By Dr Arvind Mathur, WHO Representative to Timor-Leste
Universal healthcare is often perceived as an impossible ambition for resource-constrained nations, a privilege reserved for the world’s wealthiest economies. However, young countries like Timor-Leste are rewriting this narrative with incremental but powerful steps.
In many ways, Timor-Leste embodies this year’s Universal Health Coverage Day theme: Health: It’s on the Government!
Timor-Leste’s constitutional guarantee under Article 57 of free healthcare at the point of delivery places it among a select group of nations committed to eliminating financial barriers to care. As a result, Timor-Leste has one of the lowest out-of-pocket health expenditures in Southeast Asia.
While there is much to be done to improve the quality and reach of services, the government’s firmness to shield its citizens from the financial burden of illness is clear. That said, affordability alone cannot suffice as public health services must also be accessible and of high quality.
In that regard, 2024 has been a remarkable year—opening new chapters for the country while building on the foundations laid in previous efforts.
A $6 million budget boost has raised the total health allocation from $67.6 million to $73 million for 2025, with crucial funding directed towards essential medicines and medical products. This allocation is a statement to make primary healthcare more sustainable by relying on domestic resources, which automatically ensures long-term resilience in the health sector.
Progress this year spanned across prevention, detection, treatment, disease elimination, and health system strengthening.
A historic step in prevention was the launch of the HPV vaccine for young girls, achieving nearly 100% coverage within weeks of the rollout. This initiative will lay the foundation for a future with significantly reduced cervical cancer rates. For those already affected or under suspicion, three fully operational colposcopy centers now offer cutting-edge diagnostic tools for HPV detection, a much-needed thrust for timely intervention.
This year, the ambitious Primary Health Care (PHC) package took flight after two years of extensive preparation and training. As part of the Say No to 5S project, Timor-Leste’s teachers and community health workers launched health screenings for thousands of students. The screenings included comprehensive assessments of growth, vision, hearing, skin, and oral health. This initiative shows the government’s commitment to catch diseases early and places vulnerable populations, especially children, at the heart of its health agenda. Plans are already in place to expand these screenings to remaining basic education schools nationwide by early next year.
Eliminating lymphatic filariasis as a public health threat will stand as one of Timor-Leste’s most remarkable achievements of the year—a debilitating parasitic disease spread by mosquitoes, causing painful and disfiguring effects. This milestone placed the nation among only five in the WHO South-East Asia Region to achieve such success.
Universal Health Care coverage would be an unachievable dream without robust health systems and physical infrastructure. To that effect, the Ministry of Health is working towards the revitalization of community health volunteers, mobilizing a force of local foot soldiers to execute UHC in its truest form.
Efforts to strengthen capacity have also extended to building advanced, tertiary-grade infrastructure. The launch of Timor-Leste’s first PSA oxygen generation plant at HNGV is a pivotal achievement. With two additional plants in the works for Baucau and Manatuto, the country has set its course to build a reliant network for locally producing this critical medical resource.
Despite these consequential advancements, it is important to acknowledge that the journey to Universal Health Coverage in Timor-Leste is only just beginning. To truly achieve UHC, the government must maintain its focus on health investments – especially primary care, address systemic inequities, and strengthen the social and economic structures that shape health outcomes.
On this Universal Health Coverage Day, we should reflect on some important questions: What are the systemic barriers that deny access to essential care and how do we cross them?
Let Health be recognized as a universal entitlement, not a luxury reserved for the few.
Let this be the day we demand nothing less than health for everyone, everywhere.
TATOLI