Thank you, Dr Ofrin, and a very warm welcome to Your Excellencies, D-G and distinguished participants.
Maintaining essential health services throughout the COVID-19 response is a core pillar of WHO’s strategic preparedness and response plan and has been central to the Region’s efforts thus far.
People’s ordinary health needs do not disappear due to extraordinary events.
Health security is not only about building capacity to prevent, prepare for and respond to acute events. It must also be about building capacity to maintain essential health services for the duration of a response and into the recovery.
In the coming session we will speak to this need as together we continue to respond to the COVID-19 pandemic by aggressively applying basic public health measures that we know work.
Your efforts today will reinforce the Region’s all-hazard approach to emergency risk management, as well as its quest to achieve universal health coverage (UHC).
Both Flagship Priority Programmes are essential to achieving health for all, which is the goal to which all others lead.
The Delhi Declaration on Emergency Preparedness, the Sendai Framework for Disaster Risk Reduction, the Pandemic Influenza Preparedness Framework, the targets identified in WHO’s General Programme of Work and the Sustainable Development Goals must continue to guide efforts to build health system resilience Region-wide.
Solidarity and cooperation must define the Region’s onward mission, as they have from the very beginning of the response, and for so many years, as evidenced in the Region’s Flagship Priorities, the South-East Asia Regional Health Emergency Fund, and the South-East Asia Regulatory Network, among other innovative mechanisms.
Excellencies,
Last month we came together at the SEAR Health Ministers’ Meeting to review the results of a WHO survey aimed at better understanding the extent to which COVID-19 had disrupted essential health services.
The survey showed that between March and June many countries in the Region experienced disruptions in services for communicable diseases, noncommunicable diseases (NCDs), mental health, reproductive, maternal, newborn, child and adolescent health, and nutrition.
In several cases the data show that disruptions have the potential to stall or even reverse progress on each of our eight Flagship Priorities.
We look forward to your reflections and your continued commitment to the Region’s “Sustain. Accelerate. Innovate” vision.
We have seen how Bangladesh has expanded its health workforce and developed and implemented guidelines to maintain routine immunization.
Bhutan has developed micro-plans to ensure health facilities can provide vital services should strict physical distancing measures be applied, which they were for the first time in August.
DPR Korea has made special efforts to maintain immunization coverage, with a focus on preventing vaccine stock-outs, and also reinforcing the health workforce.
India has implemented a national 24/7 psychosocial support helpline, and continues to strengthen health worker capacity to screen, refer or treat mental health issues.
Maldives has expanded the provision of telemedicine services, achieving significant penetration.
Myanmar has allocated additional funds to the health sector, some of which have been invested in strengthening the primary care services on which all people, of all ages, incomes, ethnicities and genders rely.
In a remarkable show of commitment, Nepal resumed and completed a supplementary immunization activity that covered more than 2.5 million children with measles and rubella-containing vaccine amid strict hygiene and physical distancing measures.
Sri Lanka has made special efforts to secure people’s access to medicines required to manage NCDs, for example by issuing extended prescriptions and arranging door-step deliveries.
Thailand has implemented strict infection control protocols to enhance the safety of patients, professionals and people at all levels of the health system.
Timor-Leste has made concerted efforts to engage communities to ensure they are comfortable accessing routine immunization and other key services. Notably, it has also developed a real-time data portal to identify which sub-districts are performing well, and where further resources are needed.
Excellencies,
Your efforts are commendable.
Your innovative thinking and rapid action have overcome many demand and supply-side barriers, helping to quickly revive essential services and prevent a great deal of avoidable morbidity and mortality.
In building on your successes, I urge you to contribute to and harness the full power of collaborative, regional action, as you have gathered to discuss.
Today I want to underscore three messages that are essential to achieving our vision, and which will facilitate our joint progress throughout the pandemic response and into the recovery and beyond.
First, we must continue to learn from each other’s experiences and adapt and apply best practices.
Telemedicine has shown substantial value in connecting patients to service providers, which is particularly important to protect high-risk groups. Engagement with the private sector and non-health actors has shown great promise in expanding health system capacity.
As you have demonstrated, health workforce challenges can be offset through a combination of strategies, including the recruitment and repurposing of staff and the redistribution of roles.
Ongoing efforts should be made to keep health workers safe from infection and violence and to provide mental health and psychosocial support.
Better data at the sub-national level is essential to identifying and filling gaps and informing rapid action.
We must make full use of the Region’s IHR Knowledge Network, which is specifically designed to facilitate real-time learning among national IHR focal points.
Second, we must continue to leverage formal and informal opportunities to pool our collective strengths.
The Region has in recent years built formidable institutions that provide real advantages in responding to the crisis.
For example, the South-East Asia Regional Health Emergency Fund (SEARHEF) has supported the COVID-19 response activities of three countries in the Region.
It must remain fully operational, for which special efforts are required to strengthen the preparedness funding stream.
The South-East Asia Regulatory Network can facilitate the exchange of information on new diagnostics, therapeutics and vaccines, and on the implementation of good manufacturing practices.
From very early in the outbreak you have shared with one another a range of critical resources, from laboratory supplies to personal protective equipment and more.
I urge all countries to continue to step up as and where needed, and to model the solidarity that is required to overcome this crisis.
Third, together we must continue to make the case for sustained and scaled up investments in health.
A massive global economic contraction is occurring.
Unemployment, poverty and inequality are rising. Public revenues, remittances and household incomes are falling.
Countries in the Region will be particularly hard hit.
The latest projections from the International Monetary Fund and the Asian Development Bank suggest that in 2020 most countries in the Region face a decrease in GDP, which could exceed 10%.
Higher borrowing may mitigate the immediate impact, but rising debt levels will create fiscal pressures that could be felt for many years.
Without pro-active reprioritization, public financing for health could stagnate or even decrease, risking the reversal of years of progress made towards UHC.
We must make a bold, impassioned case for current health spending to not only be sustained, but also scaled up.
Our Region has some of the highest out-of-pocket spending on health in the world.
Even if government expenditure remains constant, declining household incomes will force more people to incur catastrophic costs, or to simply go without.
That is unacceptable and will have grave implications for all areas of sustainable development.
Debt relief measures will be needed, in addition to support from global partners.
But we must look within and build on the substantial and often innovative efforts we have made in recent years to increase health spending.
It is only by doing so that we can achieve a Region in which all people can access the health services they need, without financial hardship, and in which emergency preparedness is integrated across all health system components.
It can be done. The case is ours to make, and the momentum ours to drive.
Excellencies,
In focusing on these and other key areas of the response and recovery, you can be certain of WHO’s full support.
Over the last eight months WHO has been relentless in helping you meet this once-in-a-generation challenge.
Despite a near-global shutdown WHO has procured and delivered more than 1.1 million pieces of personal protective equipment to the Region’s Member States.
We have shipped more than 1.78 million diagnostic tests and ensured all countries in the Region have the laboratory capacity to carry out RT-PCR testing – the gold standard.
As early as February, a Region-specific preparedness and response plan was developed, in keeping with our focus on driving impact tailored to country needs.
I have been in constant correspondence with you to offer support and to highlight key WHO initiatives and guidance.
For many months now we have carried out virtual and in-person trainings to increase health worker capacity in a range of areas, from clinical case management to contact tracing, risk communication, surveillance and more.
We will continue to connect Member State needs and partner capacity via innovative mechanisms such as the Central Supply Portal and the Partners Platform, and by convening our Regional Health Partners’ Forum.
Through WHO’s Solidarity trials we are facilitating Member State participation in global research and development efforts aimed at obtaining novel diagnostics, therapeutics and vaccines.
Through the Access to COVID-19 Tools (ACT) Accelerator and its COVAX Facility we are working to secure your access to the life-saving goods such efforts will produce.
Crucially, since March the Regional Office has been working with Member States to implement key WHO guidance on maintaining essential health services – pillar 9 of our strategic preparedness and response plan.
Based on an in-depth study, I have now directed the Regional Office and Country Offices to strengthen Member State capacity in this regard, which will also help build more resilient health systems as part of the recovery.
For example, WHO will strengthen evidence and build capacities to improve the knowledge base on health service disruptions and how they can be overcome.
To do this, we will harness the full capacity of WHO collaborating centers, research and academic institutions, with a focus on not only documenting disruptions, but also understanding how they impact poor and vulnerable groups.
The Regional Office will continue to provide in-depth epidemiological analysis of the pandemic while helping Member States avoid carrying out uncoordinated, programme-specific surveys.
WHO will support Member States to build resilient health systems that can function effectively amid the “new normal”.
Country Offices will be critical to this process.
The Regional Office stands ready to support Member States to carry out supply chain risk assessments to assess supply constraints for medicines, diagnostics and medical devices.
We stand ready to amplify advocacy aimed at attracting investments in strengthening health systems resilience as a key part of the recovery.
Importantly, WHO will articulate the needs of vulnerable groups and promote health equity, gender and human rights within the pandemic response.
In doing so, we will work with countries to include “health equity” as an objective in COVID-19 response plans.
We will prioritize dialogue with partners on access to health care and social protection for migrants.
WHO will continue adapting its work at the regional and country levels to support the ongoing COVID-19 response.
We will enhance strategic partnerships aimed at immediate, near and long-term collaboration, and will continue to engage civil society organizations and NGOs to achieve impact where it matters most – at the grassroots.
Excellencies,
The crisis we face is above all a health crisis, but for as long as it continues it will have far-reaching impact on all areas of social and economic development.
The key to navigating our way through it is in the name – “pandemic”.
“Pan” meaning “all”, and “demos” meaning “people”.
All people, all sectors, all countries and all partners must come together to strengthen the response and build a recovery and future that is more health secure, and in which all people’s health needs are met as a precondition to achieving the sustainable development to which we strive.