The South East Asia (SEA) region is home to one-fourth of the world’s population, known for its young population, diversity, languages, traditions, and rich cultural heritage. The region has made substantial progress in health with its recent economic and technological advancement. However, it is still confronted with myriad public health challenges that impact the health and well-being of its population. The region has unfinished elimination of communicable diseases (for instance, around 45% of world TB cases are in this region), at the same time, noncommunicable diseases are on the rise, and air pollution and climate change have further compounded the public health challenges here.
The World Health Organisation (WHO) SEA region, therefore, requires comprehensive and collaborative strategies for effective interventions and prevention. To gain further insight and to throw the spotlight on emerging health priorities, we engaged in a conversation with Dr Shambhu Acharya, Director (Country Programmes), WHO HQs, who is also one of the candidates for the next Regional Director of WHO in the SEA region.
The conversation took place in the post-pandemic setting where all the countries, especially in the SEA region, are still recovering from its aftermath and working hard to accelerate the progress in achieving the health SDG targets. At the onset, Dr Acharya said, “The COVID-19 pandemic has exposed vulnerabilities in a healthcare system across the world and the South East Asia Region (SEAR) is no exception, necessitating investing more in a resilient health system, with primary healthcare as its foundation. As evidenced, 90% of basic health services can be provided at the PHC level and a strong PHC with preparedness capacity can respond better to any outbreaks, epidemics, or pandemics like COVID-19.
Infectious Diseases and Emerging Threats
One of the primary health challenges in SEAR is still the prevalence of communicable and infectious diseases. Vector-borne diseases (VBDs) like malaria, dengue, and Chikungunya fevers, and others like tuberculosis (TB) continue to pose threats to achieving universal health coverage. Additionally, the region continues to face challenges of emerging infectious diseases, such as avian influenza, and the Zika virus, which have the potential of quickly spreading across borders, demanding rapid surveillance, response, and preparedness from the existing health systems.
Maternal and Child Health
Despite continued success in this area, progress on maternal and child mortality rates seems to be plateauing in the SEAR. Compared to high-income countries, lack of maternal care, inadequate prenatal care, and limited access to skilled birth attendants contribute to persistent high maternal and child death rates. Child & adolescent malnutrition and inadequate response to most preventable diseases have adversely affected the health of children, leading to long-term consequences for their development and overall health. “Considering the demographic bonus (Re: growing numbers of adolescents) in the region, we certainly wish to ensure a much healthier, active, and productive population resource in the coming years”, underlined Dr Acharya.
Non-Communicable Diseases (NCDs)
Non-communicable diseases, including cardiovascular diseases, diabetes, and cancer, have emerged as significant public health challenges in the region. Factors such as unhealthy diet, tobacco use, lack of physical activity, and inadequate health service provision especially at the primary health care level for primary prevention and treatment of NCDs contribute to NCDs-related morbidity and mortality. Dr Acharya emphasised that these diseases place a tremendous burden on national health budgets, and health systems and affect the health and wellbeing of the population. And that “…the behavioural change and working around the social norms, which include avoiding unhealthy lifestyle practices need to be the centrifugal force driving individuals and their communities in adopting positive behaviours and lifestyles”.
Mental Health
Shifting gear during the conversation, Dr Acharya pointed to the growing numbers of people with mental health issues, especially among adolescents and the elderly, which has been exacerbated after the COVID-19 pandemic. Mental health issues are often overlooked but are critical challenges in the SEAR like in any other region. The stigma surrounding mental health, lack of awareness, and limited access to mental health services hinder individuals from seeking proper care. Moreover, people do not see mental health care due to stigma and discrimination. He recommended, “…addressing mental health challenges requires not only healthcare interventions but also societal awareness, acceptance and care to reduce the stigma associated with mental illnesses. I look forward to scaling up the mental health program in the SEA region to support countries in building a more robust and responsive mental health system.”
Universal Health Coverage and Strengthening Resilient Health Systems
The SEA region constitutes diverse countries with varied socioeconomic backgrounds and healthcare challenges, while also facing significant health disparities. In this context, Universal Health Coverage (UHC), based on resilient Health Systems Strengthening (HSS) emerges as the paramount priority. Its significance stems from the urgent need to address existing healthcare gaps, promote equitable access to essential services, and build resilient healthcare infrastructures. Dr Shambhu Acharya further underlined, as his top priority, “…the growing need for sustained financing for health and s building resilient health system with PHC as its foundation to ensure each and every citizen of the region has access to affordable and quality of health services to ensure no one is left behind”.
Health Inequities and Access to Healthcare
According to WHO and World Bank UHC monitoring report 2023, more than half of the world population still lacks basic health services. Since the SEAR is home to one-fourth of the population with varying levels of development, disparities in healthcare access and quality persist in the region, especially in remote and marginalized communities. Limited healthcare facilities, inadequate and misdistribution of healthcare professionals, and socioeconomic factors create barriers to accessing essential health services. Efforts to address health inequities must focus on improving healthcare infrastructure at the PHC level, increasing the number of trained healthcare workers, especially at the PHC level, and ensuring affordable and accessible healthcare services for all.
The public health challenges in the SEAR are multifaceted and require a holistic approach that must encompass substantive prevention strategies, field-based interventions, and a revisit to policy and associated reforms. Collaborative efforts between governments, civil society, communities, non-governmental organisations, and international partners are crucial to overcoming these challenges. By investing in healthcare infrastructure, promoting health education and awareness, and addressing the social determinants of health, the region can work towards building healthier communities and a brighter, healthier future for all its residents.
Wrapping up the conversation, Dr Shambhu Acharya emphasised, “…achieving health-related SDGs in the SEA can be a global game-changer, which is hosting over a quarter of the world’s population. With its economic, technological, and medical/pharmaceutical advancement with pioneer in low-cost production and innovative solutions, Dr Acharya is confident that health-related SDGs can be achieved working together with the member states”.
(The author is Sr. Consulting Adviser, Strategic Communication & Programmes for the UN System in Asia and the Pacific)
