Honorable Secretaries, Ministry of Health and Population,
Director General, Department of Health Services,
Directors and Division Chiefs,
Distinguished Guests, Media,
Dear Friends and Colleagues,
This year’s World Health Day, marks the special occasion of WHO’s 75th anniversary.
Seventy-five years ago, the Constitution of the World Health Organization came into force: It was a treaty between the nations of the world as the aftermath of the deadly and destructive war. They recognized that health is a fundamental human right and is vital for establishing and sustaining peace and security.
Thus, WHO was founded to promote health, keep the world safe and serve the vulnerable – so everyone, everywhere can attain the highest level of health and well-being.
This year’s theme, “Health for All” is reflective of the values set out in WHO’s constitution. “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” The guiding light enshrined in WHO Constitution, will always be relevant. When health is at risk, everything is at risk.
Over the past seven and a half decades, there has been extraordinary progress in protecting people from diseases and destruction, including smallpox eradication, reducing the incidence of polio by 99%, saving millions of lives through childhood immunization, and declines in maternal mortality. WHO has been an important partner in accomplishing this progress.
Nepal stays committed to addressing health and social inequities. The Constitution of Nepal enshrines the right to free basic health care services and emergency health care for all citizens.
The Public Health Service Act, 2018 further elaborates on free basic health services by including vaccination, maternal, infant and child health, communicable disease, and non-communicable diseases, physical disability, mental health, health of the elderly, health promotion, Ayurveda and any other other accredited alternative health service and other services prescribed by the Government of Nepal.
In line with Sustainable Development Goals, the Government of Nepal is committed to achieving Universal Health Coverage by 2030. Nepal has also rolled out a range of policy interventions aimed at addressing health and social inequities.
Nepal has achieved several public health successes in the past few decades. Some important examples include: eradication of small pox, elimination of leprosy as a public health problem, elimination of maternal and neonatal tetanus, polio, and trachoma. Hepatitis B has been successfully controlled.
Yet, as the ongoing Covid pandemic has shown that universal access to healthcare still remains a distant goal. Health inequalities persist. Communicable diseases continue to pose a threat. Rise in antimicrobial resistance and drug resistant pathogens threaten to undermine progress. Global pandemic of non-communicable diseases, climate change need urgent attention. Sustained attack on science and misinformation campaigns by vested interests need immediate attention.
COVID-19 pandemic has forcefully exposed inequality and poverty. It’s impact has been disproportionately harsh on those who are already vulnerable such as the poor, lower paid members of the workforce, elderly, persons with disability, migrant labourers and homeless among others. It has laid bare the inequities that influence health and has underlined the urgency of addressing health inequities. It has illustrated how health has social and economic ramifications and social welfare has consequences for public health. It has highlighted that health equity can only be attained by addressing the structural roots of inequity. Health policies must be implemented in conjunction with policies that directly address the social determinants of health.
In Nepal too, poorer populations systematically experience worse health than richer populations.
Some examples are:
- Neonatal and under-5 mortality have declined. Yet, the decline is not proportional across the provinces.
- Inequity in the use of maternal health services is also reflected in skilled attendance at birth.
- The burden of communicable diseases such as TB, hepatitis and HIV is acute among poor and disadvantaged populations.
- Expenditure during the last decade is mostly driven by out-of-pocket spending which stands at 57.4 % of current health expenditure. High out-of-pocket expenditure implies financial hardship for Nepalese households and is reflective of unequitable access to healthcare services.
- Inequities also persist in the physical distribution of health facilities in Nepal
- Unequal access to secondary and tertiary health care has been observed.
- Nepal is experiencing a growing burden of non-communicable diseases (NCDs). It is estimated that non-communicable diseases such as cardiovascular disease, chronic respiratory diseases, cancers, diabetes, accounted for 66% of all deaths. The NCD service gap is reflected in the fact that only 5 in 100 Nepalese with hypertension have their BP controlled and only 6% have blood sugar controlled. The five year survival rate of childhood cancer is 40% and treatment abandonment rate 9%.
Nepal can accelerate action for improving health and addressing health inequities through:
1) Following the path of attaining universal health coverage by adopting a primary health care approach that aims at people-centred care, social equity, financial protection, quality care and a strong public health system.
The main objective of Primary Health Care is to provide a continuum of preventive, promotive, curative and rehabilitative care and not just medical care alone
Health equity is a shared responsibility. It requires the engagement of all sectors of government, of all segments of society, as well as international community. This adds urgency to strengthening multisectoral coordination for health.
At the end this is also the moment to remember our colleagues whom we have lost on the forefront of providing healthcare generally and for COVID19 particularly. Health workers and health facility support staff are central to healthcare service delivery and pandemic response. The COVID-19 pandemic continues to have a profound impact on health and care workers, in terms of increased workload, higher risk of infection and death. They are exposed to hazards such as psychological distress, fatigue and stigma, violence, mental health issues. Healthcare workers must be protected against assault, violence and discrimination. Investments should be urgently directed at strengthening human resources for health.
- Investments in health are not just investments in a healthier future; they’re a down payment on a fairer, safer and more prosperous world.
- Life is priceless.
- Saving lives, promoting health, keeping the world safe, and serving the vulnerable is not a cost. It is an investment.
I end my remarks by echoing WHO Director General, Dr Tedros, who once said:
Health is not a cost, it's an investment;
It’s not simply an outcome of development, but the means;
It’s not a luxury, but a fundamental human right.
Let us continue to work towards delivering Health for All so that the people of Nepal- regardless of their geographical disposition, their gender orientation, their economic and social status, can enjoy the highest attainable standards of health.
Thank you to the Ministry of Health and Population and NHEICC for leading the organizing of this important event. And thank you to all present here for your attention and engagement.
Wish you a Happy World Health Day.
Dhanyavad.