In recognition of the immense and increasing public health risks caused by climate change, Member countries of WHO South-East Asia Region last week unanimously endorsed the Malé Declaration, committing to build health systems able to anticipate, respond to, cope with, recover from and adapt to climate-related shocks and stress.
“Climate change is happening, and is a risk to public health. Whether from greater severity and intensity of extreme weather events, changes in the spread and abundance of disease-carrying vectors such as mosquitoes, or changes to the physical environment that cause displacement or threaten livelihoods, climate change is already having an impact across our Region. The Declaration demonstrates the commitment of the South-East Asia Region’s Member countries to take effective and immediate action,” Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia, said.
The Declaration being adopted at the Seventieth Regional Committee session of the WHO South-East Asia Region – the Region’s highest decision-making body – builds on recent initiatives at country, regional and global levels to tackle the public health risks caused by climate change. The Declaration is accompanied by a Framework for Action to be implemented between 2017 and 2022, and calls on UN agencies and other international organizations, development partners, philanthropic agencies, academic and civil society organizations to mobilize human, financial and technical resources for this purpose.
“Building health systems resilience to climate change requires buy-in from all stakeholders,” the Regional Director emphasized. “As outlined in the Declaration, core action points include establishing and strengthening climate change and health information systems and research; integrating climate risks with national disaster risk management; enhancing health sector preparedness for climate-related events, including by securing essential services such as water and sanitation, waste management and electricity; and initiating the greening of the health sector by adopting environment-friendly technologies and using energy-efficient services. By fully implementing these and other initiatives, health systems can protect vulnerable populations across the Region against health risks caused by climate change,” Dr Khetrapal Singh said.
The Regional Director emphasized WHO’s support to Member countries as they implement the Malé Declaration, and committed to mobilizing resources, promoting knowledge and experience-sharing mechanisms, and providing technical support to Member countries at the same time as building local capacity. She affirmed WHO’s commitment to presenting a progress report at the Seventy-fifth session of the WHO Regional Committee for South-East Asia in 2022.
“WHO South-East Asia Region is committed to supporting Member countries as they strive to strengthen health systems to deal with one of the 21st century’s most pressing issues – climate change. We know what must be done. We can and must act now to meet the immense and increasing public health risks caused by climate change,” Dr Khetrapal Singh said.
She also paid a glowing tribute to the host country. “The Maldives has a proud record in public health. In 2016: Maldives was the first country in the South-East Asia Region to eliminate Lymphatic filiariasis. The year before, 2015: Maldives was declared malaria free. This year: measles has been eliminated. These are outstanding achievements. We warmly congratulate you,” she said.
“I know that you are aiming to end TB by 2020 - 10 years ahead of the overall regional target. I know too you are doing pioneering work on vector control to combat dengue and other vector-borne diseases. For those here that may not know: in the early 1980s Maldives was among the poorer countries of the world.”
Now, following years of sustained growth, Maldives is an upper-middle income country with resources to ensure its people live healthy and prosperous lives. The achievements I referred to show what economic growth can do for public health. But - it is the other half of the story that I want to emphasize today, she said.
“A side of the story that is relevant to every country in our Region.
Sustained investment in health is a vital weapon if governments wish to ensure that hard-won economic progress continues. Do not be in any doubt at all about the risks to growth. They are serious.
The growing toll of non communicable diseases, Anti-microbial resistance Traffic accidents and violence, drug and substance abuse, poor diets and sedentary lifestyles , and the threat that I know that you live with daily on these islands - the impact on health of a changing climate.
Success is a product of skilled governance - in the health sector, of course. But - critically - across society.
“The Maldives has followed other countries in the Region in starting to address the commercial determinants of ill health. A 40% increase on the import duties levied on cigarettes, 58% on energy drinks and 17% on sodas. This is laudable,” she said.
But we all know there is more to do, and that the politics of doing so - will be tough. Whether it be controlling the prices of medicines, or ensuring the safety of our food.
As we look across the Region there remains an unacceptable gap between what we say about the importance of health to our economies and the resources that governments actually commit to health.
The Maldives is a leader in terms of spending per capita.
As resources for health increase, though, it is no longer just a question of spending more, but of spending wisely - and spending strategically.
People’s expectations are changing: they want the best health care possible and are increasingly vocal if their demands are not met.
Strategic use of resources promotes greater equity.
Using the purchasing power of government wisely can help redress the balance between prevention and curative care.
It can create the incentives that people need to make healthy life choices.
In this Region we are committed to the achievement of Universal Health Coverage. Every single country is making headway and we have powerful means to measure progress. UHC must never be just a slogan. The challenges we all face are real and complex.
But UHC is the best and most powerful means we have at our disposal for changing peoples’ lives through better health.
The power of WHO is the power of countries working together. Catalysing action, nurturing partnerships.
“We have a lot to learn - from each other, and from the rest of the world.
The Regional Committee is an opportunity to reflect on our achievements. But it is also an opportunity to chart the course ahead.
As we debate and discuss over the next few days I see three overarching themes that should underpin all our work.
First, we must strive for a more equitable, effective and results-oriented health sector Second: we must build bridges across society to address the social, political and commercial determinants of ill health
And third: we must follow our principles - promoting equity and rights; basing action on science, evidence and research; and leveraging the immense power of partnership,” Dr. Poonam said.
The Maldives spends the highest amount on the health sector from the budget which is 26 percent. However, we have other challenges and to build a health system resilient to the climate change is the key challenge, Minister of Health Maldives Abdulla Nazim Ibrahim said.
“Managing waste is a huge challenge. We are in the process of establishing environmental friendly disposal system,” he said.
(Pix credit: Sanjeevi Jayasuriya and WHO)