Pacific Forum Statement on Health at PFD Plenary

Delivered by:
Hon Samuel Abal, MP
Minister for Foreign Affairs, Trade & Immigration
Papua New Guinea

Public health is central to attainment of the Millennium Development Goals (MDGs) by 2015 and the future development of a healthy and sustainable Pacific region. The range and complexity of public health problems in the Pacific is immense. Country capacities and resources to respond are limited. We are island nations with small populations. This makes it more costly to establish and maintain higher level services.

Despite improvements in selected health indicators, progress has slowed or reversed in some countries. Health determinants, risk factors, morbidity and mortality patterns are changing rapidly and health systems are struggling to meet people’s changing needs and expectation

Our countries are experiencing a ‘triple burden of disease’. It is related to the increasing burden of Non-communicable Diseases, the ongoing issue of infectious and Communicable Diseases and the major emerging threats related to environment , climate changes, and also to human development issues. It is already impacting negatively on our economies and ecosystems.

Moreover our Health services are fragile and are struggling to meet the needs of our populations. This situation strongly challenges our public health managers and we must ensure now that health investment is adequate, responsive and targeted to the changing profile of disease burden on our populations and to the identified priorities of our countries. For example the shortage of skilled Health Care Workers is a major and persistent problem. It is due to both inadequate numbers being trained and to substantial migration. This hampers an effective response to major challenges like, diabetes, maternal and child health, HIV and STI, malaria or dengue. Responses must take into account the specific factors that impact on our countries’ capacities and must ensure sustainable and efficient delivery of services.

Pacific Health Ministers have called for immediate action to halt and reverse the trend of those diseases in the region through multi-sectoral engagement and resource mobilisation, and they have endorsed the current Pacific Regional Strategy on HIV/AIDS (2004-2008) to be extended for a further five years. They agreed to commit their governments to implementing the five decisions embodied in the Vanuatu Commitment and discussed a framework for health priorities and funding of health initiatives for the Pacific as in many instances, effective pooling of resources and participation in regionally coordinated initiatives can provide greater benefits than individual efforts.

Effective and sustainable strengthening of our health systems is the most important priority. Significant improvements in health outcomes are unlikely without major improvements in the accessibility, quality and efficiency of health systems.

Health workforce planning, training and development need to be accelerated in almost all our countries to address the current shortage of skilled health personnel across most workforce categories and disciplines.

Other priorities that need to be addressed at the national level include infrastructure development, procurement of supplies, improved health information systems and information dissemination.

Within whole of society approaches, it is also essential we involve government services and non-government institutions, such as churches, civil society, community and individuals, in national health delivery systems. We must also address non health determinants that impact on health.

The Pacific region is one area in the world where regional coordination and implementation of suitably developed initiatives have been shown to work well in many sectors. The objective 6 of the Pacific Plan recommends a harmonised approach in the health sector. Regional assistance to health must add value to national systems, particularly in those areas where coordination of activities is best done regionally.

Health financing across the region has not necessarily reflected the public health priorities of countries and at the regional level, almost all of the existing strategies exist as independent entities and linkages are not clear. There is no clear overall expression of what is trying to be achieved in the health sector in the Pacific. There are also gaps in a number of areas, where there are no articulated strategies. The concept of a ‘framework of health priorities for the Pacific’: evolving from the Pacific Plan, if developed, would present a holistic picture of the challenges facing the health sector in the Pacific, including the health priorities that need to be addressed. It would acknowledge the positive impacts on health outcomes of investments by ‘non-health’ government sectors. The primary intent is to bring added value to each country’s national strategies for health.

At the national level, some countries are developing health sector wide approaches (SWAps) when there is strong motivation to enhance coordination, reduce fragmentation and transaction costs related to multiplicity of projects, together with the desire to increase accountability and build capacity of government processes. The SPC joint countries strategies process (JCS) provides a model for planned engagement aligned with national development strategies and articulates the intent to improve the responsiveness, relevance, effectiveness and strategic impact of regional agency interventions.

Our region and our countries need collaborative strategic approaches to health to overcome the challenges posed by distance and isolation, and by their smallness and narrow resource base. Effective pooling of resources and regionally coordinated initiatives can add value and provide greater benefits for our fragile health systems. Fostering partnerships with non health sectors and whole of government approaches have the potential to magnify the effects of our health spending and greatly improve overall health outcomes for all Pacific people.