April 7 marks the founding anniversary of the World Health Organization (WHO). It was on this day, in 1948, that the WHO Constitution came into force for the first time.
It is on this day that the world observes ‘World Health Day’ each year. This year, we mark the occasion under the theme “My Health, My Right”.
This year’s theme was chosen to champion the right of everyone, everywhere, to have access to quality health services, education, and information. It tells us of the right to safe drinking water, clean air, and good nutrition. It reminds us that quality housing, decent working and environmental conditions, and freedom from discrimination are rights that should be enjoyed by everyone.
Indeed, ensuring that every person reaches their highest attainable standard of physical and mental well-being is at the core of WHO’s mission. It is incumbent upon us to ensure that each person’s race or religion, their political beliefs, or their economic or social conditions are no impediment to this.
My own vision for WHO’s South-East Asia Region is a region where people ‘take a holistic approach to health and well-being, and are physically and mentally empowered to achieve their full potential’. I would like to see a region where ‘the right to health is enjoyed by everyone, starting from before birth, including the most vulnerable, and covering every community’.
A region that has seen many gains
One might ask how the right to health is manifested? This is done by ensuring universal access to high-quality health services, and addressing underlying determinants of health, such as education, safe food and water, adequate housing, good environmental conditions and more.
In short, the right to health requires that both health services and the underlying determinants of health are available, accessible, acceptable and of adequate quality.
On World Health Day, we say with pride that the South-East Asia region has seen many gains, and has much to celebrate with regard to the right to health. Over the years, WHO member states have racked up improvements in many different health indicators.
The Universal Health Coverage service coverage index has improved from 47 (in 2010) to 62 (in 2021). The average density of medical professionals has increased by 30.5% since 2015, currently standing at just over 28 per 10,000 people. These gains in numbers are complemented by ongoing transformative health professional educational initiatives throughout the region.
From 2000 to 2020, our region reduced the maternal mortality rate by 68.5%. Under-five mortality dropped from 84 to 29 per 1,000 live births, and neonatal mortality fell from 41 to 17 per 1,000 live births.
Regional immunisation coverage for diphtheria tetanus toxoid and pertussis (DTP3), measles-containing-vaccine second-dose (MCV2), and pneumococcal Conjugate vaccine (PCV3) significantly increased from 2021 to 2022. Most member states are meeting or expected to meet the global target of 2030, of over 90% coverage for DTP3 and MCV2.
Between 2015 and 2021, new HIV infections in the region declined by 25% and malaria incidence rates by 62%. The average International Health Regulations (IHR) core capacity index scores improved from 64 to 68 between 2015 and 2022.
There are challenges
Nonetheless, challenges remain.
Nearly 40% of the region’s population still lacks coverage by essential health services, and the COVID-19 pandemic has stalled or even reversed progress in some member states.
Adequate investment in health remains a challenge, with current government health expenditure in the region being unacceptably low. As a result, the out-of-pocket health expenditure faced by people is unacceptably high. The proportion of households experiencing financial hardship in accessing basic health care has been rising in several countries, pushing many households into avoidable financial hardship.
We continue to face challenges in tackling communicable diseases such as tuberculosis (TB), and although the probability of death between the ages of 30 and 70 years from four major diseases (cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases) has decreased by 13% since 2000, it still remains unacceptably high at 21.6%.
Worryingly, poor quality care accounts for more deaths than lack of access to care. Those from vulnerable and disadvantaged groups often receive the worst care. Too many still face stigma related to certain health conditions, such as HIV/AIDS, disability, or mental health conditions. They also face discrimination in the health system based on their gender, class, ethnicity, religion, sexual orientation, or other characteristics.
Gender inequality hampers equitable access to diagnosis and treatment for non-communicable health conditions. For example, when compared with men, a higher proportion of women with raised blood glucose go untreated. This gap is also seen for hypertension. Violence against women and girls persists, constituting a violation of their human rights — and a critical public health concern.
Against this backdrop, we call on governments to increase investments in health and strengthen health systems, particularly focusing on primary health-care. Good laws and policies are essential to address various health determinants, including tobacco control, environmental protection, and better nutrition. Health services must be made more accessible, acceptable, and of better quality for all individuals, without discrimination.
Focus areas
To address these and other issues, I have outlined five priority areas where I intend to focus during my tenure. These include mental health, women and children (including pregnant women), vulnerable population groups, climate change, and technology and innovations.
The gains we make in these areas will be felt throughout our communities and countries, and will leave lasting multi-generational benefits.
It is up to governments and organisations such as WHO, as duty-bearers, to respect, protect, and fulfil the right to health and ensure its progressive realization.
On World Health Day, on the 76th founding anniversary of the World Health Organization, let us renew our commitment to a future where health is not a privilege but a promise — a promise to safeguard the dignity and well-being of everyone, everywhere.
Let us remember “My Health, My Right”.
Saima Wazed is Regional Director of the World Health Organization South-East Asia Region
