The Third Annual Meeting of South-East Asia Public Health Education Institutions Network (SEAPHEIN), Inaugural Address, 25-28 September, Jaipur, Rajasthan

Inaugural Address By Dr Samlee Plianbangchang Regional Director, WHO South-East Asia At The Third Annual Meeting of South-East Asia Public Health Education Institutions Network (SEAPHEIN) Jaipur, Rajasthan 25-28 September 2007 The Third Annual Meeting of South-East Asia Public Health Education Institutions Network (SEAPHEIN) 25-28 September 2007 Jaipur, Rajasthan Inaugural Address by DR SAMLEE PLIANBANGCHANG REGIONAL DIRECTOR, WHO SOUTH-EAST ASIA Dr Digamber Singh, Honourable Minister of Medical, Health, Family Welfare and Ayurveda, the Government of Rajasthan; Mr R.K. Meena, Principal Secretary Health, the Government of Rajasthan; Mr M.L. Mehta, Trustee Secretary, IIHMR; Dr S.D. Gupta, Director, Indian Institute of Health Management Research; Dr Phitaya Charupoonphol, Dean, Faculty of Public Health, Mahidol University; Honourable guests; Distinguished Participants, Ladies and gentlemen, It is a great honour for me to deliver the inaugural address at the third meeting of South-East Asia Public Health Education Institutions Network (SEAPHEIN). I gratefully thank the organizers of the meeting for the invitation. I thank the Government of Rajasthan for allowing us to hold this important meeting in the State. I thank all participants for sparing their valuable time to come to share their experiences. I am very pleased to see many prominent public health figures in the Region gathered here. I also notice that we have colleagues from outside the South-East Asia Region from Japan, Viet Nam, Lao PDR and Pakistan. Public health has no boundaries. I specially welcome them to join the network activities. And I would like to see more coming from outside the Region. 2 The theme of the meeting, “Moving SEAPHEIN to Influence Public Health Policy and Action” is indeed encouraging and timely. For many reasons, it is time for us to revisit public health of countries in this part of the world. This is with the view to strengthening our public health systems and public health infrastructure. This revisit should be done with unwavering conviction and commitment to “good health for all people, through the implementation of primary health care approach”, this is to be done in the spirit of equity and social justice in health care; recognizing health as a fundamental right of everyone. While the basic philosophy and principle of public health may still be valid today, its concept and approach may need reorientation; in order to catch up with today’s changing health scenario. The framework for health development has significantly expanded during the last three decades. Governments worldwide have been striving for their citizens to live longer and healthier lives. They would like to see all their peoples lead a socially and economically productive life. Among others, governments would also like to pursue health development with the following aims: to reduce the burden of diseases, communicable and noncommunicable, by shifting the emphasis of health care and services to promotive and preventive interventions; the governments would like to reduce health care expenditure to ensure cost-efficiency and cost-effectiveness in the use of available resources for providing health services; and the governments would like to reduce poverty, through the implementation of public health programmes, that benefit particularly the underserved and underprivileged. They would like to see health at the centre of overall development, nationally and internationally. And they would like to use health as a bridge for peace everywhere. There will be no health, if there is no peace. 3 Health has always been identified as a critical area in human resource development. Health increases human potential to contribute effectively to social and economic development. To achieve these strategic objectives, the governments need to ensure: equitable access to health care and services by all people; reaching the unreached, who are usually poor and underserved; promotion of healthy lifestyles in the entire population; prevention of disease and illness as the key strategy in public health interventions. And, very importantly, in the process, they have to ensure long-term sustainable development and self-reliance in health in their own countries. Only those long-term sustainabilities can help countries move upward in their development efforts. To reiterate, as far as health is concerned, the governments have to focus priority attention to primary prevention, and maintenance of good health for all, as the key strategy in their health development. To achieve these objectives countries need capability and capacity in public health interventions. The countries need robust public health systems; the countries need strong public health infrastructure. The countries need managerial capability to be able to develop and implement public health programmes effectively. What do we mean by public health programmes? Public health programmes are the programmes that: need to be community- and population-based; serving the entire population. The programmes that focus their interventions on health risks and health determinants; the programmes that need to be ecologically and environmentally sound in their development and implementation; the programmes that must be developed within the socio-economic, cultural and political context of the country; the programmes that must be implemented through multidisciplinary and multisectoral approaches; the programmes that ensure health for all and all for health, whereby people of all walks of life are involved in health matters; and the programmes that pay 4 special attention to the poor, underprivileged, underserved, marginalized, and vulnerable. One of the strategic functions of public health is to provide full support to comprehensive community-based health development. The development that needs to be pursued through the primary health care approach; whereby community health workers of various categories and community health volunteers play a key role. We have to provide all possible support to these dedicated people; who can effectively serve the poor, who can reach the unreached. In today’s health scenario, there are many challenges that public health professionals have to face. Among the long list is climate change; climate change is coming from many development activities worldwide: but with a profound health impact; internationally and locally. We are facing emerging and re-emerging diseases, many of which are without known origins; but all these diseases create a health emergency that requires special and prompt public health actions. We are facing a double burden of diseases that need our special attention to primary prevention, health promotion and disease prevention. We are facing infectious diseases with no respect for national borders; their spread requires vigorous enforcement of International Health Regulations, to ensure international health security. Coming in a big way with globalization is liberalization of international trade agreements, which significantly impact the planning and management of national health care services. There is also rapid advancement in science and technology that have profoundly impacted the planning and management of health care and services for the 5 entire population, including the development of the required human resources for such care and services. These are some of the current challenges in health development that we have to face squarely. In the health scene, more and more, health issues are becoming public concerns; these concerns, in turn, become the subjects for public debates. And, these health concerns have been increasingly reflected on political agendas for social and economic development in countries. In this perspective, health has gone much beyond the health sector. This is an important indication that effective health development really needs “public health interventions” that call for multisectoral actions, and for “healthy sectoral policies and commitments”. These sectoral policies and commitments come from the sense of responsibility for people’s health of each development sector. Public health interventions, to be really effective, have to be managed much beyond the traditional institutional boundaries. We have to go much beyond the traditional sectors and disciplines that we have got used to. And, we have to convince other sectors than health to commit themselves to their own health responsibilities. This is the foundation of “healthy sectoral policies and commitments”; which are not less important than “multisectoral actions for health”. A lot needs to be done in strengthening public health systems and public health infrastructure in our countries. We need a multipronged strategy and approach. And we need a lot of efforts and resources to implement such a strategy and approach. However, at this stage, let us focus our priority attention to the development and strengthening of public health workforce. The workforce that can bring us a long way forward in strengthening public health systems and public health infrastructure. 6 Let us do this first through appropriate education and training in public health. Under our Public Health Initiative initiated in the WHO South-East Asia Region in 2004, we have been supporting Member States in the development and implementation of public health education and training programmes. WHO is also supporting the functioning of SEAPHEIN, which was also launched in 2004. This WHO support to SEAPHEIN will certainly continue in the foreseeable future. WHO would like to see SEAPHEIN to be a sustainable platform for countries in this part of the world to help each other in their pursuit to strengthen public health. We together, countries and WHO, will have to make a difference; this is as far as public health services for a healthier and wealthier population are concerned. The countries need to have many more competent and dedicated public health professionals, public health specialists and public health practitioners. We need a critical mass of these people. I am very glad to see that this meeting of SEAPHEIN will deliberate upon a number of important subjects that are relevant to our work under the Public Health Initiative. These include Changing SEAPHEIN to Respond to the Challenge of Globalization; and Changing SEAPHEIN to Respond to the Challenge of Current Concepts of Public Health. Also, the meeting will discuss Innovations in Teaching/Learning Methodology. In this specific area of our concern; may I suggest the meeting to examine carefully the need for reforms in public health education and training in a broader perspective. Believe me, this important area of public health really needs reform. We 7 may not be able to afford any longer the continuation of traditional ways of doing things; when things around us are constantly changing. This reform, as suggested, may include the three main areas, i.e. 1. Reform in the educational institutional structure and settings; where and how to organize such structure and settings to ensure their proper place in the national health systems, in the light of the changing concept and approach in public health. 2. Reform in the curricula and programmes for education and training of public health professionals, public health specialists and public health practitioners; what should be the best ways to develop such curricula and programmes; and what should be their best contents. 3. Reform in teaching/learning processes, how to ensure in such processes the best ways to motivate and help students to effectively develop, among other important elements, their conceptual as well as their practical skills. I am sure, with advancement in technology, especially information and communication, we can go a long way forward in such a reform process. Changes in public health are dynamic, constant and certainly predictable in many cases; therefore, reform in public health in general and in education in particular is really needed. Otherwise, we will lag far behind in our health development, and our people will suffer unnecessarily. With our capacity, know-how and knowledge of our own epidemiological, socio- cultural, economic and political context, we must be brave enough to think and act “outside the box”. We have to create “leadership role models” in public health for our younger generations. If we don’t do it, who will do for us? We all are here with the same objective. That objective is to find the best ways and means to strengthen public health systems and public health infrastructures in our 8 countries. This is in order to ensure the most effective way to develop health of all our people; to ensure that our people will live longer, be healthier, and wealthier. It is really “a noble task” in human resource development; the development of “human potentials” to serve countries more productively in both social and economic terms. Finally, ladies and gentlemen, let me wish you “all the best” and “all success” in your pursuit of this “noble task”. The task that can contribute in a considerable way to the overall development of mankind; nationally and internationally. Thank you.