K a t h m a n d u , N e p a l , 7 8 S e p t e m b e r 2 0 0 9 R e p o r t o f t h e T w e n t y - s e v e n t h M e e t i n g o f M i n i s t e r s o f H e a l t h o f C o u n t r i e s o f t h e S o u t h - E a s t A s i a R e g i o n W o r l d H e a l t h H o u s e I n d r a p r a s t h a E s t a t e M a h a t m a G a n d h i M a r g N e w D e l h i - 1 1 0 0 0 2 , I n d i a S E A - H M M e e t - 2 7 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Kathmandu, Nepal, 7-8 September 2009 SEA-HM Meet-27 Distribution: General © World Health Organization 2009 All rights reserved. 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All reasonable precautions have been taken by the World Health Organiza- tion to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either H [ S U H V V H G R U L P S O L H G 7 K H U H V S R Q V L E L O L W \ I R U W K H L Q W H U S U H W D W L R Q D Q G X V H R I W K H P D W H U L D O O L H V Z L W K W K H U H D G H U , Q Q R H Y H Q W V K D O O W K H : R U O G + H D O W K 2 U J D- nization be liable for damages arising from its use. This publication contains the collective views of an international group of H [ S H U W V D Q G G R H V Q R W Q H F H V V D U L O \ U H S U H V H Q W W K H G H F L V L R Q V R U W K H V W D W H G S R O- icy of the World Health Organization. 3 U L Q W H G L Q , Q G L D Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region iii Contents Part 1: Introduction .......................................................... 1 Part 2: Inaugural session .................................................. 4 Part 3: Business session .................................................. 13 , Q W U R G X F W R U \ 6 H V V L R Q ...........................................................1 Review of New Delhi Declaration/Follow-up actions on the G H F L V L R Q V D Q G U H F R P P H Q G D W L R Q V R I W K H 7 Z H Q W \ V L [ W K + H D O W K Ministers Meeting (Agenda item No. 3) ..................................17 Protecting Health Facilities from Emergencies (Agenda item No.4) ............................................................21 Kathmandu Declaration on Protecting Health Facilities from Disasters ...................................................................25 , P S D F W R I J O R E D O � Q D Q F L D O F U L V L V R Q K H D O W K (Agenda item No. 5) ...........................................................27 $ Q \ 2 W K H U , W H P (Agenda item No. 6) ..................................... ( O H F W L Y H 3 R V W V I R U W K H 6 L [ W \ W K L U G 6 H V V L R Q R I the World Health Assembly and 127th Session R I : + 2 ( [ H F X W L Y H % R D U G ............................................... 5 H Y L Y D O R I W K H , Q I R U P D O 0 H H W L Q J R I $ G Y L V H U V S U L R U to the Meeting of the Ministers of Health, WHO South-East Asia Region ........................................ Closing session (Agenda item No. 8) ..................................... Annexes Agenda1. ........................................................................ 7 List of participants2. ........................................................ 8 ) X O O W H [ W R I Z H O F R P H V S H H F K E \ + L V ( [ F H O O H Q F \ Mr Umakant Chaudhary Minister of Health and Population Federal Democratic Republic of Nepal............................... ) X O O W H [ W R I D G G U H V V E \ ' U 6 D P O H H 3 O L D Q E D Q J F K D Q J 4. Regional Director, WHO South-East Asia Region.................46 ) X O O W H [ W R I D G G U H V V E \ ' U 0 D U J D U H W & K D Q 5. Director-General, World Health Organization .....................49 ) X O O W H [ W R I N H \ Q R W H D G G U H V V E \ W K H & K L H I * X H V W 6. + L V ( [ F H O O H Q F \ W K H 5 L J K W + R Q R X U D E O H 0 U 0 D G K D Y . X P D U 1 H S D O Prime Minister, Federal Democratic Republic of Nepal ......... ) X O O W H [ W R I Y R W H R I W K D Q N V E \ + L V ( [ F H O O H Q F \ 0 U . K D G J D 7. % D K D G X U % D V \ D O 0 L Q L V W H U R I 6 W D W H 0 L Q L V W U \ R I + H D O W K D Q G Population, Federal Democratic Republic of Nepal ..............56
Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region 1 1. The First Meeting of the Ministers of Health of the Member 6 W D W H V R I : + 2 � V 6 R X W K ( D V W $ V L D 5 H J L R Q Z D V K H O G L Q L Q - D N D U W D , Q G R Q H V L D 6 L Q F H W K H Q W K H 0 L Q L V W H U V K D Y H E H H Q P H H W L Q J U H J X O D U O \ over the years. 2. The objectives of the meetings of the Ministers of Health are: To reinforce the commitment of the Member States to the attainment of the highest possible level of health for their people. 7 R H [ F K D Q J H Q D W L R Q D O H [ S H U L H Q F H V R Q W K H V R F L D O S R O L W L F D O and economic dimensions of health in the process of national development. 7 R H [ S O R U H D Q G L G H Q W L I \ Q H Z D Y H Q X H V I R U I X U W K H U L Q W H U country cooperation and collaboration in health and K H D O W K U H O D W H G � H O G V Part 1 Introduction 2 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region 7 K H P H H W L Q J V R I W K H K H D O W K P L Q L V W H U V I R F X V D W W H Q W L R Q R Q S U L R U L W \ issues and provide leadership to several important initiatives in the countries of the WHO South-East Asia Region. 4. These meetings have immensely contributed towards enhancing cooperation, reinforcing political commitment and most importantly affording an opportunity for Member States to tap the potential for ensuring the well-being of people in the WHO South- East Asia Region. ) R U H [ D P S O H W K H 7 Z H Q W \ V L [ W K 0 H H W L Q J R I W K H 0 L Q L V W H U V R I Health held in New Delhi in September 2008, deliberated on the steps needed to accelerate the achievement of the health-related 0 L O O H Q Q L X P ' H Y H O R S P H Q W * R D O V 0 ' * V $ W W K H V D P H P H H W L Q J W K H P L Q L V W H U V � F R Q F H U Q Z L W K F O L P D W H F K D Q J H Z D V U H � H F W H G L Q W K H � 1 H Z Delhi Declaration on the impacts of climate change on human health”. The declaration prioritized a series of actions required to be initiated by the Member States and also urged WHO to continue to provide leadership and technical support in building partnerships Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region between governments, the United Nations and various global health initiatives. A lot of work has since been done with tangible results. 6. The Twenty-seventh Meeting of Ministers of Health was held in Kathmandu, Nepal, during 7-8 September 2009 at the invitation of the Federal Democratic Republic of Nepal. The Right Honourable Mr Madhav Kumar Nepal, Prime Minister, Federal Democratic Republic of Nepal, delivered the inaugural address at the joint inauguration R I W K H 7 Z H Q W \ V H Y H Q W K P H H W L Q J R I 0 L Q L V W H U V R I + H D O W K D Q G W K H 6 L [ W \ second Session of the WHO Regional Committee for South-East Asia on 7 September 2009. + R Q R X U D E O H 0 L Q L V W H U V I U R P % D Q J O D G H V K % K X W D Q W K H ' H P R F U D W L F 3 H R S O H � V 5 H S X E O L F R I . R U H D , Q G L D 0 D O G L Y H V 0 \ D Q P D U 1 H S D O 6 U L Lanka and Timor-Leste participated in the meeting. Honourable 0 L Q L V W H U V I U R P , Q G R Q H V L D D Q G 7 K D L O D Q G Z H U H U H S U H V H Q W H G E \ W K H L U U H S U H V H Q W D W L Y H V G H V L J Q D W H G D V � R E V H U Y H U V � + ( 0 U 8 P D N D Q W Chaudhary, Minister for Health and Population, Federal Democratic Republic of Nepal, chaired the meeting. H.E. Mr Nimal Siripala De Silva, Minister of Healthcare and Nutrition, Government of the Socialist Republic of Sri Lanka, was the co-chair. 8. The programme for the Twenty-seventh Meeting of Ministers of Health included consideration of the following three working S D S H U V D Q G W R K D Y H W K H E H Q H � W R I W K H P L Q L V W H U V � J X L G D Q F H W K H U H R Q for future course of action: Review of New Delhi Declaration/Follow-up actions on W K H G H F L V L R Q V D Q G U H F R P P H Q G D W L R Q V R I W K H 7 Z H Q W \ V L [ W K Meeting of Ministers of Health Protecting health facilities from emergencies: developing safer health-care facilities , P S D F W R I J O R E D O � Q D Q F L D O F U L V L V R Q K H D O W K 9. The agenda, as adopted by the ministers, and the list of S D U W L F L S D Q W V D U H F R Q W D L Q H G L Q $ Q Q H [ H V D Q G U H V S H F W L Y H O \ Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region 4 10. A joint inauguration of the Twenty-seventh Meeting of Ministers R I + H D O W K D Q G W K H 6 L [ W \ V H F R Q G 6 H V V L R Q R I W K H : + 2 5 H J L R Q D O Committee for South-East Asia was held in Kathmandu, Nepal, on 7 September 2009. 11. H.E. Mr Umakant Chaudhary, Minister of Health and Population, the Government of the Federal Democratic Republic of Nepal, H [ W H Q G H G D Z D U P Z H O F R P H W R W K H & K L H I * X H V W W K H 5 L J K W + R Q R X U D E O H Mr Madhav Kumar Nepal, Prime Minister of Nepal, for gracing the M R L Q W L Q D X J X U D O V H V V L R Q Z K L F K K H V D L G U H D I � U P H G W K H F R P P L W P H Q W of his Government to securing the health of the people of the country. + H D O V R H [ W H Q G H G J U H H W L Q J V W R K H D O W K P L Q L V W H U V I U R P 0 H P E H U 6 W D W H V R I W K H : + 2 6 R X W K ( D V W $ V L D 5 H J L R Q R E V H U Y H U V U H S U H V H Q W L Q J K H D O W K P L Q L V W H U V I U R P , Q G R Q H V L D D Q G 7 K D L O D Q G F R X Q W U \ G H O H J D W H V ' U Part 2 Inaugural session 5 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Margaret Chan, Director-General of the World Health Organization, D S S U H F L D W L Q J K H U O H D G H U V K L S L Q W D N L Q J I R U Z D U G W K H K H D O W K D J H Q G D and Dr Samlee Plianbangchang, Regional Director of the WHO South-East Asia Region, thanking him for his help and support in regional activities for health. 0 U & K D X G K D U \ V W D W H G W K D W W K H 0 H H W L Q J R I W K H + H D O W K 0 L Q L V W H U V and the Regional Committee Session were very important for public health in the South-East Asia Region, especially to tackle communicable diseases and contain the rise in noncommunicable G L V H D V H V , Q Y L H Z R I X U J H Q W J O R E D O L V V X H V V X F K D V 3 D Q G H P L F + 1 L Q � X H Q ] D 0 U & K D X G K D U \ X Q G H U O L Q H G W K H Q H H G I R U D O O 0 H P E H U 6 W D W H V L Q W K H 5 H J L R Q W R V K D U H Q D W L R Q D O H [ S H U L H Q F H D Q G H [ S H U W L V H L Q their control. 14. Mr Chaudhary recalled the key issues in public health that were to be discussed at the meeting. Noting that Nepal faced a W K U H H S U R Q J H G W K U H D W I U R P H D U W K T X D N H V O D Q G V O L G H V D Q G � R R G V K H emphasized the importance of protecting hospitals from disasters. Other issues facing the Region were the impact of the global economic downturn and its effect on health budgets of States. 7 K H 0 L Q L V W H U F R P P H Q G H G : + 2 I R U W K H 2 U J D Q L ] D W L R Q � V Y H U \ useful collaboration with the Ministry of Health and Population of Nepal for the past 56 years. The role of WHO, he said, began with the provision of assistance but has grown over the years into V X E V W D Q W L Y H V X S S R U W I R U H [ W H Q G L Q J S X E O L F K H D O W K L Q F O X G L Q J U H Y L W D O L ] L Q J 6 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region primary health care. He appreciated support provided through the South-East Asia Regional Health Emergency Fund, which helped 1 H S D O P L W L J D W H W K H H I I H F W V R I W K H G H Y D V W D W L Q J � R R G L Q J E \ W K H 5 L Y H U Kosi in 2008 and control recent outbreaks of diarrhoea. 16. He said that the government had made primary health care an integral component of national health policy and programmes. He apprised the distinguished gathering of the steady progress made towards health promotion and health development in areas such as control of tuberculosis through DOTS, elimination of leprosy by the end of 2009, reducing child mortality and accelerating progress to meet the Millennium Development Goals. The Minister reiterated the steadfast commitment of the Government of the Federal Democratic Republic of Nepal to provide free maternity services and essential drugs to all people, especially the poor and marginalized, up to the district level. , Q F R Q F O X V L R Q 0 U & K D X G K D U \ V D L G W K D W S X E O L F K H D O W K W R G D \ I D F H V some serious challenges but these should not rob the government and the people of hard-won public health gains, especially for the poor, vulnerable and hard-to-reach populations. (For full text of the address, see Annex 3). 7 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Address by Dr Samlee Plianbangchang, Regional Director, WHO South-East Asia Region 18. The Regional Director welcomed the Ministers and other distinguished delegates, and conveyed his grateful thanks to the Government of the Federal Democratic Republic of Nepal for hosting the meeting. He conveyed his sincere thanks to the Right Honourable Mr Madhav Kumar Nepal, Prime Minister of Nepal, for kindly consenting to inaugurate the joint session. 19. Dr Samlee highlighted that the South-East Asia Region is K R P H W R R I W K H Z R U O G � V S R S X O D W L R Q D Q G E H D U V R I W K H Z R U O G � V P R U W D O L W \ D Q G R I W K H J O R E D O G L V H D V H E X U G H Q + R Z H Y H U W K H U H J L R Q D O D Y H U D J H I R U W K H + X P D Q ' H Y H O R S P H Q W , Q G H [ L V D E R Y H 0.5. 20. He reiterated the formidable challenges still being faced by W K H 5 H J L R Q Q D P H O \ P D W H U Q D O L Q I D Q W D Q G F K L O G P R U W D O L W \ W K H G R X E O H E X U G H Q R I F R P P X Q L F D E O H D Q G Q R Q F R P P X Q L F D E O H G L V H D V H V D Q G W K H generally weak health systems infrastructure. 21. The Regional Director commended Nepal for the remarkable S U R J U H V V P D G H W R Z D U G V Q D W L R Q D O K H D O W K J R D O V 7 K H F R X Q W U \ � V immunization coverage had increased from 75% in 2005 to 84% in 2008 and there was a substantial rise in the per capita calorie consumption, which was now above the regional average. 22. The Government of Nepal also deserved commendation, he V D L G I R U E H L Q J W K H � U V W $ V L D Q F R X Q W U \ W R V L J Q D � 1 D W L R Q D O & R P S D F W � Z L W K , Q W H U Q D W L R Q D O + H D O W K 3 D U W Q H U V K L S V + H X Q G H U O L Q H G W K H N H \ V X E M H F W V I R U G H O L E H U D W L R Q E \ W K H P L Q L V W H U V at the meeting: the impact of the global economic downturn on 8 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region K H D O W K S U R W H F W L Q J K H D O W K I D F L O L W L H V L Q H P H U J H Q F L H V D Q G D O V R W K H progress in the implementation of the New Delhi Declaration on Protecting Human Health from Climate Change. 7 K H 5 H J L R Q D O ' L U H F W R U H [ S U H V V H G G H H S F R Q F H U Q W K D W W K H P H H W L Q J Z D V E H L Q J K H O G D W D W L P H Z K H Q W K H L Q � X H Q ] D S D Q G H P L F was sweeping across the world. However, it would also provide an opportunity to collectively consider the latest situation and how to move forward. The effects of the global economic uncertainty were D O V R E H L Q J H [ S H U L H Q F H G + H S R L Q W H G R X W W K D W V W U D W H J L F S O D Q Q L Q J I R U P R U H H I � F L H Q W X V H R I U H V R X U F H V V K R X O G E H W K H N H \ I R F X V (For full text of the address, see Annex 4). Address by Dr Margaret Chan, Director- General, World Health Organization 25. T h e D i r e c t o r - General, Dr Margaret Chan, conveyed her appreciation to the Ministers of Health of Member States of the Region and thanked the Government of the Federal Democratic Republic of Nepal for hosting the two important meetings. 9 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region 6 K H H [ S U H V V H G F R Q F H U Q W K D W W K H Z R U O G L V H [ S H U L H Q F L Q J W K H most severe economic downturn in three decades and is in the P L G V W R I W K H � U V W L Q � X H Q ] D S D Q G H P L F L Q I R X U G H F D G H V 7 K H D G Y H U V H effects of climate change were also being felt. 27. However, she was glad to note that the world is also in the midst of the most ambitious drive in history to reduce poverty and bridge the gaps in health outcomes through achieving the Millennium Development Goals. Public health initiatives needed unprecedented commitment to counter the consequences of the global crises. This was especially true for developing countries, where the disparities in income levels, opportunities and health outcomes were greater than ever. 28. Dr Chan stated that the health of women was one of her two priority areas. She commended Nepal for developing policies aimed at reducing maternal mortality in a systematic manner, as U H � H F W H G L Q W K H 0 D W H U Q L W \ , Q F H Q W L Y H 6 F K H P H L P S O H P H Q W H G L Q She emphasized that the number of deaths during pregnancy and delivery will not go down until more women have skilled attendants at birth, access to emergency obstetric care and also cost-effective means of transport at their disposal. She stressed that a renewed commitment to primary health care underpins efforts to improve W K H K H D O W K R I Z R P H Q D Q G W K L V L V H Y L G H Q W L Q D U H S R U W R Q � : R P H Q and Health” that she has commissioned and which will be released in November. 6 K H D O V R H [ S U H V V H G F R Q F H U Q D E R X W W K H Q H Z + 1 S D Q G H P L F virus, which had established itself in about 190 countries, and stated that the capacity of our health systems will determine the S D Q G H P L F � V L P S D F W L Q G L I I H U H Q W F R X Q W U L H V , Q F R Q F O X V L R Q W K H ' L U H F W R U * H Q H U D O V W D W H G W K D W S X E O L F K H D O W K K D G D P D M R U U R O H W R S O D \ L Q W K H P D Q D J H P H Q W R I W K H L Q � X H Q ] D pandemic. She urged the health ministers to get the message across to heads of states, heads of governments and ministers of � Q D Q F H W R X U L V P D Q G W U D G H U H J D U G L Q J W K H Q H H G I R U I D U U H D F K L Q J R I W H Q F R V W O \ G H F L V L R Q V L Q D Q D W P R V S K H U H R I V F L H Q W L � F X Q F H U W D L Q W \ L Q order to resolve this public health emergency. (For full text of the address, see Annex 5). 10 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Inaugural Address by the Chief Guest, His Excellency the Right Honourable Mr Madhav Kumar Nepal, Prime Minister of the Government of the Federal Democratic Republic of Nepal 7 K H 5 L J K W Honourable Mr Madhav Kumar Nepal, Prime Minister of the Government of the Federal Democratic Republic of Nepal, delivered W K H , Q D X J X U D O $ G G U H V V W R the distinguished delegates at the joint inauguration of the Twenty-seventh Meeting of Ministers of + H D O W K D Q G 6 L [ W \ V H F R Q G Session of the WHO Regional Committee for South-East Asia as the Chief Guest. 7 K H 3 U L P H 0 L Q L V W H U H [ W H Q G H G K L V E H V W Z L V K H V I R U W K H V X F F H V V R I W K H + H D O W K 0 L Q L V W H U V � 0 H H W L Q J D Q G W K H 5 H J L R Q D O & R P P L W W H H 6 H V V L R Q saying it was a privilege for the Federal Democratic Republic of Nepal to host the same. Nepal last hosted the Meeting of Health Ministers in 2000 and the annual session of the Regional Committee in 1992. 7 K H 3 U L P H 0 L Q L V W H U U H L W H U D W H G W K D W K L V * R Y H U Q P H Q W D F F R U G H G the highest importance to the meeting. Along with maintaining good relations with all states, and neighbouring states in particular, the Government considered multilateralism as a basic tenet of its foreign policy and accorded due importance to all events of global impact. & R P P H Q G L Q J W K H O H D G H U V K L S R I W K H : R U O G + H D O W K 2 U J D Q L ] D W L R Q L Q securing the health of the people of South-East Asia in collaboration with Member States, the Prime Minister said the Region faced a F R P S O H [ U D Q J H R I K H D O W K F K D O O H Q J H V 7 K H G L V F X V V L R Q V D W W K H 7 Z H Q W \ V H Y H Q W K 0 H H W L Q J R I 0 L Q L V W H U V R I + H D O W K D Q G W K H 6 L [ W \ V H F R Q G 6 H V V L R Q of the WHO Regional Committee for South-East Asia would focus 11 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region on the key issues of protecting human health from climate change, progress and challenges in the eradication of polio, strengthening the health workforce of the Region, combating counterfeit medical S U R G X F W V W K H L P S D F W R I W K H J O R E D O � Q D Q F L D O F U L V L V D Q G S D Q G H P L F L Q � X H Q ] D S U H S D U H G Q H V V 5 H L W H U D W L Q J K L V * R Y H U Q P H Q W � V F R P P L W P H Q W W R L P S U R Y H W K H health services provided to the people, the Prime Minster said the budget for the health sector had increased three-fold in the last few \ H D U V W R D U R X Q G R I W K H F R X Q W U \ � V J U R V V G R P H V W L F S U R G X F W 7 K H Government is committed to provide a basic health-care package to all citizens as their fundamental right. Free maternal delivery services would be provided for all women through a public-private partnership. A package of essential drugs was also provided free at all public health institutions up to the district level. 7 K H 3 U L P H 0 L Q L V W H U D O V R V D L G W K D W W K H R Y H U D O O L P S U R Y H P H Q W across the health sector in his country was measurable against most health indicators: Maternal mortality had declined by almost E H W Z H H Q D Q G Q H Z E R U Q D Q G X Q G H U � Y H F K L O G mortality was declining and polio eradication status continued to E H P D L Q W D L Q H G + H V W D W H G W K D W 1 H S D O H [ S H F W H G W R D F K L H Y H O H S U R V \ elimination by the end of 2009. 7 K H 3 U L P H 0 L Q L V W H U H [ S U H V V H G J U D W L W X G H W R : + 2 D Q G other international partners for their support and reiterated his * R Y H U Q P H Q W � V F R P P L W P H Q W W R I X U W K H U V W U H Q J W K H Q W K H K H D O W K V \ V W H P The outcome of the collective efforts of the distinguished delegates at the meeting would lead to a common vision and provide for collective health security in the Region. (For full text of the address, see Annex 6). Vote of thanks by H.E. Mr Khadga Bahadur Basyal, Minister of State, Ministry of Health and Population, Government of the Federal Democratic Republic of Nepal + ( 0 U . K D G J D % D K D G X U % D V \ D O 0 L Q L V W H U R I 6 W D W H 0 L Q L V W U \ of Health and Population, Government of the Federal Democratic Republic of Nepal, proposed the vote of thanks and placed on record, on behalf of the Ministry of Health and Population, his deep appreciation and gratitude to the Right Honourable 12 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Mr Madhav Kumar Nepal, the Prime Minister of Nepal, for inaugurating the Twenty- V H Y H Q W K + H D O W K 0 L Q L V W H U V � 0 H H W L Q J D Q G W K H 6 L [ W \ second Regional Committee Session. + H W K D Q N H G W K H 3 U L P H 0 L Q L V W H U I R U U H D I � U P L Q J the strong commitment of the Government to the health of the people, and also thanked the Ministers of Health for being present despite their busy schedules. He appreciated Dr Margaret Chan, Director-General, for sharing her Z L V G R P D Q G H [ S H U L H Q F H + H W K D Q N H G ' U 6 D P O H H 3 O L D Q E D Q J F K D Q J Regional Director, for his leadership and continued support to Member States of the SEA Region. 7 K H 0 L Q L V W H U D O V R W K D Q N H G D O O R I � F L D O V R I : + 2 Z K R V H K H O S D Q G cooperation made the event a success. He appreciated the hard Z R U N E \ R I � F L D O V D Q G V W D I I R I W K H 0 L Q L V W U \ R I + H D O W K D Q G 3 R S X O D W L R Q and also the ambassadors, government secretaries and special guests, and the heads of various organizations, for their presence D Q G V X S S R U W + H K R S H G W K D W W K H G H O L E H U D W L R Q V R Y H U W K H Q H [ W I H Z days would lead to practical recommendations to improve the health of the people in the Region. (For full text of the address, see Annex 7). Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Introductory Session 41. H.E. Mr Ghulam Nabi Azad, Minister of Health and Family Welfare, Government of , Q G L D D V W K H & K D L U R I W K H + H D O W K 0 L Q L V W H U V � ) R U X P welcomed all the delegates to the Twenty-seventh Meeting of the Health Ministers and thanked the Government of Nepal for hosting this important meeting. He also thanked the Right Honourable Mr Madhav Kumar Nepal, Prime Minister of the Federal Democratic Republic of Nepal, for inaugurating W K H + H D O W K 0 L Q L V W H U V � 0 H H W L Q J D Q G for his thought-provoking and inspiring address. The Minister also stated that the address by Dr Margaret Chan, WHO Director-General, S U R Y L G H G D J O R E D O S H U V S H F W L Y H R Q K H D O W K D Q G G H Y H O R S P H Q W L Q K L V address, the Regional Director, Dr Samlee Plianbangchang had highlighted the health challenges that confronted the Region and the opportunities that were available to overcome them. 42. The Minister commended the spirit of cooperation and coordination shown by all Member States of the Region that saw D O O R I W K H P V S H D N L Q J Z L W K � R Q H Y R L F H � R Q J O R E D O S X E O L F K H D O W K L V V X H V with telling effect. 3 D U W Business session 14 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region 15 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region 8 Q G H U V F R U L Q J W K H L P S R U W D Q F H R I W L P H O \ D F W L R Q D J D L Q V W W K H D G Y H U V H H I I H F W V R I F O L P D W H F K D Q J H W K H 0 L Q L V W H U V D L G � : K L O H F O L P D W H change is a matter of concern, we need to evaluate the evidence and assess the impacts, both long and short term, of climate change on health in order to better plan and implement adaptation measures. At the same time, we should be conscious of the challenges of poverty and malnutrition facing us and our responsibility to pursue all-round development to overcome them.” 7 K H 0 L Q L V W H U H [ S U H V V H G K L V V D W L V I D F W L R Q W K D W W K H 7 Z H Q W \ V H Y H Q W K + H D O W K 0 L Q L V W H U V � 0 H H W L Q J Z R X O G E H G H O L E H U D W L Q J D Q G D G R S W L Q J D G H F O D U D W L R Q R Q � 3 U R W H F W L Q J K H D O W K I D F L O L W L H V I U R P H P H U J H Q F L H V � � D subject of immense public health importance. 45. He also underlined the importance of the last item on the D J H Q G D � , P S D F W R I W K H J O R E D O � Q D Q F L D O F U L V L V R Q K H D O W K � , Q W K L V F R Q W H [ W K H H P S K D V L ] H G W K D W L W Z D V Y H U \ L P S R U W D Q W W R H Q V X U H W K D W budgetary support to the health sector was not only protected but also enhanced at this crucial juncture. Despite the crisis, the E X G J H W I R U K H D O W K L Q , Q G L D K D G L Q F U H D V H G 46. H.E. Mr Umakant Chaudhary, Minister of Health and Population, the Government of the Federal Democratic Republic of Nepal, was unanimously elected Chairman of the Twenty-seventh Meeting R I + H D O W K 0 L Q L V W H U V D V Z H O O D V R I W K H + H D O W K 0 L Q L V W H U V � ) R U X P I R U 2009-2010. H.E. Mr Nimal Siripala de Silva, Minister of Healthcare and Nutrition, Government of the Democratic Socialist Republic of Sri Lanka, was unanimously elected Co-Chair. 16 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region ' U 6 D U D W K 0 6 D P D U D J H ' H S X W \ ' L U H F W R U * H Q H U D O 3 O D Q Q L Q J Ministry of Healthcare and Nutrition, Government of the Democratic Socialist Republic of Sri Lanka was elected Rapporteur. 48. H.E. Mr Umakant Chaudhary thanked the ministers for electing him Chairman for the Twenty-seventh Meeting of Health Ministers D Q G I R U W K H + H D O W K 0 L Q L V W H U V � ) R U X P I R U 49. The Minister said that he considered his election as Chairman an honour not only for himself but also for his country, and that he was conscious of the challenges and responsibilities involved in his role. He added that ever-increasing collaboration and solidarity among countries of the Region would make it possible to resolve common health problems, as well as to contribute to efforts aimed at overcoming global health problems. $ V & K D L U R I W K H P H H W L Q J W K H 0 L Q L V W H U H [ W H Q G H G D Y H U \ Z D U P welcome to all the delegates and wished them a pleasant and enjoyable stay in Kathmandu. 51. The Chair commended the speeches made by the WHO Director-General and by the WHO Regional Director for South-East Asia, which outlined the health challenges confronting the Member States. He placed on record his great appreciation for their views, thoughts and leadership. 7 K H 0 L Q L V W H U H [ S U H V V H G F R Q � G H Q F H W K D W W K H + H D O W K 0 L Q L V W H U V � meeting would prove to be a milestone in strengthening mutual 17 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region goodwill and cooperation for health development and that the bond of fraternity and friendship would be strengthened among Member States. 7 K H : + 2 ' L U H F W R U * H Q H U D O ' U 0 D U J D U H W & K D Q U H P D U N H G W K D W V K H G H H P H G L W D J U H D W K R Q R X U W R E H D E O H W R � O L V W H Q D Q G O H D U Q � from the deliberations among the honorable Ministers of Health of all Member States of the SEA Region F a Region that accounted I R U W K H O D U J H V W S U R S R U W L R Q R I W K H J O R E D O G L V H D V H E X U G H Q She commended the Ministers of Health and their respective governments for their commitment and dedication in working W R J H W K H U W R V R O Y H W K H L U F R P S O H [ K H D O W K S U R E O H P V : K L O H ' U & K D Q commended Member States on the progress being made by them in implementing the New Delhi Declaration on the impacts of climate change on human health, she underscored the need for collective and enhanced efforts to improve the status of maternal health. Review of New Delhi Declaration/ Follow-up actions on the decisions and recommendations of the Twenty-sixth Health Ministers Meeting (Agenda item No. 3) 54. Dr Poonam Khetrapal Singh, Deputy Regional Director, WHO South-East Asia Region, made a presentation on the subject. 55. The attention of the honourable ministers was drawn to the working paper on the agenda item, which lists follow-up actions initiated by the Member States of the Region, as well as by the 5 H J L R Q D O 2 I � F H R Q W K H recommendations/ action points in respect of the topics deliberated at the 7 Z H Q W \ V L [ W K 0 H H W L Q J of the Ministers of Health of the WHO South-East Asia Region, held in New ' H O K L , Q G L D September 2008. 18 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region ' U 3 R R Q D P 6 L Q J K U H I H U U H G W R W K H � 1 H Z ' H O K L ' H F O D U D W L R Q R Q W K H L P S D F W V R I F O L P D W H F K D Q J H R Q K X P D Q K H D O W K � W K D W H [ S U H V V H V W K H 5 H J L R Q � V F R P P L W P H Q W W R W K H R E M H F W L Y H V V W D W H G W K H U H L Q 7 K H declaration prioritized a series of activities in countries of the SEA Region to increase the resilience of local communities, in particular the most vulnerable. 57. She said that the agenda item had been reviewed and G L V F X V V H G L Q G H W D L O D W W K H + L J K O H Y H O 3 U H S D U D W R U \ + / 3 0 H H W L Q J K H O G L Q W K H 5 H J L R Q D O 2 I � F H L Q - X Q H - X O \ Z K L F K Z D V D W W H Q G H G E \ V H Q L R U R I � F L D O V I U R P F R X Q W U L H V R I W K H 5 H J L R Q 7 K H K R Q R X U E O H P L Q L V W H U V Z H U H D V V X U H G W K D W W K H 5 H J L R Q D O 2 I � F H Z R X O G F R Q W L Q X H W R Z R U N W R Z D U G V � S U R W H F W L Q J K H D O W K I U R P F O L P D W H F K D Q J H � V X S S R U W F D S D F L W \ G H Y H O R S P H Q W I R U K H D O W K S U R I H V V L R Q D O V D Q G K H D O W K Z R U N H U V F D U U \ R X W D F W L R Q R U L H Q W H G U H V H D U F K D Q G S L O R W S U R M H F W V W R K H O S L Q F U H D V H W K H H Y L G H Q F H E D V H K H O S W R H P S R Z H U O R F D O communities and collaborate with key partners to reduce the carbon I R R W S U L Q W V D Q G X Q G H U W D N H K H D O W K Y X O Q H U D E L O L W \ D V V H V V P H Q W V 59. Dr Poonam Singh outlined the recommended steps towards implementation of the 2008 New Delhi Declaration which inter alia included establishing climate change and human health cells in ministries of health, supporting community empowerment and participation in adaptation measures. WHO also would be setting 19 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region up a regional network to ensure collaboration between health scientists and practitioners, and meteorologists. Discussions 60. Member States recognized the importance of the New Delhi Declaration and noted the actions and progress made by them D Q G : + 2 V R I D U K R Z H Y H U W K H \ D O V R D F N Q R Z O H G J H G W K H Q H H G W R accelerate the implementation of the actions envisaged under the 1 H Z ' H O K L ' H F O D U D W L R Q 6 R P H R I W K H P K L J K O L J K W H G W K H L U S R S X O D W L R Q V � H [ W U H P H Y X O Q H U D E L O L W \ W R F O L P D W H F K D Q J H Q R W D E O \ S H R S O H O L Y L Q J L Q low-lying coastal areas and in mountainous regions. 61. Member States committed to establishing climate change and human health cells within their respective ministries of health. 0 H P E H U 6 W D W H V U H T X H V W H G W K H 5 H J L R Q D O 2 I � F H W R V X S S R U W W K H P L Q G H Y H O R S L Q J F R X Q W U \ S U R � O H V R Q F O L P D W H F K D Q J H D Q G K H D O W K 0 H P E H U 6 W D W H V U H S R U W H G R Q W K H X V H R I V S H F L I L F W U D L Q L Q J materials for health professionals and on ongoing research studies to assess the health impact of climate change so as to develop concrete guidelines to support local communities. Member States are committed to incorporating health dimensions into their national climate change action plans, and for this purpose requested WHO support to carry out health vulnerability assessments. 20 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region , W Z D V Q R W H G W K D W W K R X J K V R P H 0 H P E H U 6 W D W H V K D G Q R W \ H W F R Q W U L E X W H G V L J Q L � F D Q W O \ W R W K H K L V W R U L F D O D F F X P X O D W L R Q R I J U H H Q K R X V H gases in the atmosphere through emissions, they would have to bear the brunt of the effects of climate change. They also noted that health had not been considered in an adequate manner within the United Nations Framework Convention on Climate Change 8 1 ) & & & V R P H I D Y R X U H G W K H V X J J H V W L R Q W R L Q F O X G H R I � F L D O V from ministries of health in national delegations to the UNFCCC & R Q I H U H Q F H R I 3 D U W L H V & 2 3 W R E H K H O G I U R P ' H F H P E H U 2009 in Copenhagen. 21 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Conclusion + R Q R X U D E O H P L Q L V W H U V H [ S U H V V H G W K H L U V D W L V I D F W L R Q D W W K H progress made so far. They highlighted the urgency to implement actions towards protecting the health of local communities, and the fact that this required working together with others outside the health sector, especially at the district level. Protecting Health Facilities from Emergencies (Agenda item No.4) 66. Dr Poonam Khetrapal Singh, Deputy Regional Director, WHO South-East Asia Region, presented a summary of the topic and the background document. As the topic has already been discussed G X U L Q J W K H + L J K O H Y H O 3 U H S D U D W R U \ 0 H H W L Q J + / 3 K H U S U H V H Q W D W L R Q highlighted the recommendations made at that meeting which were for WHO to support Member States in their efforts to implement risk reduction measures in their health facilities, and for Member States to hold national consultations for streamlining implementations of W K H � 5 H J L R Q D O & R Q V X O W D W L R Q I R U . H H S L Q J + H D O W K ) D F L O L W L H V 6 D I H ) U R P Disasters” and support the Kathmandu Declaration on Protecting Health Facilities from Disasters. , W Z D V I X U W K H U H P S K D V L ] H G W K D W W K H L V V X H R I V W U X F W X U D O non-structural and functional integrity of health facilities during emergencies/disasters is very important because of the vulnerability R I W K H 5 H J L R Q W R G L V D V W H U V % H W Z H H Q D Q G Q D W X U D O G L V D V W H U V killed over 750 000 people in the Member States of the South-East $ V L D 5 H J L R Q Z K L F K U H S U H V H Q W H G R I W K H Z R U O G � V W R W D O G H D W K V from disasters during that period. 68. Physical integrity is of primary concern as health facilities should be built in accordance with standards so that they are able to withstand the hazards in the environment, allowing the facility to remain intact and not collapse during disasters. 1 R Q V W U X F W X U D O H O H P H Q W V L Q F O X G H X W L O L W L H V H J Z D W H U H O H F W U L F L W \ D Q G H T X L S P H Q W , Q V R P H F D V H V D O W K R X J K D K H D O W K I D F L O L W \ U H P D L Q V intact, it is rendered non-functional because the equipment is damaged and lifelines such as water and electricity supplies get or have been cut off. 22 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region 70. Organizational aspects also play a vital role. Capacities need to be strengthened so that a facility will continue to function. Providing critical services requires contingency plans and a well- trained health workforce that is ready and able to deal with the health consequences of emergencies. 71. The South-East Asia Region has developed a unique set of % H Q F K P D U N V I R U ( P H U J H Q F \ 3 U H S D U H G Q H V V D Q G 5 H V S R Q V H Z L W K W K H S D U W L F L S D W L R Q R I D O O 0 H P E H U 6 W D W H V 2 Q H R I W K H V H E H Q F K P D U N V � % H Q F K P D U N � V S H F L � H V W K H Q H H G I R U V D I H K H D O W K I D F L O L W L H V , W H P S K D V L ] H V W K D W K H D O W K I D F L O L W L H V V K R X O G E H E X L O W P R G L � H G W R U H V L V W the impact of various hazards. A set of indicators and standards also D F F R P S D Q \ W K L V % H Q F K P D U N Z K L F K 0 H P E H U 6 W D W H V K D Y H F R P P L W W H G to achieve. 6 L J Q L � F D Q W H I I R U W V P D G H E \ Y D U L R X V 0 H P E H U 6 W D W H V R I W K H 6 ( $ Region were outlined. 5 H F H Q W H [ D P S O H V R I H P H U J H Q F L H V L Q W K H 5 H J L R Q Z H U H F L W H G These included: & \ F O R Q H 6 L G U L Q % D Q J O D G H V K G D P D J H G R I G L V W U L F W K R V S L W D O V D Q G R X W R I X S D ] L O D K H D O W K F R P S O H [ H V Cyclone Nargis in Myanmar destroyed 57% of public health facilities in the affected areas with 10% to 15% of these being rendered totally non-functional. 7 K H . R V L U L Y H U � R R G V L Q , Q G L D L Q G D P D J H G F R X Q W O H V V health facilities and made them inaccessible. Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region An earthquake measuring around 7.0 on the Richter scale W K D W V W U X F N 6 R X W K ( D V W - D Y D L Q , Q G R Q H V L D R Q 6 H S W H P- E H U F D X V H G H [ W H Q V L Y H G D P D J H W R K H D O W K I D F L O L W L H V L Q F O X G L Q J R Q H K R V S L W D O S X V N H V P D V K H D O W K F O L Q L F V D Q G 28 health posts. 7 K H U H F H Q W F R Q � L F W L Q 6 U L / D Q N D O H G W R V K R U W D J H R I K X P D Q health resources in various areas and specialities to run health facilities. 7 K H P D L Q U H F R P P H Q G D W L R Q V R I W K H + / 3 Z H U H R X W O L Q H G , W Z D V stated that national consultations/workshops can help Member States discuss ways to: , P S U R Y H L Q Y R O Y H P H Q W D Q G F R R U G L Q D W L R Q Z L W K Y D U L R X V V H F- W R U V ' H Y H O R S Q D W L R Q D O S O D Q V I R U V D I H K H D O W K I D F L O L W L H V Gain consensus on methodologies and technologies that Z L O O E H D S S O L H G L Q D V V H V V P H Q W V D Q G L Q W H U Y H Q W L R Q V Link disaster risk reduction to the development pro- F H V V H V 6 W U H Q J W K H Q S X E O L F D G Y R F D F \ D Q G Organize capacity-building efforts. 75. The key points of the Kathmandu Declaration were summarized. 7 K H V H I R F X V H G R Q W K H H L J K W V S H F L � F F R P P L W P H Q W V W K D W 0 L Q L V W H U V of Health of Member States would make once the Declaration is adopted. Discussions: $ O O 0 H P E H U 6 W D W H V H [ S U H V V H G D S S U H F L D W L R Q I R U W K H 6 H F U H W D U L D W for raising and documenting the issue of safe health facilities. They pointed out the vulnerability of Member States and the Region as a whole to various types of disasters, both natural and man-made. 77. The need for health facilities to remain intact and functional since they are valuable assets of any health system was emphasized. 78. Member States noted the importance of activities that strengthen preparedness and risk reduction which are key strategies to keep health facilities properly functional in any emergency or disaster. 24 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region 79. The Minister of Health of the Democratic Republic of Timor-Leste pledged a donation of US$ 10 000 on behalf of his Government for the South-East Asia Regional Health Emergency ) X Q G 6 ( $ 5 + ( ) + H S R L Q W H G R X W W K D W W K H I X Q G U H O H D V H G D W D Q appropriate time, supported interventions to be implemented in any emergency. He recounted the situation in Timor-Leste during W K H P R Y H P H Q W I R U L Q G H S H Q G H Q F H L Q Z K H Q W K H R Q J R L Q J F R Q � L F W had led to the destruction of three out of every four health facilities L Q W K H F R X Q W U \ D Q G F D X V H G W K H � L J K W H Q P D V V H I U R P W K H F R X Q W U \ R I many health professionals. . H \ S U L R U L W \ Q H H G V Z H U H L G H Q W L � H G V X F K D V W K H U H Y L H Z R I policies and standards for design and building of health facilities L Q O L Q H Z L W K K D ] D U G D Q G Y X O Q H U D E L O L W \ D Q D O \ V L V W K H Q H H G W R K D Y H S U H S D U H G Q H V V S O D Q V L Q H Y H U \ K H D O W K I D F L O L W \ D W D O O O H Y H O V D Q G capacity-building activities for risk reduction and preparedness of the health sector. 81. Member States cited the need to engage communities in all preparedness activities and link them to health facilities so that D F W L R Q D W W K L V O H Y H O L V Z H O O F R R U G L Q D W H G D Q G H I � F L H Q W & R V W H I I H F W L Y H solutions to risk-reduction measures and interventions for making health facilities safer also need to be implemented. Conclusions 82. The Ministers of Health requested the Secretariat for further technical support and mobilization of resources for this area. The Ministries of Health would collaborate with WHO to strengthen international and national programmes, especially in the wake of the widespread devastations caused by natural disasters. $ O O P L Q L V W H U V V X S S R U W H G W K H . D W K P D Q G X ' H F O D U D W L R Q Z L W K W K H L Q F R U S R U D W L R Q R I W K H L U R E V H U Y D W L R Q V L Q W K H W H [ W , W Z D V D O V R V X J J H V W H G that the inclusion and engagement of the private sector and the K H D O W K I D F L O L W L H V W K H \ P D Q D J H E H U H � H F W H G L Q W K H G H F O D U D W L R Q W K U R X J K a national hospital accreditation process. 25 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Kathmandu Declaration on Protecting Health Facilities from Disasters We, the Health Ministers of Member States of the WHO South-East Asia Region participating in the Twenty-seventh Health 0 L Q L V W H U V � 0 H H W L Q J L Q . D W K P D Q G X 1 H S D O D S S U H F L D W H W K H H I I R U W V being made by Member States and partners in the South-East Asia Region to keep health facilities safe from emergencies and disasters. We also recognize that by optimizing the use of advances in technology and applying current good practices, stakeholders can scale up efforts to strengthen the structural, non-structural and functional aspects of protecting and increasing the resilience of health facilities. Concerned that from 1998-2009, natural disasters have killed over 750,000 people in the South-East Asia Region, which is R I W K H Z R U O G � V W R W D O G H D W K V G X U L Q J W K H S H U L R G I U R P Q D W X U D O G L V D V W H U V Aware that climate change-related events can cause disasters Z K L F K F D Q K D Y H D G H W U L P H Q W D O H I I H F W R Q K H D O W K I D F L O L W L H V Also aware that health facilities, including staff, equipment and other related resources, can become casualties when they are P R V W Q H H G H G 26 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Recognizing W K D W W K H + \ R J R ) U D P H Z R U N I R U $ F W L R Q V S H F L � H G that health facilities are the critical infrastructure that needs to be N H S W L Q W D F W L Q H P H U J H Q F L H V Recognizing further that the South-East Asia regional benchmarks, standards and indicators for emergency preparedness and response provide a framework based on which health facilities F D Q E H E X L O W R U P R G L � H G W R Z L W K V W D Q G H Y H Q W V I U R P Y D U L R X V N L Q G V R I K D ] D U G V D Q G G L V D V W H U V Acknowledging the outputs of the meeting of the Global 3 O D W I R U P I R U ' L V D V W H U 5 L V N 5 H G X F W L R Q K H O G L Q - X Q H U H J D U G L Q J structural evaluations of health facilities, enforcement of national E X L O G L Q J F R G H V � Q D Q F L D O L Q F H Q W L Y H V D Q G P H F K D Q L V P V I R U U H W U R � W W L Q J and Noting the innovative work of Member States in the Region to reduce the structural and nonstructural risks of health facilities, D V Z H O O D V W R L Q F U H D V H W U D L Q L Q J D Q G F R Q W L Q J H Q F \ S O D Q Q L Q J We, the Health Ministers, commit ourselves to: implement the goals of the Hyogo Framework for building the resilience of nations and communities to G L V D V W H U V consider the outputs of the Global Platform for Disaster 5 L V N 5 H G X F W L R Q L Q U H O D W L R Q W R V D I H K H D O W K I D F L O L W L H V 27 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region use the South-East Asia regional benchmarks, standards and indicators for emergency preparedness and re- sponse to build and modify health facilities to withstand H Y H Q W V I U R P Y D U L R X V K D ] D U G V D Q G G L V D V W H U V develop the capacity of health-sector professionals in the science and practice of health facility preparedness D Q G U L V N U H G X F W L R Q promote assessments of health facilities in Member 6 W D W H V X V L Q J H [ L V W L Q J G L D J Q R V W L F W R R O V D Q G G H F L V L R Q P D N L Q J L Q V W U X P H Q W V promote the enforcement of national building codes and V S H F L � F V W D Q G D U G V I R U K H D O W K I D F L O L W L H V include the private sector in all efforts so that health I D F L O L W L H V U H P D L Q U H V L O L H Q W W R G L V D V W H U V engage other service and public sectors such as civil engineering, architecture, transport, public works, wa- W H U D Q G V D Q L W D W L R Q H Q H U J \ D Q G � Q D Q F H W R V W U H Q J W K H Q the infrastructure related to the functioning of health I D F L O L W L H V L Q H P H U J H Q F L H V D Q G G L V D V W H U V D Q G enhance public awareness of the need to make health facilities safe and functional in emergencies. We, the Health Ministers of South-East Asia Region, urge the Director-General and the Regional Director to continue to provide leadership and technical support in building partnerships between governments, and the United Nations and relevant global health initiatives and partnerships, academia, professional bodies, Q R Q J R Y H U Q P H Q W D O R U J D Q L ] D W L R Q V 1 * 2 V U H O D W H G V H F W R U V D Q G W K H media and civil society, to jointly advocate and effectively follow up on all aspects of this Kathmandu Declaration on Protecting Health Facilities from Disasters. , P S D F W R I J O R E D O � Q D Q F L D O F U L V L V R Q K H D O W K (Agenda item No. 5) 84. Dr Poonam Khetrapal Singh, Deputy Regional Director, WHO South-East Asia Region, made a presentation on the subject. 28 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region 85. Dr Poonam Singh recalled the discussion on the topic at W K H + L J K O H Y H O 3 U H S D U D W R U \ + / 3 0 H H W L Q J K H O G L Q W K H 5 H J L R Q D O 2 I � F H 7 K H U H Z D V D F D O O I R U F R Q W L Q X H G J R Y H U Q P H Q W O H D G H U V K L S L Q S U R � O L Q J K H D O W K L Q W K H S X E O L F S R O L F \ D J H Q G D D Q G V D I H J X D U G L Q J W K H K H D O W K E X G J H W I U R P F X W E D F N V , W Z D V Q R W H G W K D W W K H I R F X V R I S X E O L F spending during the crisis may be on stimulating the economy and there needed to be a multisectoral effort to advocate for sustained investment in the social sector, including health. 86. The HLP meeting reiterated the need to step up government efforts towards social protection for health, especially for the poor D Q G Y X O Q H U D E O H , W Z D V K L J K O L J K W H G W K D W W K H F R X Q W U L H V W K D W K D Y H been most successful in protecting the poor and vulnerable during periods of crisis are those where governments have been committed to reform the health systems, and have in fact used crisis as an opportunity to accelerate long-term restructuring towards universal coverage. Thailand, during the Asian crisis in the 1990s, is a case in point. , Q D G G L W L R Q W R L Q F U H D V L Q J U H V R X U F H V I R U K H D O W K W K H U H L V D Q H H G to ensure judicious use of all available resources, including focusing public spending on priorities and a strategic engagement of the private sector. , W Z D V Q R W H G W K D W F R X Q W U L H V D U H I D F H G Z L W K Y D U L R X V G R P H V W L F and international crises almost on a regular basis and this calls for support, including from WHO, to strengthen health systems in a way that they can withstand future crises. 89. Dr Poonam Singh stated that the Regional Office was conducting case studies to understand and document the health L P S D F W R I W K H F U L V L V L Q V S H F L � F H F R Q R P L F V H F W R U V H J R Q W K H Z R P H Q H P S O R \ H H V R I W K H J D U P H Q W H [ S R U W L Q G X V W U \ L Q % D Q J O D G H V K L Q F R O O D E R U D W L R Q Z L W K % 5 $ & 6 K H D O V R L Q I R U P H G W K D W W K H 5 H J L R Q D O 2 I � F H L Q F R O O D E R U D W L R Q Z L W K W K H , Q V W L W X W H R I ( F R Q R P L F * U R Z W K 1 H Z ' H O K L K D G V H W X S D + H D O W K , Q W H O O L J H Q F H 8 Q L W W R P R Q L W R U W K H crisis and its impact on health in countries of the Region. This unit was also assisting Member States for more detailed analyses as requested. Discussions Member States noted that the social sector is very vul- Q H U D E O H W R H F R Q R P L F F U L V H V F H U W D L Q P H D V X U H V V X F K D V 29 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region targeting rural populations, strategic engagement with the S U L Y D W H V H F W R U H I � F L H Q F \ L Q W K H X V H R I U H V R X U F H V D Q G D multi-stakeholder approach have proven effective in mak- ing the health sector resilient in the face of the crisis. & R X Q W U L H V Z L W K H F R Q R P L H V G H S H Q G H Q W R Q H [ W H U Q D O P D U N H W V D U H S D U W L F X O D U O \ Y X O Q H U D E O H W R H [ W H U Q D O V K R F N V 8 Q L Y H U V D O health coverage schemes face a major challenge due to crisis. The importance of safeguarding the health budget and maintaining services, especially for the poor, and improv- L Q J H I � F L H Q F \ R I K H D O W K U H V R X U F H V Z H U H X Q G H U O L Q H G Health development needs to be seen in relation to multi- sectoral poverty reduction efforts, such as conditional cash transfers to support household economic activities. , W Z D V U H F R J Q L ] H G W K D W K H D O W K F D Q E H D N H \ L Q Y H V W P H Q W area, to be included in economic stimulus packages. , Q D G G L W L R Q W R J U H D W H U U H V R X U F H V I R U K H D O W K J U H D W H U H I �- F L H Q F \ L Q W K H X V H R I U H V R X U F H V L V U H T X L U H G � Q R W R Q O \ P R U H money for health, but also more health for money. How- ever, good performance can only be maintained through sustained investment. Among the measures that Member States have adopted are streamlining government structures and processes I R U V H U Y L F H G H O L Y H U \ W R P D [ L P L ] H H I � F L H Q F \ D Q G X V H R I D O O resources, and better coordination and avoidance of dupli- F D W L R Q V L Q H [ W H U Q D O D V V L V W D Q F H + H D O W K S R O L F \ L V D O V R E H L Q J reviewed with an orientation toward social protection. Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region The importance of continuously monitoring the health impact of the economic environment in order to respond rapidly to adverse events was emphasized. Member States underscored the need for longer-term commitments and L Q F U H D V H G V W D E L O L W \ L Q W K H � R Z R I 2 I � F L D O ' H Y H O R S P H Q W $ V V L V W D Q F H 2 ' $ I X Q G V Conclusions Health systems should in general be dynamic, constantly adapting to changing needs and priorities of countries. Member States emphasized the need to put people at the centre of health systems by reorienting health systems towards the principles of PHC, the goal of universal cov- erage and social protection. * R Y H U Q P H Q W V V K R X O G E H U H D G \ W R E U L G J H � Q D Q F L Q J J D S V resulting from decreased ODA funds so that nobody is denied health care due to lack of means in line with the philosophy of universal access embodied in the PHC ap- proach. , W Z D V U H F R P P H Q G H G W K D W E R W K F R X Q W U L H V D Q G G R Q R U V make renewed efforts to adhere to the Paris Declaration on Aid Effectiveness, which calls for country ownership of national development plans, the need for donors to align with these plans, harmonization of all assistance among donors and mu- tual accountability among all donors. , Q R U G H U W R H I I H F- tively engage with the private sector, W K H J R Y H U Q P H Q W � V oversight role and leadership need to be strengthened ap- propriately. Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Any Other Item (Agenda item No. 6) Elective Posts for the Sixty-third Session of the World Health Assembly and 127th Session of WHO Executive Board 90. At a private session, the Ministers, after due consideration, H Q G R U V H G W K H I R O O R Z L Q J H O H F W L Y H S R V W V I R U W K H 6 L [ W \ W K L U G 6 H V V L R Q of the World Health Assembly and 127th Session of the WHO ( [ H F X W L Y H % R D U G D Q G U H T X H V W H G W K H 5 H J L R Q D O ' L U H F W R U W R L Q I R U P WHO Headquarters accordingly. The following table summarizes the regional nominations: 2 I � F H Member State World Health Assembly Vice-President Myanmar & K D L U P D Q & R P P L W W H H % Sri Lanka Rapporteur, Committee A , Q G L D Committee on Credentials % D Q J O D G H V K ( [ H F X W L Y H % R D U G Vice-Chairman % D Q J O D G H V K Nomination of a South-East Asia Region 0 H P E H U 6 W D W H L Q S O D F H R I , Q G R Q H V L D Z K R V H W H U P H [ S L U H V L Q 0 D \ Timor-Leste , W Z D V G H F L G H G W K D W ' 3 5 . R U H D Z K L F K J D Y H X S L W V W X U Q W R 7 L P R U / H V W H Z R X O G E H Q R P L Q D W H G D V ( % 0 H P E H U Q H [ W \ H D U W K D W is 2011, in keeping with the policy of rotation. Revival of the Informal Meeting of Advisers prior to the Meeting of the Ministers of Health, WHO South- East Asia Region 92. At the same private session, the Health Ministers decided to revive from 2010 the informal meetings of advisers to Health Ministers, a day prior to the Meeting of Ministers of Health. Two to three advisers per Member State would attend. While the High- / H Y H O 3 U H S D U D W R U \ + / 3 P H H W L Q J Z R X O G D G G U H V V 5 H J L R Q D O & R P P L W W H H W R S L F V W K H D G Y L V H U V � P H H W L Q J Z R X O G W K R U R X J K O \ G L V F X V V L W H P V R Q Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region W K H D J H Q G D R I W K H + H D O W K 0 L Q L V W H U V � 0 H H W L Q J 7 K L V Z R X O G H Q D E O H W K H Health Ministers to complete their meeting in one day. Closing session (Agenda item No. 8) 7 K H ) H G H U D O ' H P R F U D W L F 5 H S X E O L F R I 1 H S D O D Q G + L V ( [ F H O O H Q F \ Mr Umakant Chaudhary, Minister for Health and Population, was sincerely thanked by the participating delegations for hosting the meeting in Nepal. They appreciated the warm hospitality and H [ F H O O H Q W D U U D Q J H P H Q W V P D G H E \ W K H K R V W ' L V W L Q J X L V K H G G H O H J D W H V S O D F H G R Q U H F R U G W K H L U V S H F L D O W K D Q N V W R + L V ( [ F H O O H Q F \ W K H 5 L J K W Honourable Mr Madhav Kumar Nepal, Prime Minister, Federal Democratic Republic of Nepal, for inaugurating the meeting and for his inspiring inaugural address. 94. Dr Margaret Chan, Director-General, World Health Organization, conveyed her thanks for the opportunity to participate in the Twenty- V H Y H Q W K 0 H H W L Q J R I W K H 0 L Q L V W H U R I + H D O W K D Q G W K H 6 L [ W \ V H F R Q G Session of the WHO Regional Committee for South-East Asia. 95. Distinguished delegates appreciated the agenda items that had been included and also praised the Kathmandu Declaration on Protecting Health Facilities from Disasters, which should serve as a wake-up call within the Region and beyond for this important issue. 96. Dr Samlee Plianbangchang, the Regional Director, congratulated the Honourable Health Ministers on the successful conclusion of Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region their meeting. He stated that the meeting had fully achieved its R E M H F W L Y H V D Q G P D G H D G H � Q L W H F R Q W U L E X W L R Q W R I X U W K H U V W U H Q J W K H Q L Q J the bonds of mutual friendship among the health leaders in the 5 H J L R Q + H S O D F H G R Q U H F R U G K L V W K D Q N V W R + L V ( [ F H O O H Q F \ 0 U 8 P D N D Q W Chaudhary, Minister for Health and Population, Federal Democratic Republic of Nepal, who as Chairman had guided the proceedings L Q D Q H [ W U H P H O \ E X V L Q H V V O L N H P D Q Q H U + H D O V R D F N Q R Z O H G J H G W K H F R Q W U L E X W L R Q R I + L V ( [ F H O O H Q F \ 0 U 1 L P D O 6 L U L S D O D ' H 6 L O Y D 0 L Q L V W H U of Healthcare and Nutrition, Government of the Democratic Socialist Republic of Sri Lanka, as the Co-Chair for this meeting. The contribution of the rapporteur Dr Sarath M. Samarage, from Sri Lanka, was also acknowledged. , W Z D V Q R W H G W K D W W K H 7 Z H Q W \ H L J K W K 0 H H W L Q J R I 0 L Q L V W H U V R I + H D O W K D Q G 6 L [ W \ W K L U G 6 H V V L R Q R I W K H : + 2 5 H J L R Q D O & R P P L W W H H for South-East Asia will take place in Thailand, in 2010. 2 Q E H K D O I R I W K H * R Y H U Q P H Q W R I , Q G L D + L V ( [ F H O O H Q F \ 0 U Ghulam Nabi Azad, Minister of Health and Family Welfare, offered W R K R V W W K H 7 Z H Q W \ Q L Q W K 0 H H W L Q J R I 0 L Q L V W H U V R I + H D O W K D Q G 6 L [ W \ fourth Session of the WHO Regional Committee for South-East Asia L Q , Q G L D 7 K H R I I H U Z D V X Q D Q L P R X V O \ D F F H S W H G Z L W K W K D Q N V E \ D O O the participants. + L V ( [ F H O O H Q F \ 0 U 8 P D N D Q W & K D X G K D U \ 0 L Q L V W H U I R U + H D O W K and Population, Federal Democratic Republic of Nepal, thanked the ministers, the Director-General of WHO, and the Regional Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Director for WHO South-East Asia Region, for all the compliments. He acknowledged that the successful completion of the meeting was due to the cooperation that he received from all the other ministries in the government. $ V & K D L U P D Q R I W K H + H D O W K 0 L Q L V W H U V � ) R U X P + L V ( [ F H O O H Q F \ Mr Umakant Chaudhary assured the meeting that he would do his best to make further progress in health development and to strengthen regional solidarity. He also sought the cooperation and guidance of his colleagues in discharging his responsibilities as the I R U X P � V F K D L U P D Q , Q F R Q F O X V L R Q K H G H F O D U H G W K H 7 Z H Q W \ V H Y H Q W K 0 H H W L Q J R I Ministers of Health of the Member States of the WHO South-East Asia Region closed. Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Annexes Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region - R L Q W , Q D X J X U D O 6 H V V L R Q R I W K H 7 Z H Q W \ V H Y H Q W K 0 H H W L Q J R I 0 L Q L V W H U V R I + H D O W K D Q G 6 L [ W \ V H F R Q G 6 H V V L R Q R I W K H : + 2 Regional Committee for South-East Asia , Q W U R G X F W R U \ V H V V L R Q Review of New Delhi Declaration / Follow-up actions on the G H F L V L R Q V D Q G U H F R P P H Q G D W L R Q V R I W K H 7 Z H Q W \ V L [ W K 0 H H W L Q J of Ministers of Health Protecting health facilities from emergencies: developing safer health-care facilities , P S D F W R I J O R E D O � Q D Q F L D O F U L V L V R Q K H D O W K Any other item Adoption of the report Closing session Annex 1 Agenda Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region 1. Ministers Bangladesh + ( ' U & D S W 5 W G 0 R ] L E X U 5 D K P D Q Fakir State Minister Ministry of Health and Family Wel- fare * R Y H U Q P H Q W R I W K H 3 H R S O H � V 5 H S X E- O L F R I % D Q J O D G H V K Bhutan H.E. Lyonpo Zangley Dukpa Minister for Health 5 R \ D O * R Y H U Q P H Q W R I % K X W D Q DPR Korea H.E. Professor Dr Choe Chang Sik Minister for Public Health ' H P R F U D W L F 3 H R S O H � V 5 H S X E O L F R I Korea India H.E. Mr Ghulam Nabi Azad Union Minister of Health & Family Welfare * R Y H U Q P H Q W R I , Q G L D Maldives + ( ' U $ P L Q D W K - D P H H O Minister of Health & Family Republic of Maldives Myanmar H.E. Professor Kyaw Myint Minister for Health The Government of the Union of Myanmar Nepal H.E. Mr Umakant Chaudhary Minister of Health and Population Government of Nepal + ( 0 U . K D G J D % D K D G X U % D V \ D O State Minister for Health and Popu- lation Government of Nepal Sri Lanka H.E. Mr Nimal Siripala de Silva Minister of Healthcare and Nutrition Government of the Democratic Socialist Republic of Sri Lanka Timor-Leste H.E. Dr Nelson Martins Minister of Health Democratic Republic of Timor-Leste 2. Observers Indonesia ' U % X G L K D U G M D Director-General of Community Health Ministry of Health 5 H S X E O L F R I , Q G R Q H V L D Thailand Dr Siripon Kanshana Deputy Permanent Secretary Ministry of Public Health Royal Thai Government Annex 2 List of participants Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region 3. Advisors Bangladesh ' U % D L ] L G . K R R U V K L G 5 L D ] Director 3 U L P H 0 L Q V W H U � V 2 I � F H * R Y H U Q P H Q W R I W K H 3 H R S O H � V 5 H S X E- lic of % D Q J O D G H V K Professor Dr Abul Kalam Azad ' L U H F W R U R I 0 , 6 Directorate General of Health Ser- vices * R Y H U Q P H Q W R I W K H 3 H R S O H � V 5 H S X E- lic of % D Q J O D G H V K Bhutan Ms Deki + X P D Q 5 H V R X U F H V R I � F H U $ G Y L V R U W R W K H + R Q � E O H 0 L Q L V W H U 5 R \ D O * R Y H U Q P H Q W R I % K X W D Q Dr Ugen Dophu Director Department of Public Health 5 R \ D O * R Y H U Q P H Q W R I % K X W D Q DPR Korea ' U 3 D N - R Q J 0 L Q Director ' H S D U W P H Q W R I ( [ W H U Q D O $ I I D L U V Ministry of Public Health ' H P R F U D W L F 3 H R S O H � V 5 H S X E O L F R I Korea 0 U . L P - D H + R Q Coordinator for WHO Programme , Q W H U Q D W L R Q D O 2 U J D Q L ] D W L R Q V ' H S D U W- ment Ministry of Foreign Affairs ' H P R F U D W L F 3 H R S O H � V 5 H S X E O L F R I Korea Mr Choe Yong Su 2 I � F H U ( [ W H U Q D O $ I I D L U V ' H S D U W P H Q W Ministry of Public Health ' H P R F U D W L F 3 H R S O H � V 5 H S X E O L F R I Korea India Mr Naresh Dayal Secretary Ministry of Health and Family Wel- fare * R Y H U Q P H Q W R I , Q G L D Dr R.S. Shukla - R L Q W 6 H F U H W D U \ Ministry of Health and Family Wel- fare * R Y H U Q P H Q W R I , Q G L D Dr Sharat Chauhan ' L U H F W R U , Q W H U Q D W L R Q D O + H D O W K Ministry of Health and Family Wel- fare * R Y H U Q P H Q W R I , Q G L D Mr V.S. Ramachandran 2 6 ' W R W K H + R Q � E O H 0 L Q L V W H U Minister for Health and Family Welfare Ministry of Health and Family Wel- fare * R Y H U Q P H Q W R I , Q G L D Indonesia Dr Ratna Rosita Hendardji Senior Adviser to Health Minister on Health Technology and Globaliza- tion Ministry of Health 5 H S X E O L F R I , Q G R Q H V L D , U ' R G G \ , ] Z D U G L Head ' L Y L V L R Q R I , Q W H U Q D W L R Q D O & R R S H U D- tion % X U H D X R I 3 O D Q Q L Q J D Q G % X G J H W L Q J 5 H S X E O L F R I , Q G R Q H V L D ' U $ Q J J L D , V P D L Q L , Q W H U Q D W L R Q D O & R R S H U D W L R Q ' L Y L V L R Q % X U H D X R I 3 O D Q Q L Q J D Q G % X G J H W L Q J 5 H S X E O L F R I , Q G R Q H V L D Maldives ' U , E U D K L P < D V L U $ K P H G Adviser to the Minister Director-General of Health Services Ministry of Health and Family Republic of Maldives 40 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Myanmar Dr Saw Lwin ' H S X W \ ' L U H F W R U * H Q H U D O ' L V H D V H Control) Department of Health Ministry of Health The Government of the Union of Myanmar Dr Kyaw Khaing Assistant Director , Q W H U Q D W L R Q D O + H D O W K ' L Y L V L R Q Ministry of Health The Government of the Union of Myanmar Dr Soe Lwin Nyein ' L U H F W R U ( S L G H P L R O R J \ Department of Health Ministry of Health The Government of the Union of Myanmar Nepal Dr Sudha Sharma Secretary Ministry of Health and Population Federal Democratic Republic of Nepal Dr Praveen Mishra Secretary Ministry of Health and Population Federal Democratic Republic of Nepal Dr Govinda Prasad Ojha Director-General Department of Health Services Federal Democratic Republic of Nepal Dr Yasho Vardhan Pradhan Chief, Policy , Planning and , Q W H U Q D W L R Q D O & R R S H U D W L R Q ' L Y L V L R Q Ministry of Health and Population Federal Democratic Republic of Nepal Mr Surya Prasad Acharya - R L Q W 6 H F U H W D U \ Ministry of Health and Population Federal Democratic Republic of Nepal Mr Ganga Prasad Luitel - R L Q W 6 H F U H W D U \ Ministry of Health and Population Federal Democratic Republic of Nepal 0 U 3 D G P D 5 D M % K D W W D - R L Q W 6 H F U H W D U \ Ministry of Health and Population Federal Democratic Republic of Nepal Mr Yogendra Gauchan Chief-Finance Section Ministry of Health and Population Federal Democratic Republic of Nepal Mr Kabiraj Khanal Under Secretary Ministry of Health and Population Federal Democratic Republic of Nepal ' U % D E X 5 D P 0 D U D V L Q L Senior Health Administrator Ministry of Health and Population Federal Democratic Republic of Nepal Sri Lanka ' U 5 : L P D O - D \ D Q W K D ' H S X W \ ' L U H F W R U * H Q H U D O 0 H G L F D O 6 H U Y L F H V , , Ministry of Healthcare and Nutrition Government of the Democratic Socialist Republic of Sri Lanka Dr Sarath M. Samarage ' H S X W \ ' L U H F W R U * H Q H U D O 3 O D Q Q L Q J Ministry of Healthcare and Nutrition Government of the Democratic Socialist Republic of Sri Lanka Thailand Mr Asi Mamanee & K D U J H G � $ I I D L U H V Royal Thai Embassy-Kathmandu Royal Thai Government 41 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Dr Phusit Prakongsai 6 H Q L R U 0 H G L F D O 2 I � F H U , Q W H U Q D W L R Q D O + H D O W K 3 R O L F \ 3 U R- gramme % X U H D X R I 3 R O L F \ D Q G 6 W U D W H J \ 2 I � F H R I W K H 3 H U P D Q H Q W 6 H F U H W D U \ Ministry of Public Health Royal Thai Government Dr Suriya Wongkongkathep Health Supervisor 2 I � F H R I W K H + H D O W K , Q V S H F W R U � General 2 I � F H R I W K H 3 H U P D Q H Q W 6 H F U H W D U \ Ministry of Public Health Royal Thai Government Dr Sopida Chavanichkul ' L U H F W R U % X U H D X R I , Q W H U Q D W L R Q D O Health 2 I � F H R I W K H 3 H U P D Q H Q W 6 H F U H W D U \ Ministry of Public Health Royal Thai Government Mrs Sirinad Tiantong Chief, Global Health Cooperation Section % X U H D X R I , Q W H U Q D W L R Q D O + H D O W K 2 I � F H R I W K H 3 H U P D Q H Q W 6 H F U H W D U \ Ministry of Public Health Royal Thai Government Mr Nattapol Mungkung ) R U H L J Q 5 H O D W L R Q V 2 I � F H U % X U H D X R I , Q W H U Q D W L R Q D O + H D O W K 2 I � F H R I W K H 3 H U P D Q H Q W 6 H F U H W D U \ Ministry of Public Health Royal Thai Government Nonthaburi 11000 Dr Puangpen Chanprasert 3 X E O L F + H D O W K 2 I � F H U 2 I � F H R I W K H 3 H U P D Q H Q W 6 H F U H W D U \ Ministry of Public Health Royal Thai Government Miss Pichayada Poomlaochaeng Second Secretary Royal Thai Embassy-Kathmandu Royal Thai Government Timor-Leste Dr Vitalina Vilanova 0 H G L F D O 2 I � F H U & R P P X Q L W \ + H D O W K Centre Ministry of Health Democratic Republic of Timor-Leste Dr Zoe Hawkings Mental Health Advisor Ministry of Health Democratic Republic of Timor-Leste Mr Domingos Alves Assistant to the Minister of Health Ministry of Health Democratic Republic of Timor-Leste Mr Antonio Mesquita Director of Aileu District Health Services Ministry of Health Democratic Republic of Timor-Leste 0 U % R Q L I D F L R G R V 5 H L V Director of Ermera District Health Services Ministry of Health Democratic Republic of Timor-Leste 5. WHO Secretariat Secretary Dr Samlee Plianbangchang Regional Director Members- SEARO Staff Dr Poonam Khetrapal Singh Deputy Regional Director Dr Myint Htwe Director-Programme Management Mr Clas Sandstrom Ag Director, Administration and Finance Dr N. Kumara Rai, Special Adviser to the Regional Director 42 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region 0 U $ O H [ D Q G H U Y R Q + L O G H E U D Q G Regional Adviser Environmental Health and Climate Change Dr Roderico H. Ofrin Regional Adviser Emergency and Humanitarian Ac- tion Dr Alaka Singh 7 H F K Q L F D O 2 I � F H U National Health Planning and Health Financing ' U 5 X L 3 D X O R G H - H V X V 7 H F K Q L F D O 2 I � F H U Country Cooperation Strategy 0 U 8 6 % D Z H M D Senior Administrative Secretary Members- : + 2 & R X Q W U \ 2 I � F H 6 W D I I 1 H S D O ' U $ O H [ D Q G H U * $ Q G M D S D U L G ] H WHO Representative to Nepal Mr Umesh Gupta $ G P L Q L V W U D W L Y H 2 I � F H U & : + 2 & R X Q W U \ 2 I � F H 6 W D I I Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region ( [ F H O O H Q F L H V R Q E H K D O I R I the Ministry of Health and Population, Government of Nepal, and on my own E H K D O I P D \ , R I I H U D Z D U P welcome to the Right Honourable Prime Minister Shri Madhav Kumar Nepal, D Q G H [ S U H V V P \ J U D W L W X G H to him for inaugurating this joint inaugural session today. < R X U S U H V H Q F H K H U H U H D I � U P V the commitment of the Government of Nepal to protect and improve the health of the people. , W L V P \ S U L Y L O H J H W R Z H O F R P H < R X U ( [ F H O O H Q F L H V W K H + R Q R X U D E O H Health Ministers from Member States of the WHO South-East Asia Region. We are indeed honoured by your presence here. , W L V D O V R P \ S U L Y L O H J H W R Z H O F R P H ' U 0 D U J D U H W & K D Q ' L U H F W R U General, WHO, who is with us today. We value your leadership in W D N L Q J I R U Z D U G W K H J O R E D O K H D O W K D J H Q G D , D O V R Z H O F R P H ' U 6 D P O H H Plianbangchang, Regional Director, WHO South-East Asia Region. We appreciate your help and support in all our regional activities and L Q L W L D W L Y H V , D O V R Z H O F R P H D O O W K H G L V W L Q J X L V K H G G H O H J D W H V S D U W Q H U V and guests present here for these two important meetings. Annex 3 Full text of welcome speech by His Excellency Mr Umakant Chaudhary Minister of Health and Population Federal Democratic Republic of Nepal 44 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region 7 K H J D W K H U L Q J R I V R P D Q \ K H D O W K H [ S H U W V L V Y H U \ L P S R U W D Q W to the future of public health in our Region and to each of our countries. Under WHO leadership, countries of the Region are cooperating with each other to strengthen common strategies and tackle communicable diseases, as well as to contain the rising graph of noncommunicable diseases among our populations. Transnational communicable diseases have become an urgent global issue, as all F R X Q W U L H V V W U X J J O H W R F R Q W D L Q W K H V S U H D G R I W K H L Q � X H Q ] D Y L U X V H V � W K H S D Q G H P L F + 1 D V Z H O O D V W K H + 1 , Q W K H V H D V L Q R W K H U G L V H D V H V Z H Q H H G W R V K D U H Q D W L R Q D O H [ S H U L H Q F H V D Q G H [ S H U W L V H ( [ F H O O H Q F L H V , O R R N I R U Z D U G W R \ R X U G L V F X V V L R Q V L Q F O X G L Q J R Q � 3 U R W H F W L Q J K H D O W K I D F L O L W L H V L Q H P H U J H Q F L H V � * L Y H Q 1 H S D O � V varied terrain, from mountainous to the terai plains, we very well X Q G H U V W D Q G W K H W K U H D W I U R P H D U W K T X D N H V O D Q G V O L G H V D Q G � R R G V : H also understand the importance of protecting our health facilities particularly during disasters. The global economic downturn and its potential health impact L V D Q R W K H U L P S R U W D Q W W R S L F \ R X Z L O O G L V F X V V 3 D V W H [ S H U L H Q F H V K R Z V that the health status of the poor and the vulnerable populations is I X U W K H U W K U H D W H Q H G E \ V X F K W U H Q G V , Q W K H I D F H R I H F R Q R P L F K D U G V K L S V we need to protect health budgets and to accelerate health system restructuring to strengthen it from within to withstand any future global upheavals. , Q W K L V V F H Q D U L R R I V H Y H U H J O R E D O � Q D Q F L D O F R Q V W U D L Q W V : + 2 � V collaboration has become even more meaningful particularly with U H I H U H Q F H W R W K H 2 U J D Q L ] D W L R Q � V H I I R U W V W R P R E L O L ] H H [ W H U Q D O U H V R X U F H V for priority health programmes. The 56 years of collaboration between WHO and the Ministry of Health and Population in Nepal have been very useful for the G H Y H O R S P H Q W R I 1 H S D O � V K H D O W K V H F W R U 7 K H & R X Q W U \ & R R S H U D W L R Q Strategy has helped to support the priority health needs of the country. 2 Y H U W K H \ H D U V : + 2 � V F R O O D E R U D W L R Q K D V J U R Z Q I U R P P H U H provision of assistance to more substantive support in strengthening public health, revitalizing primary health care and in further strengthening development of human resources for health. 0 R U H U H F H Q W O \ : + 2 � V W L P H O \ V X S S R U W W K U R X J K W K H 6 R X W K ( D V W Asia Regional Health Emergency Fund was much appreciated as L W F R P S O H P H Q W H G J R Y H U Q P H Q W � V H I I R U W V L Q W D F N O L Q J W K H . R V L � R R G V and outbreaks of diarrhoea in some areas. 45 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region , Q 1 H S D O W K H + H D O W K 6 H F W R U 5 H I R U P L Q L W L D W L Y H I R U G H Y H O R S L Q J D high-quality public health service system for the people, especially the poor and the marginalized, is an integral part of the current socio-political transformation. Our government is committed to provide free health care services and essential drugs down to the district level. Free maternity care services are also being provided at health institutions, nationwide. The primary health care approach is the cornerstone of our national health policies and programmes. We welcome the commitment of the WHO Director-General, Dr Margaret Chan, to primary health care and look up to WHO and its partners for I X U W K H U V X S S R U W I R U W K L V D S S U R D F K , Q O L Q H Z L W K W K L V D S S U R D F K R X U current priorities include upgradation of physical infrastructure, and strengthening of staff skills, service capacity and the health workforce at all levels. Overall, there has been steady progress in most areas of health development in the country, covering both communicable and the noncommunicable diseases. The main health indicators V K R Z S U R J U H V V O L N H U H G X F W L R Q L Q F K L O G D Q G P D W H U Q D O P R U W D O L W \ 7 % control is effectively managed through the DOTS strategy and our V W D W X V L Q S R O L R H U D G L F D W L R Q L V P D L Q W D L Q H G % \ W K H H Q G R I Z H K R S H W R D F K L H Y H O H S U R V \ H O L P L Q D W L R Q D Y L D Q L Q � X H Q ] D S U H S D U H G Q H V V K D V E H H Q L Q L W L D W H G D Q G L V E H L Q J P D L Q W D L Q H G D Q G P R U W D O L W \ G X H W R $ 5 , P D O D U L D D Q G R W K H U F R P P R Q F R P P X Q L F D E O H G L V H D V H V K D V F R P H down. And efforts are under way for the prevention and control R I + , 9 $ , ' 6 Nepal continues to make steady progress towards meeting the 0 L O O H Q Q L X P ' H Y H O R S P H Q W * R D O V I X U W K H U S U R J U H V V L V H [ S H F W H G Z L W K W K H H [ S D Q G H G X V H R I D Y D L O D E O H K H D O W K F D U H V H U Y L F H V 7 K L V K D V E H H Q possible due to the concerted efforts of the government, supported by relevant sectoral ministries, WHO and other partners. ) L Q D O O \ , Z R X O G O L N H W R U H L W H U D W H W K D W S X E O L F K H D O W K W R G D \ I D F H V some serious challenges. We have to ensure that these do not rob X V R I R X U K D U G Z R Q S X E O L F K H D O W K J D L Q V , W Z L O O U H T X L U H R X U F R Q F H U W H G and collective efforts to strengthen the health system and to ensure equity and accessibility of health care for all, particularly for the poor, the vulnerable and those living in remote and hard-to-reach U H J L R Q V , Z L V K \ R X D O O W K H E H V W L Q \ R X U G H O L E H U D W L R Q V R Y H U W K H Q H [ W few days. 7 K D Q N \ R X 46 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Annex 4 Full text of address by Dr Samlee Plianbangchang, Regional Director, WHO South-East Asia Region + L V ( [ F H O O H Q F \ 0 U 0 D G K D Y Kumar Nepal, the Honourable Prime Minister, Government of the Federal Democratic Republic of Nepal, Honourable Ministers of Health of Countries of the WHO South-East Asia Region, Dr Margaret Chan, Director-General, World Health Organization, distinguished country representatives, honourable guests, ladies and gentlemen: , Z D U P O \ Z H O F R P H \ R X D O O W R W K H M R L Q W L Q D X J X U D W L R Q R I W K H Twenty-seventh Meeting of Ministers of Health of the Countries of W K H 6 R X W K ( D V W $ V L D 5 H J L R Q D Q G W K H 6 L [ W \ V H F R Q G 6 H V V L R Q R I W K H WHO Regional Committee for South-East Asia. , J U D W H I X O O \ W K D Q N W K H * R Y H U Q P H Q W R I W K H ) H G H U D O ' H P R F U D W L F 5 H S X E O L F R I 1 H S D O I R U K R V W L Q J W K H V H W Z R L P S R U W D Q W P H H W L Q J V , W K D Q N + L V ( [ F H O O H Q F \ 0 U 0 D G K D Y . X P D U 1 H S D O W K H + R Q R X U D E O H Prime Minister, Government of the Federal Democratic Republic of Nepal, for agreeing to inaugurate this joint inauguration session. , W K D Q N W K H K R Q R X U D E O H + H D O W K 0 L Q L V W H U V D Q G G L V W L Q J X L V K H G & R X Q W U \ Representatives for sparing their valuable time to attend the P H H W L Q J V , W K D Q N W K H : + 2 ' L U H F W R U * H Q H U D O I R U K H U J U D F L R X V presence to address the joint inauguration, and to participate in the deliberations during the two meetings. 47 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region 7 K H 6 R X W K ( D V W $ V L D 5 H J L R Q L V K R P H W R R I W K H Z R U O G � V S R S X O D W L R Q R U D E R X W E L O O L R Q S H R S O H , W K D V G L V W L Q F W J H R J U D S K L F D O and demographic features. The social, cultural and economic dimensions are diverse among Member countries. The Region D F F R X Q W V I R U R I W K H Z R U O G � V P R U W D O L W \ D Q G R I W K H J O R E D O disease burden. However, the regional average of the Human ' H Y H O R S P H Q W , Q G H [ + ' , L V Z H O O D E R Y H , Q W K H U H J L R Q D O D Y H U D J H O L I H H [ S H F W D Q F \ D W E L U W K Z D V over 64 years. The population growth rate has come down to well below 2.4%. Nevertheless, formidable challenges remain in the 5 H J L R Q L Q D U H D V R I P D W H U Q D O L Q I D Q W D Q G F K L O G P R U W D O L W \ G R X E O H E X U G H Q R I F R P P X Q L F D E O H D Q G Q R Q F R P P X Q L F D E O H G L V H D V H V D Q G the generally weak health systems infrastructure. As far as our host country is concerned, Nepal has made considerable progress towards its national health goals. The F R X Q W U \ � V L P P X Q L ] D W L R Q F R Y H U D J H L Q F U H D V H G I U R P L Q W R L Q 2 Y H U W K H O D V W � Y H \ H D U V W K H S H U F D S L W D F D O R U L H F R Q V X P S W L R Q S H U G D \ L Q W K H F R X Q W U \ K D V L Q F U H D V H G E \ X Q L W V V X U S D V V L Q J W K H U H J L R Q D O D Y H U D J H R I F D O R U L H V S H U F D S L W D S H U day. 1 H S D O L V W K H � U V W $ V L D Q F R X Q W U \ W R V L J Q D � 1 D W L R Q D O & R P S D F W � Z L W K , Q W H U Q D W L R Q D O + H D O W K 3 D U W Q H U V K L S V W K H S D U W Q H U V K L S V W K D W emphasize aid effectiveness as well as national ownership and leadership in health. The Government of Nepal deserves commendation for these and other achievements in their health development efforts. This meeting of health ministers and this session of the WHO Regional Committee is another step forward in the quest for health development in the SEA Region. The honourable ministers will deliberate upon two key V X E M H F W V W K H L P S D F W R I J O R E D O H F R Q R P L F G R Z Q W X U Q R Q K H D O W K D Q G protecting health facilities in emergencies. The ministers will also review progress in the implementation of the New Delhi Declaration on Protecting Human Health from Climate Change. For the Regional Committee, in addition to the matters relating to WHO programme development and management, a number of important areas will be reviewed and discussed, such 48 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region D V P H D V O H V W K H F R G H R I S U D F W L F H I R U L Q W H U Q D W L R Q D O U H F U X L W P H Q W R I K H D O W K S H U V R Q Q H O D Q G 6 W U H Q J W K H Q L Q J W K H K H D O W K Z R U N I R U F H L Q W K H SEA Region. 7 K H W Z R P H H W L Q J V D U H E H L Q J K H O G D W D W L P H R I W K H L Q � X H Q ] D $ + 1 S D Q G H P L F D F U R V V W K H Z R U O G 2 Q W K L V R F F D V L R Q Z H Z L O O K D Y H an opportunity to update ourselves about the latest situation and on how to move forward. We are also meeting at a time when we face the repercussion of the global economic uncertainty. 6 W U D W H J L F S O D Q Q L Q J I R U P R U H H I � F L H Q W X V H R I D Y D L O D E O H K H D O W K resources will have to be our key focus during these meetings. The combined wisdom and regional solidarity will take us a long way forward in facing these formidable challenges. , J U D W H I X O O \ W K D Q N W K H K R Q R X U D E O H P L Q L V W H U V D Q G G L V W L Q J X L V K H G representatives for their concern over the issues being tabled for W K H L U F R Q V L G H U D W L R Q , Z R X O G D O V R O L N H W R W D N H W K L V R S S R U W X Q L W \ R I H [ S U H V V L Q J P \ W K D Q N V W R W K H O R F D O R U J D Q L ] L Q J F R P P L W W H H D Q G W R R W K H U Q D W L R Q D O V W D I I P H P E H U V I R U W K H H [ F H O O H Q W D U U D Q J H P H Q W V P D G H for the two events. , Z L V K W K H K R Q R X U D E O H P L Q L V W H U V D Q G G L V W L Q J X L V K H G representatives productive deliberations during the course of W K H L U P H H W L Q J V , Z L V K W K H W Z R P H H W L Q J V D V X F F H V V I X O F R Q F O X V L R Q D Q G R X W F R P H V $ Q G , Z L V K D O O R I X V D Q H Q M R \ D E O H V W D \ L Q W K H F L W \ of Kathmandu. 49 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region < R X U ( [ F H O O H Q F \ 0 U 0 D G K D Y Kumar Nepal, Prime Minister of the Federal Democratic Republic of Nepal, Honourable ministers, ambassadors, distinguished delegates, Dr Samlee, ladies and gentlemen, Good morning. First, let me thank the government of Nepal for hosting the joint session of W K H 7 Z H Q W \ V H Y H Q W K + H D O W K 0 L Q L V W H U V 0 H H W L Q J D Q G 6 L [ W \ V H F R Q G Session of the Regional Committee for South-East Asia. The world is in the midst of the most severe economic downturn in at least three decades. The world is in the midst of W K H � U V W L Q � X H Q ] D S D Q G H P L F I R U I R X U G H F D G H V The world is already feeling the effects of climate change, and these effects will continue to escalate for quite some decades to come. And yet, the world is also in the midst of the most ambitious drive in the history to reduce poverty and reduce the great gaps in health outcomes through achieving the Millennium Development Goals. Annex 5 Full text of address by Dr Margaret Chan, Director-General, World Health Organization 50 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region How does public health position itself in this cross-current of trends? From one direction, public health is bolstered by unprecedented commitment, determination to reach ambitious goals, and creativity L Q � Q G L Q J Z D \ V W R G R V R From another direction, public health is battered by global crises, with global consequences that are unfairly biased against those countries and populations least able to cope. How do we keep the momentum for better health from faltering under the pressures of a global economic recession, a F O L P D W H W K D W L V F K D Q J L Q J I R U W K H Z R U V H D Q G D Q L Q � X H Q ] D S D Q G H P L F that is now unstoppable? The need to stay the course is greater today than ever before. Precisely because of these global crises, the price of failure keeps getting higher. Developing countries have the greatest vulnerability to global crises and least resilience. They are hit the hardest and take the longest to recover. Already, the world is dangerously out of balance. The differences, within and between countries, in income levels, in opportunities, and in health outcomes, are greater today than at any time in recent history. , I Z H G R Q R W P D L Q W D L Q W K H F X U U H Q W P R P H Q W X P I R U E H W W H U K H D O W K stay the course, keep our promises, and stick to our goals, a bad situation is certain to get worse. $ F O H D U H [ D P S O H L V W K H K H D O W K R I Z R P H Q 6 L Q F H W D N L Q J R I � F H this has been one of my priority areas. , D P S O H D V H G W R E H L Q D F R X Q W U \ 1 H S D O W K D W L V T X L F N O \ developing policies aimed at reducing maternal mortality, and doing so in a systematic way. < R X U D S S U R D F K L V D O V R D S U D F W L F D O D Q G U H D O L V W L F R Q H D V U H � H F W H G L Q W K H 0 D W H U Q L W \ , Q F H Q W L Y H 6 F K H P H L P S O H P H Q W H G L Q 51 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region As we all know, the number of deaths during pregnancy and delivery will not go down until more women have skilled attendants at birth and access to emergency obstetric care. Financial barriers to care, including the costs of transport, must also be addressed, as is being done here in Nepal. Nepal has also a plan for advancing the status of women, and W K L V W R R L V P R V W Z H O F R P H D Q G , Z L V K W R W K D Q N W K H * R Y H U Q P H Q W for their positive plans to lift women up. These and other plans emphasize social equity as a central W H Q H W R I S U L P D U \ K H D O W K F D U H / D W H U W R P R U U R Z , Z L O O E H F R P P H Q W L Q J R Q W K H L P S R U W D Q F H R I W K L V 5 H J L R Q � V F R P P L W P H Q W W R D U H Q H Z D O R I primary health care. A renewed commitment to primary health care underpins efforts to improve the health of women. This relationship is V W D U N O \ H Y L G H Q W L Q D U H S R U W R Q : R P H Q D Q G + H D O W K W K D W , K D Y H commissioned. 7 K H U H S R U W Z K L F K Z L O O E H U H O H D V H G L Q 1 R Y H P E H U H [ S O R U H V W K H many health risks that women face throughout the life course, and sets out an agenda for change. Your need for strong leadership is important. You need comprehensive and responsive health care that goes beyond a narrow focus on reproductive health. You need the right policies and, above all, you need the data for setting priorities and monitoring progress. / D W H U W R P R U U R Z , Z L O O D O V R V X P P D U L ] H Z K D W Z H N Q R Z D E R X W W K H L Q � X H Q ] D S D Q G H P L F D Q G W K H U D Q J H R I L O O Q H V V L W L V F D X V L Q J We know that the new H1N1 pandemic virus has rapidly established itself in about 190 countries and is now the dominant L Q � X H Q ] D Y L U X V V W U D L Q 7 K H S D Q G H P L F Z L O O E H Z L W K X V I R U T X L W H V R P H months to come. Once again, the capacity of our health systems to respond Z L O O S O D \ D G H F L V L Y H U R O H L Q G H W H U P L Q L Q J W K H S D Q G H P L F � V L P S D F W L Q different countries. 52 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Though the new virus is virtually identical in all outbreak sites, i.e. in 190 countries, we have to anticipate a very different impact in countries with limited resources and weak health systems with limited capacities, especially for intensive care. $ K H D O W K V \ V W H P L V D V R F L D O L Q V W L W X W L R Q , W G R H V Q R W M X V W G H O L Y H U E D E L H V D Q G S L O O V W K H Z D \ D S R V W R I � F H G H O L Y H U V O H W W H U V , W G R H V P R U H W K D Q W K D W 3 U R S H U O \ P D Q D J H G D Q G � Q D Q F H G D K H D O W K V \ V W H P that strives for universal coverage contributes to social cohesion and stability. This world desperately needs more social cohesion and V W D E L O L W \ , W D O V R G H V S H U D W H O \ Q H H G V J U H D W H U E D O D Q F H D Q G I D L U Q H V V especially in access to health care. Ladies and gentlemen, Public health had no say in the policies that seeded the � Q D Q F L D O F U L V L V R U V H W W K H V W D J H I R U F O L P D W H F K D Q J H % X W S X E O L F K H D O W K K D V P X F K W R V D \ D E R X W W K H L Q � X H Q ] D S D Q G H P L F K R Z L W L V P D Q D J H G and how its impact can be reduced. This is one occasion when heads of state, heads of governments D Q G P L Q L V W H U V R I � Q D Q F H W R X U L V P D Q G W U D G H Z L O O O L V W H Q F O R V H O \ W R ministers of health. % H W Z H H Q W K H H [ W U H P H V R I S D Q L F D Q G F R P S O D F H Q F \ O L H V W K H V R O L G ground of vigilance, and this is our territory. We need to get the messages and the advice right, based on H D U O \ G D W D D V W K H \ E H F R P H D Y D L O D E O H L Q W K H F R Q W H [ W R I D U D S L G O \ evolving situation. We need to make some far-reaching, often costly G H F L V L R Q V L Q D Q D W P R V S K H U H R I F R Q V L G H U D E O H V F L H Q W L � F X Q F H U W D L Q W \ This is the kind of situation we will be heading for as we manage this public health emergency. 7 K L V L V Q R W H D V \ % X W W K L V L V D S X E O L F K H D O W K H P H U J H Q F \ D Q G this is our job. Thank you. Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region At the outset, on behalf of the people and the Government of Nepal and on my own behalf, let me convey my best wishes for the success of the Twenty-seventh Meeting of the Ministers of Health and W K H 6 L [ W \ V H F R Q G 6 H V V L R Q R I the WHO Regional Committee for South-East Asia. , W L V P \ J U H D W S O H D V X U H W R welcome the Health Ministers of our Region and the visiting dignitaries and distinguished participants to this joint inaugural session of these two very important meetings being held here in our capital city, Kathmandu. , W L V D S U L Y L O H J H I R U 1 H S D O W R E H K R V W L Q J W K H V H P H H W L Q J V 7 K H O D V W meeting of health ministers was held in Kathmandu in 2000 and the last time the Regional Committee held its session here was L Q , G R K R S H W K D W D O O R X U G L V W L Q J X L V K H G J X H V W V Z L O O K D Y H D pleasant and comfortable stay in our country. As you all know, Nepal is passing through a transitional period and the government is focused on the priority tasks of taking the peace process to its positive and meaningful conclusion and drafting a new constitution on time. Despite our focus on those tasks, we have accorded a very high importance to these meetings. Annex 6 Full text of keynote address by the Chief Guest, His Excellency the Right Honourable Mr Madhav Kumar Nepal, Prime Minister, Federal Democratic Republic of Nepal 54 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region : K L O H 1 H S D O I R O O R Z V D S R O L F \ R I F X O W L Y D W L Q J H [ F H O O H Q W I U L H Q G V K L S and cooperation with all countries particularly our neighbouring countries, multilateralism is one of the basic tenets of our foreign policy. We accord importance to developments that have a global impact. ( [ F H O O H Q F L H V D Q G G L V W L Q J X L V K H G G H O H J D W H V \ R X F R Q W L Q X H to provide remarkable leadership to health programmes in the Region. Like most WHO regions, the South-East Asia Region faces D F R P S O H [ V H W R I K H D O W K F K D O O H Q J H V W R G D \ D V F D Q E H D V V H V V H G I U R P the key issues under discussion among countries and the resolutions D G R S W H G E \ W K H 6 L [ W \ � U V W 6 H V V L R Q R I W K H 5 H J L R Q D O & R P P L W W H H K H O G L Q 1 H Z ' H O K L O D V W \ H D U 7 K H V H L Q F O X G H G � 5 H Y L W D O L ] L Q J S U L P D U \ K H D O W K F D U H � � 7 R E D F F R F R Q W U R O � D Q G � 3 U H Y H Q W L R Q D Q G F R Q W U R O R I G H Q J X H � 2 Y H U W K H Q H [ W I H Z G D \ V \ R X Z L O O E H G H O L E H U D W L Q J X S R Q H P H U J L Q J and important issues including protecting health facilities in H P H U J H Q F L H V W K H L P S D F W R I W K H J O R E D O � Q D Q F L D O F U L V L V R Q K H D O W K S U R W H F W L Q J K X P D Q K H D O W K I U R P F O L P D W H F K D Q J H W K H 6 R X W K ( D V W $ V L D 5 H J L R Q D O + H D O W K ( P H U J H Q F \ ) X Q G S U R J U H V V D Q G F K D O O H Q J H V L Q S R O L R H U D G L F D W L R Q V W U H Q J W K H Q L Q J W K H K H D O W K Z R U N I R U F H L Q W K L V 5 H J L R Q F R P E D W L Q J F R X Q W H U I H L W P H G L F D O S U R G X F W V D Q G S D Q G H P L F L Q � X H Q ] D S U H S D U H G Q H V V D Q G V K D U L Q J R I L Q � X H Q ] D Y L U X V H V D Q G D F F H V V W R Y D F F L Q H V D Q G R W K H U E H Q H � W V D P R Q J R W K H U W R S L F V This government has made a commitment to improve the health services provided to the people. The budget for the health sector has been increased three-fold in the last few years to around R I W K H F R X Q W U \ � V * U R V V ' R P H V W L F 3 U R G X F W * ' 3 D Q G W K U R X J K health sector review, the government is committed to upgrade K H D O W K S U R Y L V L R Q , W L V F R P P L W W H G W R S U R Y L G H D E D V L F K H D O W K F D U H package to all citizens as a fundamental right. Through a public- private partnership, free maternal delivery services are being provided for all women. At the same time, a package of essential drugs is provided free at all public health institutions up to the district level. % \ V H W W L Q J X S D V S H F L D O X Q L W I R U W K H U H Y L Y D O R I S U L P D U \ K H D O W K F D U H W K H J R Y H U Q P H Q W K D V W D N H Q � U P V W H S V L Q L W V V W U D W H J \ W R U H D F K out to the people. Such strategic measures and efforts to achieve the Millennium Development Goals are bringing the health system closer to the rural community. 55 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region The overall improvement across the health sector is measurable against most health indicators. Maternal mortality has declined by D O P R V W E H W Z H H Q D Q G Q H Z E R U Q D Q G X Q G H U F K L O G P R U W D O L W \ D U H G H F O L Q L Q J D Q G S R O L R H U D G L F D W L R Q V W D W X V F R Q W L Q X H V W R E H P D L Q W D L Q H G 7 K H U R X W L Q H ( [ S D Q G H G 3 U R J U D P P H R I , P P X Q L ] D W L R Q ( 3 , O H Y H O V D U H E H L Q J P D L Q W D L Q H G D Q G W K H + D H P R S K L O O R X V , Q � X H Q ] D % Y D F F L Q H L V E H L Q J L Q W U R G X F H G L Q W R W K H S U R J U D P P H L Q S K D V H V L W V introduction has already commenced in several districts. Many strides have been made in leprosy control and by the end of 2009, Nepal should be able to eliminate leprosy. 7 K H J R Y H U Q P H Q W � V H I I R U W V K D Y H E H H Q Z H O O V X S S R U W H G E \ : + 2 and other international partners. We are grateful to our partners D Q G D V V X U H W K H P R I R X U J R Y H U Q P H Q W � V F R P P L W P H Q W W R I X U W K H U strengthen the health system for the overall improvement of the health of our people. , D P F R Q � G H Q W W K D W W K H R X W F R P H R I \ R X U F R O O H F W L Y H H I I R U W V R Y H U W K H Q H [ W I H Z G D \ V Z L O O O H D G W R D F R P P R Q Y L V L R Q D Q G S U R Y L G H I R U R X U F R O O H F W L Y H K H D O W K V H F X U L W \ , Z L V K \ R X D O O W K H E H V W L Q \ R X U deliberations. 56 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region Annex 7 Full text of vote of thanks by His Excellency Mr Khadga Bahadur Basyal, Minister of State, Ministry of Health and Population Federal Democratic Republic of Nepal < R X U ( [ F H O O H Q F \ W K H 5 L J K W Honourable Prime Minister Shree Madhav Kumar Nepal, Health Minister Mr Umakant & K D X G K D U \ + R Q � E O H 0 L Q L V W H U V of Health from countries of WHO South-East Asia Region, Dr Margaret Chan, WHO Director-General, Dr Samlee Plianbangchang, Regional Director, WHO South-East $ V L D 5 H J L R Q ( [ F H O O H Q F L H V Distinguished Delegates, Ladies and Gentlemen. The Meetings of the Health Ministers and Regional Committee sessions of the South-East Asia Region of WHO are the two most important policy setting meetings for the Region. Collectively, the S R O L F \ P D N H U V D Q G W H F K Q L F D O H [ S H U W V D G G U H V V W K H N H \ K H D O W K L V V X H V for the region, and review progress and action on the decisions P D G H L Q S D V W P H H W L Q J V , D P K R Q R X U H G W R S U R S R V H W K H Y R W H R I thanks on this momentous occasion. On behalf of the Ministry of Health and Population, we would like to thank the Right Honourable Prime Minister Shree Madhav Kumar Nepal for gracing this important ceremony. Your presence 57 Report of the Twenty-seventh Meeting of Ministers of Health of Countries of the South-East Asia Region K H U H V L U U H D I � U P V W K H V W U R Q J F R P P L W P H Q W R I W K L V J R Y H U Q P H Q W W R the health of the people. We thank the Ministers of Health from the South-East Asia Region member countries, including ministers of government of Nepal for being present here, despite their very busy schedules. We would like to thank Dr Margaret Chan, the WHO Director- General together with her team for being here and for sharing her Z L V G R P D Q G H [ S H U L H Q F H Z L W K D O O R I X V < R X U D G Y L F H D Q G O H D G H U V K L S are greatly valued by all. We would like to thank Dr Samlee 3 O L D Q E D Q J F K D Q J 5 H J L R Q D O ' L U H F W R U I R U : + 2 � V 6 R X W K ( D V W $ V L D 5 H J L R Q and his team, for supporting to host these important meetings in Nepal. We thank you for your leadership and your continued support to the Member States of the Region. We know that members of W K H : + 2 6 H F U H W D U L D W E R W K D W W K H 5 H J L R Q D O 2 I � F H D Q G D W W K H 1 H S D O & R X Q W U \ 2 I � F H K D Y H S X W L Q D Q H Q R U P R X V D P R X Q W R I H I I R U W W R H Q V X U H the success of the meetings and we thank them. , Z R X O G O L N H W R U H F R U G P \ D S S U H F L D W L R Q D Q G W K D Q N V W R W K H R I � F L D O V D Q G V W D I I R I W K H 0 L Q L V W U \ R I + H D O W K D Q G 3 R S X O D W L R Q I R U W K H L U K D U G Z R U N D Q G H I I R U W V I R U W K H V X F F H V V R I W K H P H H W L Q J V , Z R X O G O L N H W R J L Y H P \ D S S U H F L D W L R Q D Q G W K D Q N V W R W K H ( [ F H O O H Q F L H V Ambassadors, government secretaries, special guests and heads of the various organizations for their presence and support for the success of the meetings. Finally, we look forward to fruitful and productive deliberations R Y H U W K H Q H [ W I H Z G D \ V Z K L F K Z L O O O H D G W R S U D F W L F D O U H F R P P H Q G D W L R Q V W R I X U W K H U L P S U R Y H W K H K H D O W K R I W K H S H R S O H L Q R X U 5 H J L R Q , Z L V K you all the best in your deliberations and for a very pleasant stay in Nepal. Thank you. K a t h m a n d u , N e p a l , 7 8 S e p t e m b e r 2 0 0 9 R e p o r t o f t h e T w e n t y - s e v e n t h M e e t i n g o f M i n i s t e r s o f H e a l t h o f C o u n t r i e s o f t h e S o u t h - E a s t A s i a R e g i o n W o r l d H e a l t h H o u s e I n d r a p r a s t h a E s t a t e M a h a t m a G a n d h i M a r g N e w D e l h i - 1 1 0 0 0 2 , I n d i a S E A - H M M e e t - 2 7