Regional Director’s Special Address at Plenary Session 1: Access to Medical Products to achieve the SDGs
9 October 2018, New Delhi, India
Excellencies, ladies and gentlemen,
Good health and wellbeing are the cornerstone of progress for individuals, communities and countries.
As Regional Director of the WHO South-East Asia Region I have seen this in each of the Region’s 11 Member States, and regard enhancing the state of health as a moral imperative in all policies at the national and state level.
Across our Region, as across the world, too many people still require access to effective and affordable health care. In the effort to provide this, the Government of India’s commitment – as reflected in the hosting of this second World Conference on Access to Medical Products – is critical.
WHO's work is guided by the Sustainable Development Goals. All countries are to achieve these Goals by 2030. As you appreciate, there has been much reference to our Organization’s 13th General Programme of Work, or GPW, which sets out our priorities between 2019 and 2023.
In doing so the GPW defines what all countries want WHO to focus on: promoting health, keeping the world safe and serving the vulnerable, with a target of reaching one billion people in each area. In achieving the ‘triple billion’ target our Region’s progress will be of great consequence.
Around one-third of the one billion people set to benefit from access to health coverage by 2023, for example, are in our Region.
Fifty per cent of the global deaths caused by tuberculosis take place in our Member States, two of which account for more than one-third of the global TB burden.
Our Region is home to almost 40% of stunted children under five years of age, as well as a quarter of those that are overweight. It also accounts for almost 27% of global mortality due to natural disasters and a quarter of all road traffic deaths.
What happens in our Region matters – so much so that our success or failure will prove decisive in the world’s effort to achieve the SDGs and the ambition they represent.
Notably, commitment to achieve universal health coverage is leading to a more integrated approach to advancing health for all. UHC has become the basis for health policy in all countries, with equitable access to quality services, financial protection and ‘leaving no one behind’ the driving principles of all that we do. They are also our most important metrics of progress.
Finishing off key neglected tropical diseases, or NTDs, is a case in point. India, for example, has now eliminated yaws. It has likewise eliminated visceral leishmaniasis in 90% of administrative blocks. This is of great significance given NTDs are primarily diseases of the poor and left behind, meaning their elimination contributes to making health systems more equitable, at the same time as reducing poverty.
To its credit, India also has ambitious plans to expand health protection schemes, as demonstrated by the roll-out of Ayushman Bharat Wellness Centres, as well as health insurance. As part of this drive it has committed to significantly increase health spending, with India’s states now required to allocate a minimum of 8% of their budgets to health.
Nevertheless, the financial part of the picture requires us to recognize that more money alone does not necessarily translate into better health: Money must be used efficiently.
Excellencies, ladies and gentlemen,
Health systems comprise a range of programmes. Strengthening them means ensuring better health outcomes for each programme. A robust health system is an essential component of a country’s capacity to protect its people when acute public health events occur. We saw this when the Indian state of Kerala faced unprecedented floods earlier this year.
I am pleased to say WHO’s global priorities resonate in our Region and are reflected in our four strategic directions of work. These strategic directions were developed in consultation with our Member States in 2014 and represent the aspirations of what is now almost two billion people Region-wide.
These four directions are: first, addressing persistent and emerging epidemiological challenges; second, strengthening emergency risk management for sustainable development; third, advancing universal health coverage and robust health systems; and fourth, articulating a strong regional voice in the global health agenda. As evident in our progress, these strategic directions have served our Region well.
Still, the main driver of financial hardship in our Region remains out-of-pocket payments for health care, the bulk of which is on medicines. While we can report a modest downward trend in recent years, out-of-pocket spending constitutes more than 30% of total health expenditure in seven Member States.
But we are beginning to see change. Data shows essential health service coverage has improved in all Member States. Across the Region, initiatives have been undertaken to improve the accessibility and affordability of medicines. Importantly, health budgets have increased in several countries, including Bhutan, India, Indonesia, Maldives, Myanmar and Thailand. I am certain this trend will continue as political support for public health grows.
I am likewise gratified to see that each of the Region’s Member States’ regulatory agencies are active participants of the South-East Asia Regulatory Network, which has just unveiled an Information Sharing Platform. This Platform and the collaboration it will promote will lead to quicker access for all people everywhere to all medical products. Already I see drug regulators talking to each other and exchanging notes on product quality.
Apart from ensuring access to medical products, enhancing human resources for health is fundamental to achieving UHC. When it comes to our Region’s pursuit of that goal, these two priorities stand out.
As part of our wider emphasis on prioritization, the Region has also defined eight Flagship Priorities. These include measles elimination and rubella control by 2020; the prevention of noncommunicable diseases through multisectoral policies and plans, with a focus on ‘best buys’; ending preventable maternal, newborn and child deaths, with a focus on neonatal deaths; scaling up capacity in emergency risk management; universal health coverage with a focus on human resources and essential medicines; building national capacity for preventing and combating antimicrobial resistance; finishing the task of eliminating diseases on the verge of elimination such as kala-azar, leprosy, lymphatic filariasis, schistosomiasis and yaws; and accelerating efforts to End TB by 2030.
Together we are making progress.
Indeed, health now matters at the highest levels of government, and is increasingly seen as a whole-of-government concern, no longer confined to its designated ministry. Across our Region, partnerships to promote health are being strengthened, with key alliances now spanning many sectors. Antimicrobial resistance, noncommunicable diseases and the health impacts of climate change among other issues have brought governments, civil society, industry, academics and many others together to work towards common causes.
I am keen to observe that this drive is reflected here today, at this second World Conference on Access to Medical Products, and very much appreciate the responsiveness and commitment this represents.