Global Health Issues, Talk, 9 July 2007, Chulalongkorn University, Thailand.

Talk By Dr Samlee Plianbangchang Regional Director, WHO South-East Asia At Global Health Issues Chulalongkorn University, Thailand 9 July 2007 Global Health Issues 9 July 2007 Chulalongkorn University, Thailand Talk by DR SAMLEE PLIANBANGCHANG REGIONAL DIRECTOR, WHO SOUTH-EAST ASIA Dr Samlee Plianbangchang, Regional Director, WHO South-East Asia Region, spoke on “Global Health Issues” at Chulalongkorn University on 9 July 2007. Referring to the International Health Regulations (2005), he said that the world faced several health problems, including communicable and noncommunicable diseases. In order to effectively tackle these diseases globally, there was a need to develop or ensure “International Health Security”. This year’s World Health Day theme was “International Health Security” and the purpose was to make people aware that the health risks that we faced today in terms of global warming, man-made or natural disasters or disease outbreaks can spread from one country to another very easily with large numbers of people travelling within and outside countries because of advancement in transportation. Among the mechanisms available to ensure health security were the International Health Regulations which were being used to prevent diseases from crossing borders or from crossing regions. The International Health Regulations (2005) were the most important tools to ensure a healthy and safer future for the world. With regard to the spread of diseases, in particular communicable or infectious diseases, everyone should know about and understand these Regulations, especially students attending the Master of Public Health course. Dr Samlee suggested that the Regulations be included in the MPH course. “All of us have the responsibility to implement these Regulations,” he added. Furthermore, he explained that the “International Framework Convention on Tobacco Control” was adopted to prevent a group of diseases caused by smoking. 2 Dr Samlee said that health was being used to spread or maintain peace all over the world specially where conflicts and fighting was taking place, from the Middle-East to Sri Lanka and in many other parts of the world. Health and peace were interrelated with each other. He also felt that using health to spread peace played a critical role in the contemporary world because experience had shown that we can do vice-versa. Referring to the linkage between health and poverty he said it was a global issue. Poverty eradication in a few years or in the future was utopian. One of the alternatives to handle this problem was using health to reduce not eradicate poverty. “But we have to know how we can develop or bring health to reduce poverty. We may issue the strategies, the public health strategies or interventions to prevent diseases and to promote health”, Dr Samlee added. When people are healthy they can go to work and this also boosts economic development. On the other hand, if people are ill they cannot go to work and this adds to the burden, not only of the health system but also to the country’s economic progress as well. Dr Samlee urged countries to reduce the disease burden, otherwise it could lead to an economic slowdown and make families poorer. “If we undertake primary prevention of diseases and health promotion, the disease burden can be reduced and the frequency of diseases occurring every year can be decreased. When we promote economic development, we also need to simultaneously invest in public health interventions to prevent diseases and promote health awareness. These processes need to be considered in a balanced way,” he added. Referring to HIV/AIDS, he said it was a top priority for all countries. We do not know the hidden magnitude of this disease because it comes with social stigma and discrimination. Nor can we know the real figure. It is a hidden enemy that can cause a huge impact unless we are prepared for it,” he said. With regard to the goal of “Health for All”, Dr Samlee said, ”we cannot ensure health for everyone, instead, we can only ensure that poor people have easy access to health care services. If the health care providers only sit in the health care centres or clinics 3 waiting for the patients to come, they will serve only a small number of people. A vast majority of those who get sick will go to traditional healers or take medicine by themselves. Even worse, when we talk about health promotion and disease prevention, a lot of people will not benefit from public health interventions unless we go to them”, he added. How to ensure “Health for All”, to the have and the have-nots, was a priority issue for every country. ”Whether through public health interventions or medical interventions, we have to ensure that the interventions can be delivered not only to people in the community but to the entire population in the country as well. The unreached are normally the poor people who are always marginalized and are vulnerable as well. To reach those people is a key issue globally”. Dr Samlee said. In this context, it was important to consider the role of the health workforce – from doctors, nurses, pharmacists or public health professionals to community health workers and community health volunteers. “Among these people”, he pointed out, “community health volunteers and community health workers have a very important role to play in public health interventions in the community to ensure reaching the unreached.” These community health workers, however, received the least support, financially or otherwise from the government. “But the undeniable reality is that they are very crucial in carrying out public health interventions at the grassroots level for reducing the disease burden. They should be well developed, both quantitatively and qualitatively. It is now being recognized that these people have been neglected for long. Not only do they need more attention and more investment but they need a wide range of support from education and training to medical facilities from all of us as well. The language of health is the common language all over the world which everybody must understand the same way”, Dr Samlee said. Referring to primary health care, Dr Samlee highlighted that it cannot be effective unless adequate support from institutions, medical schools, schools of public health and other related fields was provided. It also could not be effective without a proper referral system to the primary, secondary and tertiary levels. “It is an issue of balanced 4 development as well. Balanced development in terms of medical and public health interventions, of health workforce and of community health workforce and volunteers. We should keep balanced development in mind at all levels in health care system and services,” he added. Dr Samlee said that, “in the development process, when we talk about the need for the rich to help the poor, one key word we should never forget is sustainability. What we are doing today must be sustained in the future and that sustainability can also be a basis for development of a country for many years. We have to develop our infrastructures, our health systems. We also need to develop health and medical institutions to ensure that these institutions can be pivotal in supporting health development in the country”. Dr Samlee said that one of the key issues for him in the health sector was how much he could do to make the countries in the Region stronger. How could we strengthen the countries’ capacity for tackling diseases? He said that a country could use available resources in an appropriate manner for becoming stronger. “The countries have to prepare themselves to become stronger, to be self-reliant for ensuring sustainability, to be self- sustained to a certain extent in the development process,” he added. In conclusion, Dr Samlee said that “healthy public policies is another area that needs to be explored further. It is a little bit different from multi-sectoral and multi-disciplinary collaboration. Multi-sectoral and multi-disciplinary collaboration mean that the sectors work together. Healthy public policies, however, mean that each sector must keep the health concerns in mind in their development efforts.”