The World Health Organization (WHO) is bringing together on 19-21 March in Bangkok lawmakers from across Southeast Asia to discuss how to bolster their health systems back home.
Many health systems in the region - defined as health services, workforce, information, financing, leadership as well as equitable access - are ill-equipped to meet growing challenges of non-communicable diseases, including diabetes and cancer; long-term care in a region with one of the world’s largest concentrations of ageing persons; and the economic incentive to prevent diseases rather than face “skyrocketing costs” of treatment, said Samlee Pilanbangchang, WHO regional director in Southeast Asia.
“When you try to promote health as wellness, people have disease ingrained in their heads… Health is associated with illness. It is something negative. When we try to promote health, people don’t understand - still,” he told IRIN.
Most countries in the region spend less than the internationally recommended 5 percent of gross domestic product (GDP) and Myanmar spends less than the 34 purchasing power parity (PPP) dollars per person per year needed to ensure basic health care.
In the region, only Vietnam and Timor-Leste exceeded the recommended minimum of health spending as a percentage of GDP, 7 and 12 percent respectively, though Timor-Leste is also ranked as one of the worst countries worldwide for its child health care, according to the UK-based NGO, Save the Children.
|Health spending in Southeast Asia|
|Country||Health spending as percentage of GDP||Government expenses on health as percentage of total health expenses||External resources - including donor financing for health - as percentage of total health expenses||Per capita health expenses in purchasing power parity (PPP)||Per capita health expenses covered by government (PPP)|
|Papua New Guinea||3.5||69.3||17.5||81||56|
|Source: WHO Global Health Observatory Data Repository, 2009, http://apps.who.int/ghodata/|
Myanmar’s government investment in health care is among the lowest globally - 2 percent of GDP - and patients bore almost all of what was not covered by the government, which was 9.7 percent in 2009, the most recent year for which WHO compiled data.
Only when the out-of-pocket percentage falls to 15-20 percent does the risk of financial catastrophe become negligible, according to WHO.
Healthy equity and social justice are still lacking in the region, despite the “hip hip hooray” media accorded universal health coverage programming, said Samlee.
“It [universal health coverage] is not working yet,” he added, citing the region’s status as having the world’s highest rate of out-of-pocket costs for patients.
The governments of Laos and Cambodia have mostly relied on donors to reach the poor, while those in Bangladesh, Thailand, the Philippines, Indonesia, Vietnam and Sri Lanka are in different stages of expanding care in various ways, including payroll taxes.
These efforts are only becoming more urgent said Porapan Punyaratabandhu, a senator from Thailand and secretary-general of the Asian Forum of Parliamentarians on Population and Development. “Equity is a matter of life and death.”
Parliamentarians are called on to advocate the boosting of health spending, workforces and access to health care in their home countries in addition to drafting “healthy public policies”, such as conducting health assessments before large infrastructural projects are undertaken or setting up industries.