WHO / J. Kelly Halina
WHO Regional Director Dr Saia Ma'u Piukala delivers his address and report at the seventy-sixth session of the Regional Committee in Fiji.
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Address at the seventy-sixth session of the WHO Regional Committee for the Western Pacific

Dr Saia Ma'u Piukala, WHO Regional Director for the Western Pacific, Nadi, Fiji

20 October 2025

Chairperson, Honourable Atonio Lalabalavu,

Honourable ministers,

Distinguished representatives from Member States and partner agencies,

Ladies and gentlemen:

Good morning colleagues and friends.   

A year ago, we embraced the metaphor of weaving a mat – a symbol of unity, strength and shared purpose. 

Today, as I look back on the past year, I am deeply moved by what we have woven – together. 

The mat we envisioned is now vibrant with colour and meaning, each strand representing the dedication, innovation and resilience of our Region. 

It is with great pride and humility that I present to you highlights from the Report of the World Health Organization in the Western Pacific Region, covering the period from 1 July 2024 to 30 June 2025.  

This year’s achievements are not just milestones – they are reflections of your leadership.  

You are the drivers of change, the energy behind progress, and the reason we’ve been able to advance primary health care, climate and health system resilience, emergency preparedness, health promotion and digital transformation. 

Only leaders like you – committed, courageous and collaborative – can make this happen. 

Together, we are not just improving health systems. We are saving lives. We are shaping futures.  

And we are proving that when we weave together, we create something far stronger than any one strand alone. 

While we gather today to celebrate our collective achievements, I must also acknowledge the weight of the world we are navigating together. 

The year 2024 was the hottest year on record – underscoring the climate crisis. 

Rising temperatures have disrupted our food systems, melted polar ice, stirred our oceans, and tested the resilience of our cities, islands and communities.  

Climate change has also affected our bodies and burdened our minds.  

Looking north, the extreme winter in Mongolia, limited health-care access, and killed millions of livestock, threatening the livelihoods of herding communities. 

In the East, the Vanuatu December earthquake disrupted hospital clinical services. 

In the West, seasonal typhoons – including Typhoon Yagi – displaced populations, and damaged hundreds of health-care facilities in the Lao People's Democratic Republic, the Philippines and Viet Nam. 

And for the first time in decades, we saw armed conflict on the Thai-Cambodian border.

We are living in a time of “permacrisis” – a world where emergencies are constant. 

But amid this turbulence, one truth is undeniable: health remains the foundation of peace, prosperity and survival. 

This year’s report is not just a record of activities – it is a reflection of how, together, we have stood firm in the face of adversity.  

It shows how the Regional Office, with a renewed management team, has worked hand in hand with our 38 countries and areas, and our partners, to provide steadfast support, at a time of great uncertainty. 

Our work this year has been guided by a shared vision: that health is not a luxury, but a right.  

That health is not a sector, but a pillar – essential to individual dignity, community strength, national resilience, and global solidarity. 

The lessons of the COVID-19 pandemic are as relevant as ever. 

We must continue a dual-track approach: delivering people-centred care through strong primary health systems; and preparing better for emergencies arriving faster than before.

Yes, we are facing financial challenges – triggered by the withdrawal of key donors, and shifting global priorities. 

But these challenges have also opened new doors. 

We are seeing a powerful shift, towards more South-South collaboration.

Countries are stepping up – crafting their own plans, investing their own resources, and leading their own futures.

This report captures this momentum in the first full year of implementing our regional vision: Weaving Health for Families, Communities and Societies. 

This narrative is not just about what WHO has done. It is about what you have achieved. 

As your Secretariat, we have simply woven together the threads of your work country by country. 

While this report cannot capture the full depth of your efforts, it offers a powerful glimpse into what is possible when we act as one Region, united by purpose and driven by impact. 

The five vertical strands of our Regional vision have helped organize our collective action. 

The three horizontal enablers have strengthened our ability to support you  our Member States – more effectively, and more responsively.

As we present the Programme Budget this week, we will also show how we are aligning our resources to where they are needed most – in your countries, in your communities, and on the frontlines of care.

In my travels across the Region, I have seen first-hand the courage of our health workers, the innovation of our ministries, and the resilience of our people. 

I have seen that when we come together, we do more than respond – we transform. 

“In the face of storms, we do not unravel. We tighten the weave.”

Measurable outcomes are not just a theme of this report. They are the backbone of our work together. 

From the very beginning of my term as Regional Director, now approaching its two-year mark, I’ve held firm to a simple truth: We cannot manage what we cannot measure. 

Our regional vision calls us to deliver results, and to do so with precision. 

That’s why this year, we’ve taken a significant step forward. 

We’ve established baseline data for 10 of the 18 Delivery for Impact indicators, country by country. 

These indicators, are not just numbers. They are a reflection of lives improved, systems strengthened, and futures protected. 

This report also includes comparative country profiles drawn from authoritative sources to help us see where we stand – and where we must go next. 

Because in this Region, we don’t just celebrate progress. We measure it. We own it. And we build on it – together.

First: Transformative primary health care, for universal health coverage.

At the heart of our regional vision lies a simple but powerful truth: health must be accessible to all, not just to some – under the umbrella of universal health coverage.

Over the past two decades, we’ve seen remarkable progress. 

The UHC Service Coverage Index in our Region rose from 44.1 in 2000 to 75.6 in 2021 – proving the commitment of our Member States. 

But progress has slowed since 2019, and the pandemic has exposed deep cracks in equity. 

Catastrophic health spending is currently affecting one fifth of the Region's population, up from one sixth in 2000, placing unbearable pressure on families.

And service coverage still ranges widely – from 30% in one country to 89% in another – highlighting persistent disparities, especially in our Pacific island nations. 

Yet, there is hope. Countries are stepping up, with bold reforms and renewed energy. Just a few examples: 

China’s National Health Care Security Administration is building systems to finance long-term care for older people – in partnership with the Ministry of Finance and the National Health Commission. 

The Framework for Sustainable Health Development, in the Federated States of Micronesia, sets a clear path for investment and coordination. 

Viet Nam now covers 95% of its population under public health insurance – with  reforms introduced last year, to enhance quality and efficiency. 

But achieving UHC means tackling the deeper drivers of health system effectiveness  such as antimicrobial resistance or AMR.  

This year, we saw strong momentum: Papua New Guinea and the Philippines strengthened their national AMR guidelines and plans. 

Fiji, Nauru, Palau and Tonga received AMR surveillance training. 

Despite global funding challenges, our Region is pushing forward on the unfinished agenda of communicable diseases: Cambodia is nearing malaria elimination. 

Lao PDR is closing the gap on schistosomiasis. 

Papua New Guinea screened 79% of its target population for neglected tropical diseases.

Fiji, French Polynesia, and Wallis and Futuna led mass drug administration against lymphatic filariasis.

And Viet Nam was recognized for eliminating trachoma. 

On noncommunicable diseases, countries are strengthening surveillance and care: Fiji, Nauru, Niue and Tuvalu, updated their NCD data using the WHO STEPS approach. 

The Philippines achieved 85% blood pressure control in one province in its Healthy Hearts Programme, now scaling up nationwide.

Solomon Islands enhanced diabetic foot care through coaching and quality improvement, reducing wait times and expanding services.

Tuberculosis remains a major challenge, but innovation is driving progress: Cambodia cut TB mortality by 50%, and incidence by 42% since 2000, using AI-assisted chest x-ray screening. 

Mongolia adopted a system optimization strategy in its 2025–2028 national TB plan.

And immunization efforts continue to protect millions: Cambodia responded to a measles outbreak with a campaign reaching 1.5 million children. 

The Federated States of Micronesia, Vanuatu and Tonga strengthened immunization policies and lab testing.

On HPV vaccination: Lao PDR has vaccinated more than 600 000 girls since 2020, with 80 000 more in the past year.

Mongolia aims to reach 90% coverage for 11-year-olds, with 40% already vaccinated.

A strong health workforce is the backbone of equitable care.  

While physician and nurse numbers have improved, pharmacist density remains low. 

Countries are responding: The Philippines launched the PhilPac initiative with Pacific island countries to address chronic shortages through mutual exchanges. 

Cambodia, Fiji, Papua New Guinea and Solomon Islands developed long-term workforce strategies. 

Transformative primary health care is also gaining ground: China is piloting integrated care for 59 million people with digital solutions and financial reforms.

Nurses in Brunei Darussalam lead national screening for major NCDs, including cancers. Kiribati, Nauru and Tonga enhanced pharmaceutical systems.

This is what transformative primary health care looks like – bold, inclusive and rooted in the realities of our Region. 

Together, we are not just closing gaps. We are building bridges. 

And we are proving that with the right vision, the right tools and the right partners, UHC is not just possible – it is well within reach. 

Turning now to Climate-resilient health systems: Building strength where it matters most. 

In the Western Pacific, climate change is not a distant threat. It is a daily reality. 

Rising sea levels, extreme weather events and shifting rainfall patterns are already reshaping the health landscape across our islands and coastlines.  

Our health systems must evolve – not just to survive these changes, but to thrive despite them.

Recent data from 16 countries show that 88% of health-care facilities have access to basic water services. 

But that also means, more than one in 10 still lack this fundamental necessity.

In four countries – primarily in the Pacific – coverage falls below our regional target of 80%, with two countries below 70%. 

But water access is just the beginning. It is the floor, not the ceiling, of climate resilience.  

To truly safeguard our communities, we must invest in solar energy, infrastructure retrofitting, and workforce training – and we are doing just that. 

Here, let me specifically mention climate resilience projects, supported by the Korea International Cooperation Agency (KOICA): 

In Fiji, the Verata Nursing Station was reopened after major renovations and solar power installation, under the SHAPE Project, a multi-year initiative, led by KOICA, WHO, and the Ministry of Health and Medical Services. 

SHAPE Project has strengthened five other health facilities, installed solar power in 18 facilities, trained more than 600 health workers, and enhanced disease surveillance and community adaptation. 

In Kiribati, the Te-MaMAURI KOICA initiative is assessing climate risk and building culturally appropriate resilience strategies for outer islands. 

On another front, proximity to the sea is a wake-up call. 

A recent survey across 14 Pacific island countries revealed that 62% of health facilities are located within 500 metres of the coastline.

In low-lying atoll nations, such as Kiribati, Marshall Islands, Nauru, Palau, Tuvalu and Tokelau, every single health facility falls within this vulnerable zone. 

These findings underscore the urgency of adaptation – not just in policy, but in physical infrastructure.

Our Region is not alone in this journey.

Through the Alliance for Transformative Action on Climate and Health or ATACH, more than 95 countries and areas have committed to building climate-resilient and low-carbon health systems. 

Many Western Pacific countries are active members, contributing local knowledge and benefiting from global collaboration.

We have so many examples of climate adaptation in action: China launched its first National Action Plan on Health Adaptation to Climate Change involving 12 ministries in a coordinated framework.

Solomon Islands and Fiji developed National Health Adaptation Plans.

Viet Nam hosted a national conference on air pollution, and is implementing climate-resilient infrastructure in hospitals, including solar energy and water systems.

“Resilient health systems, are not built in calm waters. They are forged in the storm.”

In a Region as diverse and dynamic as ours, health security is not just a technical goal – it is a moral imperative. 

We know that resilience begins with preparedness. 

That’s why countries across our Region are strengthening core capacities under the International Health Regulations. 

This past year, we’ve seen bold leadership and decisive action: In Mongolia and Singapore, careful reform led to the launch of Centres for Disease Control, sharpening the public health system architecture and evidence-informed decision-making.   

Public health emergency operations centres are now equipped and trained in Fiji, Mongolia, Tonga and Vanuatu – a major achievement for efficient emergency response. 

Cambodia and Cook Islands launched their national pandemic preparedness plans, advancing their readiness posture for future respiratory disease pandemics. 

Cook Islands, Lao PDR, the Philippines, Solomon Islands and Vanuatu conducted IHR Joint External Evaluations – or JEEs – to prioritize measures for more effective health security. 

Samoa and Cambodia developed comprehensive national action plans for health security, informed by their JEEs.  

The cooperation between countries on the IHR is notable.   

I thank Australia, China, Japan, New Zealand, Republic of Korea and Singapore for funding IHR health security work – including JEEs – in our Region.   

Cambodia, Mongolia, Philippines and Samoa have leveraged their JEE findings to be awarded Pandemic Fund grants worth US$ 65 million.   

Through the connected country leadership, we have seen more timely IHR event notification – shifting from a median of 20 days in 2023 to two days in 2025.   

I thank countries for their commitment to obligations under the IHR that protect the health of people everywhere.   

Turning now to surveillance and laboratories: The frontline of detection.  

Multiple outbreaks – from dengue to leptospirosis, measles and HIV – were experienced by multiple countries and areas – including Fiji, French Polynesia, Guam, Kiribati, Mongolia, New Caledonia, the Philippines, Samoa, Tokelau, Tonga, Vanuatu and Viet Nam.  

Of these, six received life-saving supplies worth US$ 816 000 from WHO emergency stockpiles, generously enabled by China and Japan. 

And three received technical experts under the regional Global Outbreak Alert and Response Network to bolster their responses.  

Laboratory capacity is the cornerstone of effective outbreak response. 

Today, only 15 countries in our Region – or 53% – have in-country sequencing capabilities. 

The rest – mostly in the Pacific – rely on external laboratories. 

Our goal is to increase this to 70% by 2029, with at least four more countries building their own capacity.  

We are already seeing progress: The Pathogen Genomic Laboratory at the Fiji Centre for Disease Control is now equipped to rapidly detect and respond to threats like influenza, COVID-19 and mpox.  

Laboratories in Papua New Guinea and seven other countries are being trained in sequencing by Australia’s Centre for Pathogen Genomics, to establish and strengthen end-to-end genomic surveillance capacities. 

I’m also proud of the progress made in Emergency Medical Teams regionwide. 

EMTs from Singapore, the Philippines and the Pasifika Medical Association achieved global classification, and Fiji’s team was re-classified. 

This means that, as of 30 June, our Region hosts 40% or 17 out of 41 classified EMTs globally.  

And I must take a moment to recognize that in the last week, Indonesia had its first EMT join the ranks of classified global teams.  

EMTs from our Region continue to be among the first to respond when emergencies strike.   

EMTs from Australia, Japan, the Philippines and Singapore were deployed to Myanmar in response to a devastating earthquake.   

And Vanuatu coordinated the deployment of EMTs from Australia, Fiji, Indonesia, Japan and New Zealand – along with its own VanMAT – in response to last December’s earthquake.   

EMTs also support mass gatherings. A joint Samoa and New Zealand EMT was activated for the Commonwealth Heads of Government Meeting in Samoa. 

And Papua New Guinea’s EMT was activated for the Papal visit last September.   

This is what resilience looks like – communities that are prepared, systems that are responsive, and societies that stand ready to protect their people.   

Honourable ministers and distinguished guests: We are not just building capacity. We are building confidence. We are building trust. 

And we are building a Region where health security is not a privilege, but an interwoven promise.  

“Resilience is not the absence of crisis. It is the presence of strength, strategy and solidarity.”  

For healthier people throughout the life course...Health is not just about access to services – it’s about the environments we live in, the choices we make, and the systems that support us, from birth  to old age.  

In the Western Pacific Region, we are shifting our focus upstream  towards the social and commercial determinants of health  to prevent disease before it begins and to promote well-being across every stage of life. 

Healthy ageing is advancing  through lifelong promotion, supportive policy, and age-friendly environments with China expanding integrated care for older people, and the Philippines rolling out a national plan and age-friendly initiatives. 

Oral health, a long-neglected issue, is also rising on the agenda  marked by the WHO Global Oral Health Meeting in Bangkok  and advanced through country action. 

This includes the Philippines policy development and training toolkit, so primary health-care providers can deliver essential oral health services. 

This year, countries have made meaningful strides in adopting WHO 'best buys' for NCD prevention. 

Seventeen of the Region’s 38 countries and areas have fully or partially implemented at least 10 of the 15 recommended interventions.  

But seven countries still lack sufficient data  highlighting the urgent need for stronger policy momentum and technical support.

We must invest in better data systems – to track progress, verify outcomes, and ensure that no community is left behind – because what gets measured, gets improved. 

Tobacco control, remains a regional priority. 

Tobacco use is one of the most preventable causes of death in our Region. 

While many countries have advanced tobacco control, tobacco use prevalence remains high. 

And the rise of electronic nicotine and non-nicotine delivery systems is deeply concerning, especially among our young people. 

But our Region is responding with bold action. 

Cook Islands raised the legal age of sales to 21, increasing tobacco taxes by over 50% over the next three years. And has declared four islands smoke-free  the result of two decades of community-driven advocacy. 

Cambodia designated Battambang and Kampong Cham as new smoke-free Tourism Cities, protecting more than 200 000 people from secondhand smoke. 

Marshall Islands is using the Global Youth Tobacco Survey to inform legislation and protect adolescents. 

Viet Nam banned e-cigarettes and heated tobacco products, starting January 2025  and has approved the revised Excise Tax Law to increase tobacco tax.  

And Australia changed its law so that all vapes and vaping products, with or without nicotine, can only be sold in a pharmacy for the purpose of helping people to quit smoking or manage nicotine dependence.   

Healthy diets and alcohol control are the next frontier in tackling NCDs. 

While tobacco control is gaining ground, far fewer countries have implemented strong measures on alcohol consumption and unhealthy diets. 

That’s why alcohol control is a key agenda item at this week’s Regional Committee. 

Still, there are bright spots: Viet Nam approved an alcohol tax increase aiming to curb alcohol consumption nationwide.

Singapore became the first country in the Region to eliminate industrially produced trans fats from its national food supply  and received WHO’s validation certificate. 

Cambodia rolled out a national salt reduction campaign. 

And Papua New Guinea updated its NCD protocols and training manuals to align with WHO best buys. 

Another area where our Region simply must do better is injury prevention, including a focus on road safety. 

Needless injury and death can be prevented through relatively simple measures and strict enforcement. 

Viet Nam passed legislation requiring children under 10 to sit in rear seats as part of a broader strategy.

And Metro Manila launched a Road Safety Action Plan (2024–2028) for its 15 million residents. 

Here, I would like to report far more progress next year as we have a long way to go.  

On a brighter note, mental health is finally receiving the attention it deserves.  

Singapore Health Services Community Hospitals were designated the first WHO Collaborating Centre for Social Prescribing. 

And Palau finalized an analysis to inform its national suicide prevention strategy advanced through school health programmes.  

There is a growing need to focus on our young people Region-wide, given the burden of mental health issues they increasingly face. 

Health is a journey  not a destination. And in our Region, we are walking that path together – towards healthier lives, stronger communities, and a future in which prevention is as powerful as a cure.

“When we invest in health across the life course, we don’t just add years to life  we add life to years.”

In today’s world, data is more than numbers – it’s a lifeline. 

When collected and used wisely, health data can transform how countries identify priorities, make investment decisions, and course-correct policies to ensure no one is left behind. 

Yet, many countries in our Region remain off track to meet their health-related SDG targets. 

The challenge is clear: we must strengthen our health information systems to monitor progress, guide action, and build trust in our decisions. 

While we’ve seen improvements in population surveys and health service data, many countries still struggle to track key indicators, relying on global estimates that may not reflect local realities.

But there is momentum, and it’s growing.

Lao PDR piloted a programme to send vaccine reminders via text message to 50 000 parents, improving immunization follow-up.

Malaysia introduced its first National Health Literacy Policy, integrating health education across schools, media and digital platforms.

Brunei Darussalam expanded the BruHealth platform, originally built for COVID-19, to help individuals manage appointments, screenings and medical records. 

Papua New Guinea developed its National Digital Health Strategy (2025–2030), aligning with global frameworks, and incorporating inputs from national and local stakeholders. 

As we look ahead, we must prioritize areas that will deliver the greatest impact: Immunization, especially childhood vaccination, remains our top priority. 

Declining coverage in some countries – often triggered by disinformation – threatens public health, and safety in our Region and around the world. 

Hypertension control is a low-cost, high-impact intervention that can dramatically reduce premature deaths, from stroke and heart disease.

Tobacco and alcohol-related morbidity must be tackled through proven WHO best-buys and policy reforms. 

Oral health must be integrated into primary health care, supported by lifelong promotion and policies. A healthy mouth and smile are fundamental to daily life. 

Healthy ageing shapes future-ready social and health systems. 

This includes PHC-led integration with community long-term care, caregiver support, and age-friendly environments. 

Safe water in health-care facilities is essential  especially as 70% of our population live in coastal areas, vulnerable to sea-level rise and flooding. 

Emergency preparedness must be rooted in community inclusion and resilience. 

And as we accelerate the use of AI and digital technology, we must ensure these tools are accessible to all bridging gaps, not widening them. 

“Innovation in health is not about machines – it’s about meaning. It’s about making every life count.” 

The vision of Health for All  the foundation of WHO’s mandate in the Western Pacific Region, and globally  is not a distant dream.   

It is a tangible goal, and this report shows that it is within reach. 

Our Member States and partners are proving that progress is possible, even in the most challenging of times. 

As we enter the next biennium, we are called on to do more  with less.

We must deliver services more effectively, more equitably, and more innovatively.  

The world around us is uncertain, but the pathways forward are becoming clearer. 

These pathways are not forged by chance. They are shaped by the determination of the weavers of health across our Region. 

Together, we are not just responding to crisis – we are building systems that endure. 

We are not just treating illnesses  we are nurturing well-being. 

And we are not just managing programmes  we are protecting futures. 

At the heart of it all, is a simple truth: health is a human right. 

It belongs to every child, every elder, every family, and every community. 

It is the thread that binds development, dignity and hope. 

Just after I conclude this address, we will be recognizing a number of Member States whose accomplishments in eliminating specific diseases as public health threats truly symbolize “Health as a human right.”  

Kudos again to Fiji and Papua New Guinea, for eliminating trachoma; 

To Japan, for eliminating rubella; 

And to 21 Pacific island countries and areas for eliminating measles and rubella. 

Let me now close with a quote that captures the spirit of our journey: 

“Weaving health, is not about perfect threads  it’s about the strength of the weave. And when we weave together, we create a fabric strong enough, to carry generations.”  

Honourable Ministers, thank you for your leadership, your partnership, and your unwavering commitment to Health for All. 

Let us continue this journey – together. 

Thank you and vinaka vakale.