Originally published by The Lancet Regional Health - Western Pacific on 19 July 2022.
This is a piece by members of the Technical Advisory Group (TAG) Alliance composed of chairpersons or representatives of all TAGs in the WHO Western Pacific Region, including: Gillian Biscoe, Adjunct Professor at University of Tasmania and Chair of the Technical Advisory Group on Universal Health Coverage; Annette M. David, Adjunct Professor and Chair Guam State Epidemiological Outcomes Workgroup; Paul Effler, Clinical Professor, School of Medicine, University of Western Australia; Yun-Chul Hong, Seoul National University; Christopher Morgan, Senior Technical Advisor at Jhpiego; Mario C.B. Raviglione, Founding Director, Centre for Multidisciplinary Research in Health Science (MACH), University of Milan; Maxine A. Whittaker, Professor, James Cook University; and Dr Takeshi Kasai, Regional Director, WHO Regional Office for the Western Pacific.
The vision
In 2019, Member States of the WHO Western Pacific Region (WPR) adopted the For the Future vision to create a healthier and safer region. The vision requires acting “today to address the challenges of tomorrow” and outlines the major public health priorities: health security, climate change and the environment, noncommunicable diseases (NCDs) and ageing, and reaching the unreached.
Acting today means redoubling our collective efforts towards Universal Health Coverage (UHC) and achieving the Sustainable Development Goals (SDG) while also addressing current and future pandemics.
In the For the Future vision:
- Vital health services reach more people.
- Everyone has access to vaccines preventing morbidity, disability and mortality.
- No one risks impoverishment from seeking health care, and everyone benefits from UHC including social and financial protection.
- Policies and environment supporting healthy lifestyles, markedly reducing NCD risks and prevalence.
- Health systems are strong and resilient to detect and respond to public health threats; people live in healthy environments that mitigate the threats of climate change; and
- All people, including the elderly, can live healthy, socially connected and productive lives.
In the decade prior to the COVID-19 pandemic, the WPR achieved the largest absolute gain in UHC service indexes compared to other regions.
This achievement however masks uneven progress and inequities which is likely to worsen as economic growth slows because of the pandemic. Prior to COVID-19, more than 1 in 5 households in some countries spent over 10% of their income on health care and across the region up to 60% of people couldn't access essential health services.
The challenges to be faced today and tomorrow are unprecedented in scale and complexity. With inaction, there will inevitably be greater health and social inequities, gender inequalities, technology inequalities and social injustice. If different sectors do not work collectively under the principles of UHC, the risk of not reaching those most in need of health care is significant, compromising social and economic outcomes.
Achieving the vision
As a result of the COVID-19 pandemic there is a heightened political awareness of how health impacts all sectors, and how important strong and resilient health systems are to overall social and economic development. There is therefore a unique opportunity to advocate for, and achieve, increased financing in health as part of governments’ overall investment in future peace and prosperity. To fully realise this opportunity, key actors outside health are to be engaged, promoting the urgent establishment of UHC and social protection thus creating the healthy future the world wants and needs for sustainable development.
Collectively there is a need to accelerate pace and focus on:
- Enhancing whole-of-government capacity to anticipate, prepare for and respond to future emergencies at national, subnational and local levels.
- Re-envisioning health care and social support throughout the life course including embracing healthy ageing.
- Developing sustainable and resilient health systems towards UHC that can achieve NCD prevention and promote immunisation and other preventive care, reduce child and maternal mortality, mitigate climate change, and ensure access to all people; and
- Creating healthy environments and lifestyles in safe and supportive societies.
Benefits of working collectively
UHC and strong health systems, backed by social net policies, which is accessible especially to the most vulnerable are the foundations of our vision. Delivering this vision requires a multidisciplinary and cross-sectorial approach and working collectively on future challenges. This translates to practical interventions such as strengthening laboratory capacity and collectively investing in integrated platforms rather than vertical disease approaches thus benefitting all relevant disease programmes. When working with primary health care workers, where multiple programs and strategies meet, adopt a patient-centred approach – for example, link NCD and communicable disease treatment and prevention and apply improved health literacy of healthy environments and lifestyles.
Harnessing synergies and opportunities, with UHC and social protection as a platform, is critical to achieving the SDG targets. It is doubly so – as we rehabilitate our health services and programmes in a post-COVID 19 world – ensuring that the refreshed system is more equitable, responsive, accessible and affordable for all, with improved health outcomes. Ultimately, a collective and committed movement towards UHC is an investment in overall economic and social development which translates into a healthier, more productive and cohesive society.
Contributors:
All the authors have contributed equally to the manuscript.
Declaration of interests:
We declare no competing interests.