A very good morning to all, a Happy New Year, and a warm thank you to the Indian Public Health Association (IPHA) and the Indian Association of Preventive and Social Medicine (IAPSM) for inviting me to address you today.
Public health is the art and science of preventing disease, prolonging life and promoting health through the organized efforts of society, reflected in – but not limited to – the strength of a country’s health system.
Such systems have been tested like never before by the emergence and spread of COVID-19.
First, in the implementation of emergency measures to control and manage an emerging disease and its clinical manifestations.
Second, in the maintenance of essential health services amid the emergency response.
And third, in the soon-to-begin roll-out of mass vaccination campaigns at a speed and scale never before witnessed.
Addressing, anticipating and navigating this triple challenge has been a focus of the WHO South-East Asia Region throughout the COVID-19 response, and I welcome your contributions to what is a dynamic and growing body of Region-specific knowledge that policy-makers and public health professionals must continue to draw on.
WHO has in recent months synthesized a series of key lessons that Member States and partners have identified and shared, which I take this opportunity to summarize, and which I urge you to consider in coming discussions.
First, service disruptions have been minimized or mitigated where service delivery has been dynamically reorganized.
Where services such as follow-up examinations or injections have been shifted to primary level service providers, or provided through other means, such as telemedicine, the burden on overstretched services has been eased.
Where medicines have been delivered to patients’ homes, and stock thresholds have been recalibrated, access to medicines has been more consistently maintained.
Second, effective community engagement has helped address pandemic-related misinformation, while also sustaining community trust in and uptake of routine health services.
The mobilization of community health workers and volunteers in particular has facilitated the adaptation of key messages to meet local needs and concerns – a point that is especially important as countries finalize national deployment and vaccination planning.
Third, the sufficient provision of personal protective equipment and training on infection prevention and control has been essential to maintaining health workforce morale.
There is no patient safety without health worker safety, and we must continue to prioritize the health and well-being of all health personnel as we embark on this International Year of Health and Care Workers.
Fourth, governance, both health sector specific – public and private – and across sectors, has mattered more than ever.
Multisectoral, whole-of-nation approaches have enabled some countries to draw on established mechanisms to adapt and respond more flexibly to the wide-ranging impact of public health and social measures such as physical distancing.
In some cases, the empowerment of local authorities has enhanced context-specific decision-making that has drawn on the timely monitoring of service utilization.
Fifth, the avoidance of siloed service and surveillance planning, and the use of systems thinking to integrate COVID-19 care into existing service delivery, has been a must.
The continuity of essential services has improved when pandemic contact tracers were aware of routine surveillance needs such as assessing skin lesions associated with leprosy, or hypertensive follow-ups.
Pandemic surveillance has been strengthened when screening for COVID-19 could be incorporated into routine assessments of all suspected tuberculosis or malaria cases.
Perhaps the most important lesson of all, however – and one which WHO has long highlighted – is that health systems which are built on the foundation of strong primary care are more resilient and can more efficiently adapt and respond to acute events, even in the face of enormous internal and external pressure.
In the weeks and months to come, vaccine roll-outs will provide immense pressure on health workforce capacity and resource allocations, for which we must continue to revitalize and build on existing primary care systems.
To help do that, sustained and scaled up investments will be needed, which WHO will continue to advocate for. But all of us have a role to play.
As public health professionals, I urge you to access and familiarize yourself with WHO’s new Operational Framework on Primary Health Care, which was launched in December last year, on the two-year anniversary of the Declaration of Astana, and which is aligned with the spirit and focus of the Region’s own Declaration on the Collective Response to COVID-19.
The Framework identifies 14 levers that policy-makers and public health professionals can harness and apply to strengthen primary care, build health system resilience, and achieve universal health coverage and the Sustainable Development Goal targets.
As you continue to advance these outcomes, and fulfil your public health mission, you can be certain of WHO’s full and ongoing support.
I wish you an engaging, informative and productive meeting, and once again thank the IPHA and the IAPSM for the opportunity to address you today.
I commend both organizations for their ongoing work to promote public health learning, research and exchange, for the health, well-being and sustainable development of all.
Thank you.