The World Health Organization (WHO) Regional Committee for the Western Pacific today made a commitment to leave no one behind as it works to achieve the health-related Sustainable Development Goals (SDGs). The Regional Committee also discussed measures to ensure the Western Pacific is able to respond to threats to health security and other public health emergencies. The meeting also reviewed and noted progress on HIV, immunization and disability prevention and rehabilitation.
Member States commit to leave no one behind
Today, Member States discussed and endorsed the Regional Action Agenda on Achieving the Sustainable Development Goals in the Western Pacific. The action agenda aims to guide Member States as they embark on SDG implementation in the Western Pacific Region.
The action agenda suggests practical options for Member States to consider in making the transition from the Millennium Development Goals (MDG) to the Sustainable Development Goals (SDGs) based on their own contexts, resources and entry points. It urges broader thinking about the complex matrix of factors that shape health in different environments, and suggests ways of identifying and responding to the most pressing needs of communities in order to ensure no one is left behind.
The Regional Committee's endorsement of the regional action agenda builds on last year's adoption of the regional framework Universal Health Coverage: Moving Towards Better Health. Universal Health Coverage (UHC) is a core part of the SDG agenda, bringing together different health and development efforts. Leaving no one behind is core to UHC and the SDGs.
Discussions at the Regional Committee highlighted the progress achieved during the MDG era in the Region. Member States can rely on information systems, reporting and coordination arrangements, and policies and programmes that are already in place. At the same time, achieving the SDGs also involves significantly new ways of working that go beyond business as usual – and newer roles and capabilities for the health sector in working across government sectors and stakeholders. The action agenda suggests practical actions to achieve the change in mindset that is needed.
Empowering Member States to tackle emergencies and threats to health security
The threat from emerging diseases and other public health events is real, and all Member States are vulnerable as evidenced by recent public health events such as the Ebola virus disease, Middle East Respiratory Syndrome, Zika virus and yellow fever outbreaks as well as natural disasters including typhoons, floods, droughts and earthquakes.
Prioritizing limited resources for health, strengthening and maintaining core capacities for emerging diseases and public health emergencies as required by IHR (2005), and having sufficient financing are some of the essential components of a resilient health system for Member States.
In response, WHO developed the Asia Pacific Strategy for Emerging Diseases (APSED) in 2005 and revised it in 2010. Both endorsed by the Regional Committee, the strategies guided Member States in strengthening health security by building sustainable national and regional capacities, and partnerships to ensure health security. This was done through preparedness planning, prevention, early detection and rapid response to emerging diseases and other public health events.
The APSED Technical Advisory Group (TAG) meetings provide feedback on progress with APSED implementation to Member States and partners. The 10-year evaluation of APSED revealed that the majority of Member States found the TAG meetings to be valuable. It also revealed that the APSED approach has been effective and useful because of its generic nature, flexibility to adapt to changing contexts and ability to strengthen diverse Member States’ capacities. In July 2015, the APSED TAG recommended that an updated strategy be developed to succeed APSED (2010), incorporating experiences and lessons learnt over a decade of APSED implementation.
Based on intensive consultations with Member States and partners, the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies (APSED III), which serves as a regional framework for IHR (2005), was developed to further strengthen public health emergency preparedness and response capacity and capability by focusing on improving core public health systems and increasing regional connectivity.
Progress on HIV, immunization and disability prevention
HIV and sexually transmitted infections
There has been significant progress in tackling HIV in the Region, but much still remains to be done. Overall HIV prevalence in the Western Pacific Region remains low at 0.1%. However, no significant decrease of new HIV infections has been observed since 2010. In 2015, 94 000 new infections occurred in the Region. Among children, there was only a slight drop in new infections to 1800 in 2015 from 2200 in 2012.
In 2012, there were an estimated 61 million incident cases of chlamydia, 45 million of trichomonas, 35 million of gonorrhoea and 990 000 of syphilis in the Western Pacific Region. Sexually transmitted infections (STIs) are major contributors to HIV transmission, pelvic inflammatory disease, infertility and cervical cancer.
Support from WHO for HIV/AIDS efforts in the Region has focused on five high-burden countries (Cambodia, China, Malaysia, Papua New Guinea and Viet Nam) and three low-burden countries (the Lao People’s Democratic Republic, Mongolia and the Philippines). All eight countries had been implementing national HIV/AIDS strategic plans in line with the WHO Global health sector strategy on HIV/AIDS 2011–2015.
Most of the high-burden countries in Asia have moved from prevention and control to elimination of mother-to-child transmission of HIV and syphilis linked to hepatitis B control efforts. The WHO Western Pacific and South-East Asia regions in 2015 established a biregional mechanism for validating elimination of mother-to-child transmission.
Expanded Programme on Immunization
The Western Pacific Region has made good progress in strengthening immunization services. As of 2015, a total of 16 countries have achieved the regional target of coverage above 95% with three doses of diphtheria-tetanus-pertussis vaccine (DTP3), while 21 countries achieved DTP3 coverage of 90% or above. Still, vaccination coverage varies by country, and coverage disparities may exist within countries.
The Western Pacific Region has sustained its polio-free status since certification in 2000. But the Region still faces threats of importation of wild poliovirus (WPV)—most recently in 2011 in China—and the emergence of circulating vaccine-derived poliovirus (cVDPV). In 2015, the Region identified its most serious cVDPV emergence in the Lao People's Democratic Republic.
Countries and areas have been focusing on coverage disparities and addressing issues through implementing comprehensive multi-year plans (cMYP) on immunization. Improvement plans on effective vaccine management (EVM) were developed by seven countries (during 2014–2016) to address immunization service gaps in vaccine management.
In addition, regional guidelines on immunization safety surveillance and communication were developed in 2015 to support staff capacity-building on service delivery. Countries are working on strengthening the Health Information Management System (HIMS) to generate quality immunization data to monitor and evaluate coverage disparities.
As of June 2016, a total of 13 countries and areas have been verified as meeting the 2017 hepatitis B goal. An additional 11 countries and areas have conducted nationally representative serosurveys indicating a prevalence of less than 1%. A birth dose (BD) consultation was conducted in March 2015, focusing on priority countries with low BD coverage. Following publication of the Regional Action Plan for Viral Hepatitis in the Western Pacific 2016–2020, senior officials from eight Member States with high burdens met to discuss implementation of the regional plan.
Disability prevention and rehabilitation and blindness prevention
The WHO global disability action plan 2014–2021: Better health for all people with disability (GDAP) continues to frame the priorities for WHO and Member States in the Western Pacific Region. Endorsed by the World Health Assembly in 2014, the GDAP is based on recommendations from the World Report on Disability 2011. The GDAP recognizes disability as a global public health issue, a human rights issue and a development priority.
WHO supports the development of national plans, training, epidemiological surveys and disease-specific strategies in the programme area of Blindness Prevention and Control. Towards Universal Eye Health: A Regional Action Plan for the Western Pacific (2014–2019) guides efforts to further improve eye health by Member States, WHO and international partners. Governments have been supported with evidence to prioritize planning. The programme has also developed a set of recommendations to increase the effectiveness and improve the quality of national eye care systems.
WHO has worked closely with Cambodia, Fiji, Kiribati, the Lao People's Democratic Republic, the Federated States of Micronesia, Mongolia, the Philippines and Vanuatu, achieving policy success as demonstrated through national action plans and increased government funding to disability programmes in the Region.
Countries in the Region have also strengthened efforts to reduce disability due to visual impairment through more effective policies and integrated services. In line with Towards Universal Eye Health: A Regional Action Plan for the Western Pacific (2014–2019), three new survey tools have been developed to reduce disability due to visual impairment.
Significant progress has been achieved in addressing the constantly changing public health issues of the Western Pacific Region, yet there are still challenges to be hurdled. WHO will remain steadfast in working with Member States in order to ensure that
the health and well-being of the Region's 1.9 billion people are always promoted and protected.