Person-Centred Care Is The Gateway To Health For All
The irony of current times is that despite the writing on the wall "health is a fundamental human right," the ground reality cannot be farther from the truth. Over 70% people die of non-communicable diseases (NCDs) - a significant number of them are preventable. An infectious disease like TB, which is preventable and curable, continues to be the deadliest infectious disease worldwide - especially in the Global South. When HIV combination prevention should be a reality, along with treatment as prevention, over 630,000 people died of AIDS-related illnesses in 2024 - and 1.3 million were newly diagnosed with HIV in 2024 (hardly any change when compared with 2023 data). If every life matters, then why is A for accountability, missing from global health?
After funding cuts by the US earlier in 2025 and other nations, the situation has become grimmer. "Global health suffers from sudden funding cuts, compromised logistic supply and massive reduction of the number of healthcare givers. The current time necessitates to establish the principle of achieving much more with much less by rapid enhancement of the quality of the services and healthcare," said Dr Sugata Mukhopadhyay, a noted global health thought leader who has worked on improving person-centred healthcare with governments as well as other stakeholders in several countries of the Global South, notably India and Mozambique as well as Indonesia, Nepal and Thailand. He also consults for a range of organisations including Humana People to People India (HPPI), which has demonstrated groundbreaking results in reaching the unreached high-risk people with best of public TB services and social support.
Let us first serve those who are farthest behind
Mahatma Gandhi's talisman is perhaps the best guiding light to reform the public health and social justice system: "I will give you a talisman. Whenever you are in doubt, or when the self becomes too much with you, apply the following test- "Recall the face of the poorest and the weakest man [woman] whom you may have seen, and ask yourself if the step you contemplate is going to be of any use to him [her]. Will he [she] gain anything by it? Will it restore him [her] to a control over his [her] own life and destiny? In other words, will it lead to swaraj [freedom] for the hungry and spiritually starving millions? Then you will find your doubts and your self melt away," said Gandhi ji.
Our health system must meet the needs of the poorest of the poor and weakest of the weak. And the same quality of service which goes to this person should be a benchmark for everyone else.
Person-centred care helps us reach those currently unreached with equity and rights
"Stronger engagement of the affected, infected and vulnerable community members in the decision-making process and promoting cost-effective interventions which have both scalability and impact, are critical priorities," said Dr Sugata. He was speaking in an affiliated event of the world's largest HIV science conference (13th International AIDS Society - IAS - Conference on HIV Science or IAS 2025), and right after 10th Asia Pacific AIDS and Co-infections Conference (APACC 2025) concluded in Japan.
"Person-centred care is focused and organised around the health needs and expectations of people and communities - rather than just on the diseases. In a people-centred care, everyone is as important as anyone else. There is no hierarchy. Everyone - from patients to healthcare providers to families, social workers and community members - involved co-contribute to a coordinated effort in the delivery of healthcare and services," he said.
"Person-centric healthcare aims to replace unidirectional clinical approach with a health system and community partnership approach where the people, families and communities are no more regarded merely as the beneficiaries of the healthcare services but are equally engaged in the crucial decision-making processes regarding policies, overall disease management and continuum of care," said Dr Sugata Mukhopadhyay.
Patient-centred care versus person-centred care
"We also use a terminology like 'patient-centred healthcare' which is focused on the individuals seeking healthcare as patients. However, person-centred healthcare should be much beyond the patient-centred care. Patients should not be reduced to or defined by their 'diseases' or 'illnesses' and 'conditions.' They are persons with individual preferences, needs and abilities who are full partners in their healthcare. They are people - not cases or merely a number - to count and analyse," rightly said Dr Sugata.
Differentiated service delivery model
"We also use a terminology like 'differentiated service delivery models' which are already in place in HIV programmes, and are also being initiated in TB. This model focusses on more customised treatment and care according to the specific health and non-health needs of the people as an integral part of client-centred approach to reflect the preferences, expectations and needs of the people while reducing unnecessary burden on the health system. The idea is not only to treat the health conditions but also help the clients to overcome their health-related dysfunction and disabilities that can enhance their cure and sustain good health thereafter," he added.
Should not we utilise person-centred healthcare to equally address the emotional and economic stability of the affected and infected people?
We must address stigma (as well as intersectional stigma), discrimination, violation of rights, gender equity, reduction of out-of-pocket expenditure, organise livelihood opportunities and social protection to maximise impact of the treatment outcomes in TB and HIV," said Dr Sugata Mukhopadhyay. "For example, the expected outcomes of a person-centred TB care is the successful completion of both curative and preventive treatment. Expected outcomes of a person-centred HIV care would be sustained viral suppression which can finally reduce new TB and HIV cases and premature mortality - and ensure that undetectable equals untrabnsmittable or #UequalsU is a reality for all with HIV."
"It takes a village to raise a child"
Dr Sugata commends the important and critical roles played by a number of stakeholders to reap benefits of person-centred care, such as those played by civil society and community-based partners, people who have survived TB and risen to champion the cause, people living with HIV, among others. "They are playing a critical role to achieve these goals. There should be sustained advocacy to mobilise the Ministry of Health of high-burden nations to adopt patient-friendly policies for integrated and holistic care and that should be a priority in the context of Global South."
Dr Sugata's Triple Mantra
1. "Instead of merely increasing collaboration between TB and HIV interventions, can we think about a merged and unified TB-HIV elimination programme rather than separated TB and HIV control programmes, because that is what the people need: one programme, one strategy, one implementation at the same healthcare settings by the same service providers," said Dr Mukhopadhyay. "Incidentally, it is the same group of poor and vulnerable people of HIV programmes who are also in the need of TB care and vice versa. So when clients are the same, why not the programmes?"
2. "Enhance the treatment of contacts of TB and HIV index-cases," he added. Index-case is the first identified case in a group of related cases of a particular infectious disease like TB or HIV. "We have to understand that a TB patient or a person living with HIV is part of a group of potential-affected and -infected people whom we call 'close contacts.' The index cases of TB and HIV should be treated in tandem with all their possible contacts with the help of an appropriate curative and preventive treatment package and should be monitored together to ensure completion of the curative and preventive treatment. People should be empowered to demand screening and treatment of their partners as part of the person-centred care."
3. "More capacities for person-centred care for TB and HIV have to be built at the national (or sub-national) level. And there should be appropriate guidance and cross learning materials for strengthening person-centred care, both for providers and people (like operational manuals, lesson learnt documents, patient information materials, patient charters, stigma assessment tools, etc). Equally, we should encourage community members for self- and community-monitoring for the progresses of the health condition status of services and they should be also encouraged to utilise available digital applications for such monitoring," said Dr Mukhopadhyay.
Governments must ensure that people come before profit when it comes to accelerating progress towards promises enshrined in the domestic goals as well as in the United Nations Sustainable Development Goals or SDGs. Person-centred care is a critical cog-in-the-wheel to deliver on SDG-3, SDG-5 as well as other SDGs.
Shobha Shukla, Bobby Ramakant – CNS (Citizen News Service)
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Tanmay, an energetic leader of Youth Lead Voices, moderated the session. Anurag- another talented leader of Youth Lead Voices, expressed his personal experiences and journeys using poetry and recital medium. Anurag hails from Uttar Pradesh state of India, who was first diagnosed with HIV in 2009 at the age of 9. He shared what he felt back then after getting diagnosed: a feeling of hopelessness and despair. It was only when he connected with peer networks of people living with HIV such as NCPI Plus, his life inched back towards positive and healthy living. He now supports others to stay healthy with a positive outlook towards life – because science has made it possible for every person with HIV to live healthy, normal and meaningful lifespans – just like anyone else (comparable to those with no HIV). Moreover, when viral load is undetectable, then virus stops spreading and person lives healthy. Anurag said that peer support mattered a lot –in getting tested, counselled, and supported in so many ways including for treatment adherence. A lot of leaders of Youth Lead Voices including Gunjan, Prashant and Bhawna shared challenges they face and/or recommendations to help improve HIV responses on the ground. 'Educational curriculum must have more on HIV – such as HIV combination prevention options, voluntary HIV counselling and testing, lifesaving antiretroviral therapy, undetectable equals untransmittable or #UequalsU,' said a youth. #UequalsU is when a person living with HIV is on lifesaving antiretroviral treatment and viral load is undetectable so that HIV is untransmittable to anyone else. 'Quality of counselling at antiretroviral therapy centres is not satisfactory. Counsellors are too busy to give enough time for young people,' shared another youth. 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We also must ensure that confidentiality of young people with HIV is protected all through the care continuum, she said. NACO's Dr Chinmoyee Das complemented NCPI Plus for making treatment literacy workshops successful 'and for being the messenger.' She confirmed that now onwards, for those (young or old) stable on lifesaving antiretroviral therapy, multi-months dispensing (instead of a month's supply) should be a reality. This should be happening across India. Dr Chinmoyee Das of NACO addressed the issue faced by orphans with HIV that as they can live in care centres till age of 18. She agreed the support should be extended to 5-7 more years – but this is currently being discussed as NACP-6 is getting shaped. 'There are state-specific schemes for livelihood, education, social welfare, etc, as well as through National Health Mission, so those must be fully utilised too,' she said. 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- RNZ News
Dr Shane Reti: No quotas for Pacific students at new medical school
By 'Alakihihifo Vailala , PMN Photo: Supplied / Google Maps The newly-established medical school at Waikato University, the New Zealand Graduate School of Medicine, will not implement specific quotas for Pacific students, according to the Minister for Pacific Peoples Dr Shane Reti. But he says that the academic institution, which will begin in 2028, will prioritise under-represented communities. In an interview on Pacific Mornings , Reti says, "What they have indicated is that as part of the selection process, even though they may not have targeted pathways or quotas per se, that the selection process will take into account those areas where we are under-represented, underweighted, where we have vulnerable populations as part of that selection process. Dr Shane Reti says the academic institution, which will begin in 2028, will prioritise under-represented communities. Photo: RNZ / Nick Monro "But they have indicated in this first instance that there won't be quotas per se." His comments follow the government's announcement of the new medical school at the University of Waikato. The third medical school in the country will receive $82.85 million in government funding and over $150m from the university, most of which comes from philanthropic donations. "What I would like to see are the graduates focused and directed as much as possible towards where we have need, and those areas where we have need are general practice, rural environments," Reti says. "And then within those areas, of course, we have needs for Pasifika, we have needs for Māori, we have a range of other needs." According to the Ministry of Health, Pacific people make up 2.6 per cent, or 522, of all doctors in New Zealand. This represents a threefold increase since 2005, when there were around 131 Pacific doctors. In a related initiative, Reti announced a $4m contribution to assist Fiji in addressing a severe HIV outbreak. He says the funding will mainly support educational initiatives and boost diagnostic capabilities. "Our contribution will help them with what some would say is the most important component to HIV, that is, the education component, which will have a close association with drug use through the Pacific." Reti's comments followed discussions after the recent Pacific Islands Forum Economic Ministers' meeting in Suva, which he described as action-oriented, with clear objectives aimed at tackling regional challenges. The meeting also focused on preparations for the upcoming Pacific Islands Forum (PIF) leaders' summit in Honiara later this year. Reflecting on cultural milestones, Reti celebrated New Zealand's first-ever Bislama Language Week in Papamoa, coinciding with Vanuatu's 45th independence celebrations. He praised the significance of cultural recognition and community engagement, sharing his experiences during a diplomatic mission to Vanuatu with Foreign Minister Vaovasamanaia Winston Peters. "I've had the privilege of standing on the new wharf at Vanuatu on a diplomatic mission that I've had with Minister Peters," Reti says. "I've had the privilege of standing underneath the roof of the women's market and had the privilege of standing in the talking circle beside the Parliament, and so they were able to get a further sense of, oh, he's actually been in our home. "He's been in our place. He gets us. So it was just a wonderful event, and very excited for them." -This article was first published by PMN .
