rates; water and sanitation, as well as education for all; the reduction of malnutrition; and the elimination of micronutrient disorders.
To solve this current problem, countries must ensure that they have established an adequate amount of certain affordable drugs that accomodate for the health care needs of their certain type of people and population, consult health insurance priority lists, as well as incorporate technology-related policy-making in health care to encourage the use of cost-effective health care tools. This requires building capacities to produce quality data and developing evidence-based decision-making. Fortunately, in many LMICs, data, methods, and evidence on the costs, effectiveness, and equity of health interventions are increasingly available. But health care resources and interventions remain skewed in favor of the privileged and politically-connected. In order to solve the issue for a better healthcare, one must address the current problems that are occurring. These countries all have a single government owned and operated health care system such as the Veterans Administration. When all hospitals, doctors, and nurses are employed to the one leading government of the country, it can cause “overarching, unfeasible, unacceptable or even inefficient” problems, as stated by Manoj Jain MD, MPH. Through these solutions, the countries will be able to achieve universal health coverage and flourish together.