SUBCOMMITTEE ON HEALTH AND DEVELOPMENT

Draft Regional Framework on Promoting Health and Sustainable Development adopted
The importance of diverse development factors that have an impact on health can no longer be neglected. If the health status of Asian and Pacific populations is to be improved, social, economic and environmental factors that influence health inequality must be addressed.
This is one of the key messages conveyed by the ESCAP Subcommittee on Health and Development, which met at Bangkok from 1 to 3 December. The Subcommittee was the first intergovernmental meeting on health and development to be convened in the region. It adopted a comprehensive draft regional framework for strategic action: promoting health and sustainable development.
The Subcommittee requested the ESCAP secretariat to continue to highlight health and development as a critical issue on national and regional agendas. It also requested the secretariat to assist its members and associate members in the implementation of the draft regional framework. In this regard, it underscored three areas: capacity-building for public health, health for poor and marginalized groups, and gender dimensions of health.
The cooperation between WHO and ESCAP on health and development was commended by the Subcommittee, which requested that the outcome of the deliberations of the Meeting, including the draft regional framework, be forwarded as a contribution from the ESCAP region to the WHO Commission on Social Determinants of Health, scheduled to meet in January 2005.
Furthermore, the Subcommittee requested ESCAP, WHO and other international agencies to maintain close working relations to provide practical assistance to countries and areas of the region in strengthening public health systems and establishing a solid foundation for health security systems.
Three of the eight Millennium Development Goals (MDGs) directly address health concerns, while other MDGs are also health related. This strengthened the case for integrating health concerns into development. The Subcommittee therefore emphasized the need for intergovernmental and multisectoral approaches that involved diverse government departments, civil society and the private sector to address the determinants of health.
The Subcommittee recognized the double burden of non-communicable and communicable diseases that the region faced, as well as the risks posed by new and re-emerging communicable diseases, such as HIV/AIDS, SARS and avian influenza. Concern was expressed over evidence that investment in health was being offset by the increased cost of treating smoking-related diseases, which currently accounted for 3 to 5 per cent of annual national health expenditures in some countries. Country studies showed that lung cancer was increasing at an alarming rate, mainly as a result of smoking. Tobacco control efforts exemplified multisectoral actions, which are critical to tackling public health issues.
The action taken by Governments of the region on tobacco control was appreciated. The Subcommittee urged that action on non-communicable diseases, such as tobacco control, be integrated into the 2005 worldwide review of progress towards attaining the MDGs.
Excellent presentations were delivered by Dr. K. Srinath Reddy, Coordinator, Initiative for Cardiovascular Health Research in the Developing Countries; Dr. Douglas Bettcher, Coordinator, Tobacco Free Initiative; and Dr. Suwit Wibulpolprasert, Senior Advisor (Health Economics), Ministry of Public Health, Thailand.
Dr. Reddy’s presentation focused on ways in which socio-economic determinants affected health status, with particular reference to non-communicable diseases. Dr. Reddy stressed that multisectoral public health interventions could be highly effective when policy interventions created an enabling environment and when communities were empowered. He highlighted that, in the twenty-first century, health would be a major determinant of development and that capacities would need to be built across all sectors to protect health as a human right and to harness it for development, he said.
Dr. Bettcher’s presentation focused on tobacco consumption as an example of a major health risk that led to non-communicable diseases, with half of the deaths caused by smoking occurring in the age group 35-69 and increasingly in developing countries. Dr. Bettcher underscored that the top five cigarette-consuming countries in the world were within the region. The tobacco epidemic was spreading through a complex mix of factors that transcended national borders, he said. The WHO Framework Convention on Tobacco Control (FCTC) was presented as an unprecedented example of international public health action to address the multifaceted dimensions of demand and supply. Dr. Bettcher expressed concern that non-communicable diseases, specifically those resulting from the tobacco epidemic, were not addressed by the MDGs.
Dr. Wibulpolprasert’s presentation focused on Thailand’s experience in strengthening health promotion initiatives and expanding health-care coverage. The presentation showed that economic growth and health outcomes were not necessarily positively correlated. Evidence-based policy-making and a strong social movement, the engagement of political leadership and the equitable distribution of international trade benefits were more important than economic growth in strengthening the health system and improving population health status. The presentation also highlighted the importance of the primary health-care approach and the prioritization of health services for the poor.
WHO welcomed ESCAP’s initiative in working on health and development issues and reiterated its commitment to work with ESCAP in multisectoral actions to tackle public health issues. The Asian Development Bank stated that it was ready to work closely with ESCAP to integrate health into development, and ensure access for all to essential services, prioritizing women and the poor. The Subcommittee recognized WHO’s strengths in biomedical and public health, including health promotion, as well as ESCAP’s expertise and multidisciplinary competencies, and multisectoral reach.