My vision for health of South-East-Asia Region and WHO

I will work to support the production, distribution, retention and protection of a high-quality health workforce in the region.

Dr Shambhu Acharya

  • Read Time 8 min.

I stand before you in all humility to present my candidature for Regional Director of the WHO South-East Asia Region. I say humility because the task before us is huge, but also hugely important. When we think of the billions of people in our region—a quarter of the world—we know that each one of them is aspiring to attain the highest possible state of health and well-being. It is only with humility that we can serve the people and help them to meet their aspirations. I know from my personal journey the importance of that aspiration for health and wellbeing. 

My journey 

My journey started in a farming family in the rural part in western Nepal. Where I grew up there were no roads, electricity, health centers, or proper water and sanitation. When a family member got sick, I would pray and hope for the best because there were no doctors or medicines nearby. 

Because of my upbringing, I developed a passion to improve health—not just for myself, but for everyone, everywhere—especially those in rural, underserved villages, like the one where I grew up and the one where I started my journey in public health. 

When I started my career in rural Nepal, I worked with communities who had very little by way of facilities or services but did have the determination to work together in finding solutions and building wellbeing together. With my advanced degree in Public Health, that same spirit of determination and common purpose has continued to guide me through the public health journey, and it has been the grounding of my work in WHO, in country offices, in Regional Offices and in WHO headquarters. 

I loved (and still love) interacting with individuals at the community level and policy makers—and as Director of Country Strategy and Support I know that I can reach the places where true impact is made. 

 Vision for the region 

As the next Regional Director of WHO South-East Asia Region I would strive for a healthier, safer and fairer Region, and one that can contribute to the health and wellbeing around the world. 

I have enormous optimism about our region. We have all the ingredients to make great strides in improving the health and wellbeing of the people. Our populations are young and dynamic, bursting with energy and ideas. With economic development, technological advancement and pioneering roles in affordable generic medicines and vaccines produced at large scale, our region can substantially contribute to achieving the health-related SDGs. And we have incredible strength that comes from diversity and rich culture and traditions. 

My job as Regional Director will be to work together with, you, member states to ensure that each country, big or small, or at any stage of development, is given equal opportunity and provided with support according to their needs to improve the health and wellbeing of their people. And here is how I would do that. 

My strategies 

Aligned with WHO’s global priorities and SDGs, I will anchor the South-East-Asia Regional Office’s efforts in five key areas and be accountable for delivering results in each. These five priorities are: population health approaches that tackle the root causes of ill-health, universal health coverage, pandemic prevention, preparedness and response, science and innovation, and ‘One WHO’. 

First, population health. We need to see a fundamental shift to health promotion and education in the Region. Achieving this shift will require broad engagement across all of government and society to address socio-economic, environmental, and commercial determinants through legislative, social and cultural transformation. It is not just health education; it is “education for health” as we build a social movement where everyone – civil society, youths, women, academia, students, and others – plays their role in contributing to a healthier population – but they must be given the opportunities and supported to play their unique parts. 

Population health means tackling the big issues. Climate change, for example, is not just the issue of environment; climate change is among the greatest threats to health. I will work with countries to ensure that public-health-friendly climate and environmental challenges take center-stage in health agendas. There are many opportunities for WHO to collaborate with partners working in this space and to tap additional resources including from the Green Climate Fund and other mechanisms. 

To tackle nutrition and unhealthy diet, I plan to publish the Region’s first-ever report on the commercial determinants of health, so that SEARO can better support member states to draw on the private sector as a force for innovation, but in a framework that reduces the burden of diseases owing to harmful products and commercial practices. 

My second priority will entail accelerating Universal Health Coverage through a resilient health system. COVID-19 demonstrated that no country’s health system was robust enough to respond to shocks like the pandemic. The lessons are clear: we need resilient health systems to achieve UHC with a strong foundation in primary health care. Primary health care can provide 90 percent of basic health services; it is therefore the foundation of UHC. We know, globally still half of the world population doesn’t have access to basic health services. The recent Political Declaration on UHC at UNGA reaffirms the commitment of world leaders to take bold actions toward attaining the UHC target of the SDGs by 2030. As Regional Director, I will work relentlessly with Member States to translate those commitments to actions for people – by building sustainable, resilient health systems, with strong, high quality primary health care, for all in the Region. 

During this post-pandemic era, many countries are facing economic challenges, particularly in financing the health sector. When governments cannot provide, then the burden falls on people, with devastating impacts on the poorest. This region faces the highest level of out-of-pocket health spending. I will work with Member States to advocate for: increased domestic financing for health and funding from the international community to fill the gap, particularly for primary health care. I will also support the identification of efficiencies in the use of finances in the health sector. 

I will work to support the production, distribution, retention and protection of a high-quality health workforce in the region: the region is one of the global powerhouse in training health workers, but we know there is a growing global deficit of 18 million health workers worldwide—a trained, quality, safe and valued workforce is the absolute essential of improved health. I will boost our collaboration with Member States in delivering intensified health workforce strategies to address this challenge. 

While the Region has made progress against communicable diseases, some diseases are still prevalent (such as TB, neglected tropical diseases, malaria, dengue, HIV and leprosy). I will support Member States in seizing the opportunity to eliminate communicable diseases. Our Region has about 45 percent of global TB cases—we are the key to meeting global targets to stop TB.  It will need enhanced community outreach especially to the hardest-to-reach, poorest and most marginalized. The goal of elimination requires covering that last mile, deploying point of care technologies and access to lifesaving medicines where the burden of these diseases remains highest. 

NCDs, especially burdens of hypertension and diabetes, mental health disorders and cancers are rising in the region. Although the region has made some progress to increase early screening and treatment for NCDs, there is more to do, and I will work with Member States to integrate primary prevention and treatment at PHC level. 

Maternal and child deaths are plateauing in the Region, so we need to learn and apply lessons on how to bring them down. My agenda will include supporting efforts to improve sexual and reproductive health rights and malnutrition among mothers and children across the Region. I will make gender analysis central to all our strategies, to better target our support.

 “Prepare for, protect from and respond to future emergencies and pandemic” constitutes my third priority. Based on lessons learned from the pandemic, Member States are under negotiation towards a pandemic accord aimed at ensuring enhanced prevention, preparedness capacity, and effective response. It is good to see support for an Accord based on principles of solidarity, equity and sharing of technical know-how among countries. I am grateful that our Region has been so active in working towards a successful agreement on an ambitious accord. 

Recent UN General Assembly declaration on pandemic prevention, preparedness and response emphasized the importance of building national capacity and additional resources for preventing future pandemics. I will collaborate with partners to ensure countries are well resourced and national capacities are boosted. 

We must capitalize on the Region’s global leadership in production of low-cost generic medicines and vaccines and other genetic and medical technologies.

What else we learnt from COVID-19, it is this: timing is of the essence. I will pursue a ‘7-1-7’ target approach: detect suspected outbreaks within seven days, notify and start investigation within one day, and start the response within seven days. I will work closely with Member States to establish a Regional Rapid Health Response Team as part of the global team that can be deployed within 48 hours of a request from a Member State. I will collaborate with Member States to develop a regional blueprint for addressing novel pathogens at every step from surveillance and early warning through to product development and access and making sure we implement a “one health” approach to the threat of AMR and zoonoses. I will support national institutions in designing and implementing national action plans covering policies, legislation, surveillance, public awareness and research in which multiple sectors work together to address these challenges. 

Fourth is innovation. As a Region, we power the world’s digital innovation. This Region is one of the pioneers in science, digital innovation and technological advancement, and there are major benefits to harnessing it to the cause of health equity and solidarity. I will leverage opportunities in this space, building on the recent G20 Declaration, to improve health services and encourage cooperation among countries to share locally developed solutions. 

We must capitalize on the Region’s global leadership in production of low-cost generic medicines and vaccines and other genetic and medical technologies. I promise to work with Member States to foster cooperation and collaboration on sharing experiences and technical know-how to ensure access to affordable medicines and vaccines as a matter of solidarity, including through south south cooperation. 

Together we need to work to overcome the division of the world into ‘first class’ zones with priority access and the rest with delayed access or no access at all. 

I will support member States who haven’t done so already to establish a digital platform that supports real-time collection of data, analysis, and reporting disaggregated to the extent possible on progress made on their national health objectives. 

And my final priority is to champion “One WHO”. As Director, Country Strategy and Support, I have led decentralization efforts at WHO because I believe that local decision making is an untapped strength of the Organization. I am committed to an empowered WHO country office, where local decisions are made locally and supported by all levels of WHO. I have supported the Director-General to increase the proportion of WHO’s financial resources going to countries from 37 percent to 50 percent together with increased human resources. 

I will improve communication and remove barriers across the three levels of the Organization, to help staff feel free to discuss and share their knowledge as they contribute to shared progress. As well as better work processes, such communication will help WHO’s strategic and operational planning to be more coordinated across all levels and ensure the global level can better respond to the needs and priorities of countries. 

I will work hand in hand with the WHO Director-General and articulate the Region’s voice in regional and global forums such as the G20, ASEAN, and others. There is a leading role we must play in the rising wave of South-South cooperation. And we need to make best use of all partners including national institutions, regional technical networks, WHO collaborating centers and knowledge hubs to further the health agenda.

Finally, office culture is key to thriving and happy colleagues. As Regional Director, I will cultivate a diverse, gender equitable, strong, fair, and safe SEARO and country offices, where staff feel empowered, motivated, encouraged to innovate and share ideas across the entire Organization. 

My final priority is to champion “One WHO”. I am committed to an empowered WHO country office, where local decisions are made locally and supported by all levels of WHO.   

I pledge that I will support Member States to sustain and build on the progress made thus far and lead the South-East Asia Region forward towards a future of well-being for all. I pledge to be a Regional Director who is humble, goal-focused, and results-driven.  While humble by nature, I am confident that I am optimally positioned to be the next Regional Director for WHO SEARO. I sincerely hope that you share that confidence and put your trust in me. 

In return, I will dedicate myself to all the people of our region, as we work together on our common goal of a region whose health and well-being advances every day, and as we power the world to a better, more secure, more prosperous, and fair future. 

[The article is drawn from excerpts of the speech addressed by Dr Shambhu Acharya to the WHO Member states of South Asia region yesterday at a program organized by WHO. Dr Acharya is Nepal’s candidate for the post of Regional Director, WHO South East Asia region].