Mr Bambang Susantono, Vice President, Asian Development Bank; Hon’ble Ministers of Health; Dr Takeshi Kasai, WHO Regional Director for the Western Pacific Region,
The global outbreak of COVID-19 demonstrates the critical impact public health events can have on all areas of social and economic life and on the attainment of universal health coverage (UHC).
And yet as you have gathered to discuss it is by no means certain that in the ongoing response to COVID-19 investments aimed at strengthening health systems for UHC will be sustained, much less scaled up – as they must be.
For Member States of the South-East Asia Region, today’s meeting builds on deliberations at last week’s Regional Committee, at which Member States adopted the Declaration on the Collective Response to COVID-19.
The Declaration reaffirms Member State commitment to respond to COVID-19 through collective and coordinated action, and in so doing to strengthen health systems for UHC.
The Declaration is aligned with a resolution on pursuing a comprehensive and coordinated response to COVID-19 adopted by the 74th session of the UN General Assembly on the 11th of September.
The spirit of both documents has been reflected in today’s discussions, which will build momentum into the joint ministers’ meeting on the 17th.
Excellencies,
You have covered significant ground in preceding sessions. Your discussions were insightful, engaging and demand deeper reflection.
Three points were of particular note.
First, the importance of identifying and documenting how countries with strong health systems for UHC have effectively responded to the pandemic.
The Republic of Korea, which has a robust health insurance system, has successfully applied the lessons learned from its MERS-CoV response.
Bhutan, which allocates 8% of public expenditure to health, and has achieved essential health service coverage of 64%, is yet to report a single COVID-19 death.
Indonesia and Malaysia emphasized the critical importance of mobilizing a whole-of-government, whole-of-society approach to the pandemic.
Malaysia, Tonga, China and Papua New Guinea have shown how their capacity to rapidly strengthen health systems has helped protect the poor and vulnerable.
We must be diligent in collecting and sharing these and other examples so that we can make the strongest possible case for investing in UHC amid competing fiscal pressures.
Second, the power of innovation.
To be resilient, public health systems must have the capacity to provide all people access to the services they need, without financial hardship.
But they must also be able to rapidly implement high-impact innovations, and to productively engage the private sector.
India, for example, has introduced key innovations for surveillance such as the Aarogya Setu app, which is used by 156 million citizens.
India has substantially expanded telemedicine and engaged the private sector to increase health system capacity, especially with regard to testing, quarantine, isolation and treatment facilities.
All governments must allow for more flexible budget formulation, reallocation and execution, which will help them break free of rigid budgetary practices and release the full potential of their health system.
The pandemic provides a crucial opportunity to evaluate budgetary innovations and, where appropriate, undertake reforms.
On this, Indonesia has been emphatic: Financial preparedness, rather than financial response, should be the goal.
Finally, you have identified a clear need to better integrate UHC and health security, for which the common goods for health framework should be leveraged.
From the primary level up, pandemic preparedness plans must be applied, and emergency capacity strengthened to ensure all facilities can contribute towards an emergency response.
But over the near and long-term, we must not only sustain, but also scale up health spending and invest in common goods for health that strengthen health system capacity and resilience, enabling health systems to meet whatever challenges arise on the path to UHC.
Precedents from past crises suggest that whenever fiscal contraction has occurred, health and social spending are the first sectors to be cut.
Amid intense fiscal pressures, finance ministries must see real value for money in what we are proposing, towards which I note Malaysia and Philippines’ efforts, shared with us today.
In ordinary times, every dollar invested in health yields an average return of between two and four dollars, which can be up to 20 times higher in low- and middle-income countries.
But that return is multiplied many times over when one considers how common goods for health can protect against acute public health events, the impact of which is now being appreciated.
Achieving our goal of sustained and scaled up investments in health will by no means be easy, but we must strive to succeed.
Together we must ensure that health ministries can effectively engage finance ministry counterparts based on evidence-informed plans and realistic budgets.
We must leverage every opportunity to make the public case for increased investments in health – yes, to achieve health for all, but also to promote the sustainable development required to recover from this challenge and build a more fair, equitable and just future.
I thank you once more for your engagement and insights and look forward to joining you for the joint ministers’ meeting later this week.
Thank you.