Daily journal: 27 October 2021

Seventy-second session of the Regional Committee for the Western Pacific • 25–29 October 2021, Himeji, Japan Page 1 25–29 October 2021 Himeji, Japan WPR/RC72/DJ/3 27 October 2021 Contents I. II. III. Programme of work Report of meetings Other meetings …………………………………………………………………... 2 …………………………………………………………………... 2 …………………………………………………………………... 7 Other information Venue Arcrea Himeji, Japan Distribution of documents All documents are available at the WHO Regional Office for the Western Pacific website. In line with WHO “green meeting” practices, printed documents are available only upon request at the WHO Enquiry Desk, located at the foyer of Arcrea Himeji. Representatives are kindly requested to collect daily their documents, messages and invitations at their designated mailboxes. Hybrid meeting platform Following a hybrid format, sessions are in person and via the Zoom webinar platform. Instructions on how to access the Regional Committee SharePoint portal for the virtual meeting platform have been sent to all representatives. Simultaneous interpretation for English, Chinese and French will be available on the Zoom platform and for in-person attendance. Video streaming The plenary sessions will be broadcast on YouTube with the relevant links available at the WHO Regional Office website and on the Regional Committee SharePoint portal. They can be viewed on personal computers, smartphones and tablets with Android 5.0, iPad iOS 13 or later operating systems. Rapporteurs meeting The meetings are convened daily in person and virtually, following the afternoon session at 15:45. Today’s meeting for in-person participants is in Room 408, Arcrea Himeji. Conference papers are posted on the SharePoint portal the morning they are scheduled to be considered for adoption. WHO publications Selected WHO publications are available at the WHO Regional Office website. A digital board and display booth can be found at the foyer of the Exhibition Halls where representatives can view and browse WHO publications, including COVID-19 guidance documents and agenda-related materials. Copies are available for free for representatives on a first-come, first-served basis. Seventy-second session of the Regional Committee for the Western Pacific • 25–29 October 2021, Himeji, Japan Page 2 I. PROGRAMME OF WORK (WEDNESDAY, 27 OCTOBER 2021) Agenda items 07:45–08:45 (core hours to accommodate different time zones) 9 *Panel discussion on primary health care (continued) WPR/RC72/4 Agenda items 9:30 to 13:30 11 12 15 School health (continued) will resume immediately after the 9:30 private informal consultation with Member States Traditional and complementary medicine Coordination of the work of the World Health Assembly, the Executive Board and the Regional Committee: 15.2 WHO reform (WHO’s work in countries) 15.3 Items recommended by the World Health Assembly and the Executive Board (Sustainable financing) WPR/RC72/5 WPR/RC72/6 WPR/RC72/9 RC72/INF/4 Agenda items 14:45–15:45 (core hours to accommodate different time zones) 9 *Panel discussion on primary health care (continued) * For convenience, two sessions for the panel discussion on primary health care are scheduled so Member States may attend in the morning or the afternoon (Japan standard time) depending on their time zone. WPR/RC72/4 II. REPORT OF MEETINGS (TUESDAY, 26 OCTOBER 2021) Second meeting Chairperson: Honourable Yamamoto Hiroshi, State Minister of Health, Labour and Welfare, Ministry of Health, Labour and Welfare, Japan Item 4 Address by the incoming Chairperson The incoming Chairperson welcomed representatives – physically and virtually – to Himeji, Japan, and expressed gratitude for their trust and confidence in electing him to chair the Regional Committee. He thanked last year’s office- bearers for their service and promised to follow their example and to manage the programme well. He commended the Regional Director for his comprehensive annual report and the Organization’s ongoing support to Member States in responding to COVID-19, while continuing to drive forward implementation of For the Future: Towards the Healthiest and Safest Region. The Chairperson concluded with an overview of four agenda items: primary health care (PHC); school health; traditional and complementary medicine; and tuberculosis (TB). He called on representatives to use the panel discussion to share their perspectives on PHC, and invited Member States to endorse the regional frameworks that will be presented this week on school health, traditional and complementary medicine, and TB, noting that all are priorities in the Region. Seventy-second session of the Regional Committee for the Western Pacific • 25–29 October 2021, Himeji, Japan Page 3 Item 7 Address by and Report of the Regional Director, including COVID-19 regional update (continued) In continuation, interventions were made by the representatives of the following Member States (in order): Brunei Darussalam, the Federated States of Micronesia, Samoa, the United States of America, Singapore, Solomon Islands and Tuvalu. Many Member States mentioned that the For the Future vision to make the Western Pacific the world’s healthiest and safest region was more relevant now than ever. They also expressed support for efforts to simultaneously implement the Region’s thematic priorities and strengthen health systems in ways that will make them more resilient and better able to manage future outbreaks and health emergencies. They applauded WHO for “shrinking” its workplan in the Region amid the pandemic to focus on essential services while increasing support for Member State pandemic responses. They also highlighted efforts of WHO to build international and multisectoral cooperation and partnerships for pandemic responses. Member States shared examples of domestic efforts to respond to the pandemic and the challenges of other public health issues, such as noncommunicable diseases, while also aiming to sustain social and economic development. They praised the accelerated development and implementation of digital health, telemedicine and other innovations for responding to the pandemic and building health systems to be more resilient. Many Member States said more must be done to address inequities in COVID-19 vaccine delivery and other areas of health services aggravated by the pandemic, such as the interruption of essential services for vulnerable and unreached groups. The Regional Director thanked Member States for sharing their experiences, taking note of efforts to deliver COVID-19 vaccines to all the people who need them, especially vulnerable groups. In responding to interventions, the Regional Director said the Region is learning from the pandemic, including adapting strategies because endemic COVID-19 is a possibility that we need to prepare for. He emphasized the importance of continuous learning and improving in all WHO’s work in countries, and of tailoring all strategies and interventions to each country’s context, such as the special circumstances of Pacific island countries and areas. The Regional Director noted the need to incorporate all country experiences and observations from the pandemic in discussions on all areas of work going forward – including mental health, PHC and universal health coverage – to improve efficiency and outputs in the Region. The Regional Director spoke about the work of the Independent Commission on allegations of sexual exploitation and abuse involving WHO staff and contractors. He said the Western Pacific Region takes these issues extremely seriously and will continue to make efforts to prevent any such incidents including through full support for the WHO management response to the Independent Commission report. These issues have an important link to gender, he added, and that For the Future addresses gender as a crucial issue and consideration. Finally, he thanked Member State governments and partners for their support and commitment to working together to fulfil the vision of making the Western Pacific the healthiest and safest region. Seventy-second session of the Regional Committee for the Western Pacific • 25–29 October 2021, Himeji, Japan Page 4 Item 8 Programme budget: a. Programme budget 2020–2021: budget performance (interim report) b. Programme budget 2022–2023 update The Director, Programme Management, introduced the agenda item on the interim report on the Programme Budget 2020–2021 and an update on the Programme Budget 2022–2023. She noted that 70.8% of available resources had been utilized as of 30 June 2021, which is higher than utilization was at the same point in the 2018–2019 biennium. The Director explained that the Region developed a “shrunk” workplan during the pandemic, which reprioritized activities as support increased for the pandemic response. She said implementation of the shrunk plan ensured that essential services continued, health system needs for the COVID-19 response were fast-tracked, and Member States received prompt responses to requests, allowing them to address their priorities along with the thematic priorities of For the Future. In other areas, the Director reported that WHO in the Region had no outstanding audits and continued to improve controls through strengthened management, training, communications and risk monitoring. She said significant progress in gender parity had been made in the regional WHO workforce, with ongoing efforts to reach out to under-represented and unrepresented countries for staff recruitment. With regard to the Thirteenth General Programme of Work 2019– 2023 (GPW 13), she noted that the Output Scorecard was rolled out in early 2021, with 41 relevant outputs for the Region, with a focus on For the Future as the regional implementation plan for GPW 13. Turning to the Programme Budget 2022−2023, the Director said planning in the Region began with Member State consultations to identify country priorities that were mapped to the thematic priorities of For the Future. She said the process will enable workplan implementation to start by January 2022. She concluded by noting that the World Health Assembly requested the Director-General to submit a revised 2022–2023 Programme Budget, including a revised appropriation resolution, as appropriate, to the Health Assembly in May 2022. This item will be discussed on Friday by the Regional Committee during the agenda item on the coordination of the work of the World Health Assembly, the Executive Board and the Regional Committee. Interventions were made by the representatives of the following Member States (in order): Viet Nam, the Philippines, the Republic of Korea, Australia and China. Member States thanked the Secretariat for the comprehensive interim report on budget performance for the biennium, which demonstrates the strong leadership of the Region in COVID-19 response efforts and implementing GPW 13. They appreciated the development of the “shrunk” workplan and noted efforts in maintaining the trend of higher implementation rates. They expressed appreciation for continued efforts to improve internal controls and overall compliance in Direct Financial Cooperation (DFC) agreements and the implementation of internal audit recommendations, and the reduction of operational costs to implement priority technical activities. They noted some gaps in financing as compared with the previous biennium that may pose a challenge in implementing GPW 13. With an increase in outbreak crisis and response activities, Member State representatives expressed support for pursuing sustainable financing for WHO, as sufficient secure and stable funding is needed to achieve the goal of making the Western Pacific the world’s healthiest and safest region. Representatives appreciated the level of transparency and accountability shown in the detailed report and noted the significant progress in the gender balance of staff. They welcomed the shift in monitoring and reporting through the Output Scorecard methodology and commended the Region for achieving an overall “satisfactory” rating. Member States supported the Programme Budget 2022–2023 and the consultative approach in operational planning and regional prioritization. Seventy-second session of the Regional Committee for the Western Pacific • 25–29 October 2021, Himeji, Japan Page 5 Representatives encouraged the Secretariat to further support strengthening country emergency preparedness and to improve data strengthening and stewardship in countries. Regarding the midterm revision of the Programme Budget 2022–2023, representatives said they looked forward to updates on the budget process being discussed in agenda item 15.3. The Director, Programme Management, appreciated the valuable guidance and comments of the Member States on both reports. On the question of utilization towards the end of the biennium, she said the Western Pacific Region has a strong culture of close monitoring of all aspects of the Programme Budget implementation, with strategic advice to all budget centres through monthly Programme Committee meetings. She detailed several ways in which budget utilization is strictly monitored, including a special focus on budget centres with slower implementation issues. She estimated that the projected implementation would be 98%, which would be consistent with the previous biennium; however, it would represent a higher utilization of funds by about US$ 80-90 million by the end of the biennium. In response to a question, she said the Western Pacific Region had already recognized that paying attention to gender, equity and human rights is an opportunity to improve health and reduce health inequalities as a part of the For the Future vision. The Director, Administration and Finance, acknowledged what a difficult period it has been for WHO, Member States and partners and appreciated their continuous support, using DFC management with zero overdue reports as an example to illustrate the strong collaboration. On operational costs, he explained how the Secretariat has been able to manage within the same resources in the past three to four biennia through a balancing mechanism where increases in one area are adjusted with reductions in another through a prioritization process, with strong networks in the regional and country offices playing a key role. On staff expenditures, the Director acknowledged that the percentage of staff expenditure has decreased this year, which is indicative of consistent staffing maintained in general. He said the Regional Office increased support in contractual services – contractors and consultants for some of the specialized work during the COVID-19 pandemic. Staff were offered several developmental opportunities, and WHO in the Region intends to continue that through acting arrangements and officers-in-charge, repurposing staff to countries during the pandemic and sending staff to other countries to uncover talents, he added. The Director said WHO in the Region is proud of the improvements made to address geographic distribution and gender balance, with the share of female professional staff rising from 36% in 2014 to 56% today. He said this is taken seriously and notes that gender parity exists at different levels including senior management and heads of office. On sexual exploitation and abuse, he reiterated the emphasis placed on these issues at the highest levels throughout the Region, noting the Regional Director’s focus on dialogue and networks to make sure everyone knows the issues and helps the Organization prevent such occurrences. Item 11 School health In a short video, the acting Director, Healthy Environments and Populations, introduced the agenda item on school health, noting that schools are a place to nurture and inspire healthy living among children and adolescents in the Region. In turn, she said children can transmit healthy behaviours and knowledge they acquire at school to their families and communities. She noted that the draft Regional Framework on Nurturing the Health of Our Future Generations in the Seventy-second session of the Regional Committee for the Western Pacific • 25–29 October 2021, Himeji, Japan Page 6 Western Pacific outlines actions for schools, governments and partners to help nurture healthy and resilient children, who will grow up to become healthy adults. Interventions were made by the representatives of the following Member States (in order): Malaysia, Japan and China. Item 9 Panel discussion on primary health care The Director, Health Systems and Services, introduced the panel discussion on the future of primary health care (PHC). The Regional Director opened the discussion, noting that the For the Future vision identified PHC as essential to achieving universal health coverage (UHC), towards which Member States had made progress. He highlighted the increasing noncommunicable disease (NCD) burden and rapidly ageing societies in the Region. PHC would play a big role in the health system transformation to address these, he said. He expressed hope that the panel discussion would help generate a new vision for PHC, adding that the experiences and knowledge gained in the COVID-19 response should also help shape the future vision for PHC. The Director, Health Systems and Services, led the panel discussion. The Honourable Silas Bule, Minister of Health of Vanuatu, recognized PHC as the most inclusive, equitable, cost-effective and efficient approach to enhance people’s physical and mental health and social well-being. The Minister said Vanuatu’s new Health Sector Strategy 2021–2030 sets PHC as the foundation for achieving UHC, with an initial focus on strengthening management of PHC services at provincial level. The Minister highlighted measures to strengthen data availability and use, bolster human resources for health, and expand health service coverage to remote and unreached areas. Vanuatu is focused on increasing community involvement by engaging with village health workers, village leaders and community health committees to strengthen health programmes in all communities, he said. A short video showed PHC from the perspective of a rural health worker in the Lao People’s Democratic Republic. The video indicated the critical trust between health workers and the communities they serve to work together for a healthier and safer community, a lack of which can cause adverse outcomes such as disease outbreaks. The Honourable Ong Ye Kung, Minister of Health of Singapore, emphasized that a strong PHC is the future of health care. He stressed the need for greater financial sustainability of the health system as a key driver of reform to strengthen PHC. He indicated the major challenge of health systems as the misalignment of incentives and interests between payers, providers and patients, which must be addressed to move towards a focus on prevention and better health outcomes. He highlighted the importance of PHC as the backbone of the COVID-19 response through promoting hygiene, home care and vaccination. The Honourable Amelia Afuha’amango Tuipulotu, Minister of Health of Tonga, emphasized that PHC is at the core of UHC and important to mitigate the increasing burden of NCDs, while ensuring that the health system can be sustainably financed in the future. The Minister indicated that Tonga’s new health policy is designed to be PHC driven, with a focus on behaviour and lifestyle changes, localized and contextual research, and new partnerships including with the private sector and young people. She also emphasized the health workforce challenges, particularly in remote islands, highlighting the need for the right numbers of health workers, ensuring continuing development for quality care and appropriate working conditions. The Honourable Aupito William Sio, Associate Minister of Health of New Zealand, affirmed that PHC is at the heart of their health and disability care reform to deliver equitably to all population groups in the country. The reform Seventy-second session of the Regional Committee for the Western Pacific • 25–29 October 2021, Himeji, Japan Page 7 was driven by the belief that PHC has the greatest potential to improve the health of the population, to address health system fragmentation and inconsistency of care, and to ensure equitable distribution of health access and outcomes, including for indigenous peoples, the Minister said. He said this would also involve engaging community and indigenous leaders and emphasized the need for (a) action on the wider determinants of health such as housing and employment; (b) modifying behaviours and lifestyles by empowering individuals; (c) adapting human-made surroundings where people live and work; and (d) an integrated health and care delivery system that provides continuous care. Finally, the Minister highlighted the need for strong workforce development to drive this reform, producing socially and culturally appropriate health workers. Item 11 School health In continuation, interventions were made by the representatives of the following Member States (in order): the Lao People’s Democratic Republic, Cambodia, the Philippines, Samoa, Viet Nam, the Republic of Korea, Mongolia, Brunei Darussalam, Australia, Fiji, Tonga, Kiribati, the Federated States of Micronesia, the United States of America and Singapore. Member State representatives universally supported the Regional Framework and its multisectoral and multi-stakeholder approach to nurture resilient and healthy future generations in the Western Pacific. They shared existing domestic policies and systems to promote health in schools, including: strengthening collaboration among health and education sectors; commencing the school health approach from the preschool stage; and prioritizing COVID- 19 prevention activities. Many Member States expressed their appreciation of the Regional Framework’s flexible approach and consideration of local contexts in adapting its implementation with the involvement of schools, families and communities. They highlighted, among others, issues for consideration with regard to delineating approaches for primary and high school environments; considering explicit engagement on gender; sharing experiences and best practices; and ensuring adequate resources and appropriate tools for both classroom and distance learning modalities. They also highlighted the need for more support on: the double burden of childhood obesity and stunting; physical inactivity; tobacco use; alcohol and substance abuse; environmental health issues; and primary health-care services in schools. The impact of prolonged COVID-19 school closures on children’s mental health and well-being was further highlighted by Member State representatives, calling for increased action towards improving health and education now more than ever. In responding to interventions, the acting Director, Healthy Environments and Populations, introduced a short video of children from the Region relating why they think health is important, especially for their future. The children mentioned the importance of maintaining a healthy life now through a safe and nurturing environment for a prosperous tomorrow. The acting Director said the Secretariat would continue to address and respond further to the interventions made by the representatives. III. OTHER MEETINGS Wednesday, 27 October 2021 13:50–14:45 Side event: Mental health (Exhibition Hall C) Thursday, 28 October 2021 13:50–14:45 Side event: Communication for Health (Exhibition Hall C)