Transforming healthcare systems in Asia and the Pacific
The Asian Development Bank is working with myriad stakeholders across the region to build a modern, resilient and trustworthy healthcare ecosystem. Here are the strategies it is adopting to reach this goal
Through vaccination, antibiotics and many other advances, modern health care has undoubtedly benefited humanity. It has contributed to the dramatic increase in life expectancy, and improved the quality of life, including for people living with chronic illnesses or previously terminal conditions such as cancer. The Covid-19 pandemic showed how modern health care responded with diagnostics, vaccines and therapeutics to overcome what would surely have been a much worse global catastrophe.
And yet the pandemic was also a testament to the negative side of modern health care. People’s trust in health care and authority decreased while vaccine hesitancy increased. Some people deliberately chose not to avail themselves of Covid-19 vaccines and therapeutics. Many did not have the opportunity to choose due to vast inequities and disparities in care, as well as the breakdown in care in certain moments that exposed our lack of resilience.
Turning to the future
To fully realise the promise of modern health care that is resilient and trusted by people and communities, we need to learn from past mistakes and create a vision for the future. To build resilience and trust, we need to transform healthcare systems in Asia and the Pacific.
At the Asian Development Bank, we work with governments, the private sector, academia, experts and civil society groups who are at the forefront of diagnosing their countries’ health problems, addressing these problems and implementing ways forward. Leveraging this experience and engagement, and recognising our role as a catalyst, solutions provider and financing institution, we work on initiatives that can help transform healthcare systems.
First, we need to invest in inclusive, sustainable and resilient health facilities. People need places – whether it is a village health centre or a tertiary hospital – to turn to for their health needs, places where they feel welcome regardless of their background. But these places need to withstand various threats – from future pandemics to natural disasters – while also not contributing to greenhouse gas emissions and climate change. We are therefore embarking on an initiative to Facilitate Inclusive, Resilient, Sustainable and Transformed (FIRST) health facilities in ADB’s developing member countries.
Second, we need to invest in human resources for health. The heart of health care remains people: healthcare facilities are only as good as the people who run them. We need to recognise the role of various healthcare workers – from community health workers to allied health professionals. We need to look at different aspects of their careers, and their physical and mental health needs. As Covid-19 showed, the resilience of the healthcare system necessarily involves being able to protect healthcare workers during times of crisis. Besides interventions supporting the production and appropriate deployment of professional healthcare workers, ADB is working to Expand and Nurture Resilient and Inclusive Community Health workers (ENRICH) in its developing member countries.
Third, we need climate action in the health sector. We have known for a long time that health and the environment are inseparable, but we have all been slow to act. Last year, ADB started the Climate and Health Initiative to accelerate climate actions in health. Among the planned CHI interventions is support for innovations and increased investments to fight persistent infectious diseases such as tuberculosis, malaria, dengue and others before they are exacerbated by climate change, through the Ending Climate-vulnerable Infectious and Tropical Diseases (ExCITD) platform. We will continue to strengthen health systems and refrain from promoting vertical disease control programmes, and we believe that it is imperative to proactively address these persistent ‘silent’ epidemics. In parallel, we will continue to help our developing country members manage climate change–related nutrition, non-communicable diseases and mental health concerns.
Fourth, we will continue to help ensure vaccine security and confidence, as they remain central to health resilience and trust. We will thus continue to support strengthening the regulation of vaccines, diagnostics and therapeutics and their timely and rapid deployment during epidemics and outbreaks. This includes getting key stakeholders, particularly developing member countries, to communicate and collaborate with each other. We will soon convene the Asia Diagnostics and Vaccines and therapeutics Network to Counter Epidemics and other disease outbreaks (ADVaNCE) to accelerate regional cooperation and integration on regulating and deploying needed resources.
Transforming health
All these initiatives build on each other. All of them require political commitments, innovation, working with the private sector, widespread use of digital tools, interdisciplinary thinking, collaboration with other sectors, inclusive participation and, above all, significant investment, not just of economic but also political and social capital. If through these initiatives, developing member countries further gain people’s trust and enhanced health system resilience, then we will have moved closer to transforming healthcare systems and building an enabling environment for inclusive, sustained, prosperous and resilient health systems and universal health coverage in Asia and the Pacific.
