Opening remarks by Bambang Susantono, ADB Vice-President for Knowledge Management and Sustainable Development, at the Health Ministers Meeting on Universal Health Coverage on Asia and the Pacific, 14 September 2020.
Honorable Health Ministers, Doctors Poonam Singh and Takeshi Kasai of the World Health Organization, distinguished guests, ladies and gentlemen. It is an honor for me to address this Health Ministers Meeting on Universal Health Coverage in Asia and the Pacific.
The past few months have been challenging for all of us. The Asia and Pacific region, and indeed the whole world, are experiencing the worst health and economic crises in recent history, due to the coronavirus disease or COVID-19. In Asia and the Pacific alone, there are now more than 6 million cases and over 110,000 deaths, and it will take years to recover from the pandemic’s economic impacts.
ADB has taken swift actions from the outset of the pandemic with an aim of “leaving no one behind”. Our response can be summarized as a three-pronged approach.
- Number One: We finance the response actions by our member countries.
- Two: We convene partners, and
- Three: We generate and disseminate knowledge.
For the financing, ADB has allocated a $20 billion US dollar package to support our developing member countries counter the severe macroeconomic and health impacts. Our support has funded both health and non-health system responses to COVID-19, including strengthening of country capacities to test and detect, trace, isolate, and treat the cases.
Number Two is the partnership. In implementing our support, ADB is closely collaborating with partners, such as WHO, UNICEF, JICA, GAVI-the vaccine alliance, and the World Bank. Today’s Meeting with WHO is one example of how partnership is a cornerstone of ADB’s response.
And as Number Three, we are also working to generate innovative knowledge solutions. For example, we have developed guidance notes to help countries prioritize investments for COVID-19 response and recovery. These notes provide specific recommendations such as:
- how to safely resume travel and movements,
- how to conduct sector-level economic impact assessments, and
- how to continue providing education in the ‘new normal’.
When the pandemic struck, almost all countries reacted with border closures, travel and trade restrictions, lockdown of cities, and closure of non-essential businesses. Under this extraordinary situation, those countries that have earlier invested in primary health care, and other systems necessary for Universal Health Coverage (UHC) made a head start in COVID-19 responses. They could rapidly detect new outbreaks at the community level, provide quality care to infected individuals, and encourage people to continue using health services. Here, the assurances that people will not incur large expenses were key.
It is true that no country has been completely exempt from the high cost of containment measures to suppress the virus, and in all countries, the vulnerable and marginalized populations have suffered most. But one thing is for sure—COVID-19 has served as a reminder that investment in UHC is critical for many reasons, but in part as a measure of health crisis preparedness.
COVID-19 has threatened people’s overall access to health services. First, many health service providers are prioritizing COVID-19 services at the expense of other essential healthcare.
Second, people are foregoing health care for various reasons. Some fear that accessing medical facilities may lead to an increased risk of COVID-19 infection. Others can no longer afford the cost of the healthcare, when the pandemic has changed their income level or employment status. As a result, routine vaccination coverage is declining in many countries, and non-communicable disease treatments are disrupted across Asia and the Pacific.
Third, progress towards UHC has been greatly affected by the pandemic, as we will be discussing today in this Meeting. This outbreak highlights the dire need to invest in resilient systems that can maintain the provision of high-quality health services with minimal disruptions even during shocks like COVID-19.
ADB recognizes the centrality of UHC for a prosperous, inclusive, and resilient Asia and the Pacific. We remain committed to supporting the UHC efforts of our developing member countries. In fact, investing in UHC is a key operational priority for ADB, as laid out in Strategy 2030, our long-term strategic plan. In the wake of the COVID-19 health crisis and the ensuing economic downturn, it is clear that investments in UHC and development are intrinsically linked.
Let me provide a few project examples of how ADB has supported the UHC agenda. First, we are promoting the use of digital technology to improve national health insurance in Tonga. Second, we are advancing regional collaboration to strengthen health security in the Mekong sub-region.
We are also strengthening primary health care services in the urban sector in India and lastly, we are supporting elderly care services to address the emerging challenges of aging population in the People’s Republic of China.
Excellencies, distinguished guests, ladies, and gentlemen.
We will continue to provide assistance to help countries combat the COVID-19 pandemic, while contributing to long-term investments in health systems and UHC. Investments in these systems will be critical for the sustained control of COVID-19 and other infectious diseases.
One emerging question is: How best can ADB and our partners support countries obtain sufficient quantities of vaccines and effectively deliver them to the people? We recognize that safe and effective vaccines will be a significant game changer in the fight against COVID-19. But the development of vaccines is no more than a first step. Until they are delivered to all countries—developed and developing—and accessible by everyone, our task is not complete.
Our approach toward COVID-19 vaccines will be underpinned by the same principles as the fundamentals of UHC. I call this the COVID-19 vaccine “Triple As”, which stand for Availability, Accessibility, and Affordability.
The vaccines must first become available. Across the world, concerted efforts are being made to invent, test and mass-produce the vaccines. When the new vaccines are proven to be safe, effective, and ready for distribution, they must be accessible by everybody who needs one—including the most vulnerable and marginalized population. That is the second “A”. To do this, quantity of production as well as comprehensive coverage of efficient distribution networks must be carefully planned, so that the supply of vaccines will reach every health facility, big and small. Each facility must be equipped appropriately and have trained personnel to handle, store and administer the vaccines. And the last “A” is affordability. The cost of the vaccines must be kept to what countries and their people can pay for.
It is becoming very clear that vaccines will be approved and become available in stages. It is simply not possible that everyone in the world will have access to a vaccine all at the same time. This makes it critical that sound strategies are developed on the vaccine supply and distribution, well-ahead of time in preparation. Our international partners like WHO, UNICEF, Gavi play a vital role in this. In collaboration with our partners, ADB is also taking actions to help countries prepare a sound policy framework and health sector capacity to realize the Triple As.
Let me close by raising a few questions on the COVID-19 vaccines to be discussed in this gathering.
First, are your governments mobilizing enough resources to meet the demand for COVID-19 vaccines in the immediate future? I hope you agree that securing sufficient financial resources is the first step in obtaining and delivering vaccines. This week’s joint symposium with Ministers of Finance is a timely opportunity to discuss how to mobilize resources for this.
Second, how can we ensure that your populations will get access to COVID-19 vaccines? Beyond mobilizing available financing, what other actions should Ministers of Health, Ministers of Finance, and development partners jointly undertake to ensure equitable access?
Third, what role can ADB play to help you ensure the safety, quality and effectiveness of COVID-19 vaccines?
I hope that these questions will prompt important reflections and insights, as you discuss today how best we can promote and accelerate progress towards UHC—during the COVID-19 pandemic, as well as in the post COVID-19 world.
I look forward to a great meeting and continued engagement with you as we explore options to revitalize our region.
Thank you.