According to a new report released today, countries in the World Health Organisation (WHO) Western Pacific region experienced the smallest decline in life expectancy during the COVID-19 pandemic compared to other WHO regions.
Life expectancy in the Western Pacific fell by only 0.07 years during 2020-21, a minimal drop compared to the global average decline of 1.7 years. The Western Pacific now has the highest life expectancy among WHO’s six regions, rising from 72.0 years in 2000 to 77.4 years in 2021.
However, despite this progress, the Region – comprising 37 countries and areas across Asia and the Pacific – is still grappling with critical challenges and is off-track in achieving the health-related Sustainable Development Goals (SDGs).
The SDGs are the global goals adopted by world leaders to end poverty and inequality, protect the planet and ensure that all people enjoy health, justice and prosperity by 2030. The new WHO report, Health statistics in the Western Pacific Region 2023: Monitoring health for the SDGs, highlights advancements made across the region while also emphasising the urgent need for action. The report shows that while the COVID-19 pandemic may have done less damage to life expectancy in the Western Pacific than other regions, it nevertheless exacerbated health inequalities and disrupted progress in other areas.
Noncommunicable diseases on the rise
While infectious diseases and injuries were previously major causes of illness and death in the Western Pacific, the region is undergoing a significant epidemiological shift. Noncommunicable diseases (NCDs) like heart disease, stroke, diabetes and cancer now account for nearly nine in 10 deaths. While the probability of premature death from NCDs has declined in the Region by over 25 percent since 2000, major challenges remain. Moreover, the Region is experiencing rapid population ageing. There are now more than 245 million people aged 65 and older in the Region – a number that is projected to double by 2050. And many older people are living with NCDs.
A major risk factor for NCDs is alcohol and tobacco use. Consumption of alcohol in the region has risen by 40 percent since 2000. Despite a decline from 7.2 litres per capita per year in 2015 to 6.1 litres in 2019, the overall increase highlights an ongoing concern for public health. Similarly, although tobacco use declined from 28.0 percent of adults smoking in 2000 to 22.5 percent in 2022, this was still above the global average of 20.9 percent.
Mental health issues are also taking their toll on the population, with alarmingly high suicide rates in some countries of the Western Pacific Region, influenced by factors such as stigma, limited access to mental health services and socioeconomic challenges.
Climate- and environment-related health concerns are yet another major challenge. While air pollution in urban areas of the Region was found to have decreased from 2010 to 2019, air quality levels are still much worse than the WHO-recommended levels. Populations living in urban areas are therefore continuing to breathe unhealthy air.
Mixed progress towards universal health coverage
Universal health coverage (UHC) is another important SDG target for which the Western Pacific Region has had mixed progress. The UHC service coverage index measures access to essential health services such as reproductive, maternal, newborn and child care, and prevention and treatment services for both NCDs and infectious diseases. Over the past 20 years, the overall UHC service coverage index in the Western Pacific increased impressively, from 49 to 79 points out of 100 between 2000 and 2021. However, people’s ability to access health-care services varies greatly across the region. In some countries, the UHC service coverage index score is as low as 30, meaning many people struggle to access basic health care, while in others, it exceeds 80, indicating a much higher level of service availability and coverage. Despite these advancements, progress has slowed and stagnated since the adoption of the SDGs in 2015, and particularly since 2019.
Despite the growing burden of noncommunicable diseases, access to essential health services for NCDs did not improve significantly, increasing only slightly from 52 points in 2000 to 58 points in 2010. Even more troubling, there has been no further progress since 2010, and access to services remains low, particularly in Pacific island countries and areas.
In contrast, access to services for infectious diseases improved significantly, rising from just 18 points in 2000 to 82 points in 2021. Immunization coverage for the WHO-recommended three doses against diphtheria, tetanus and pertussis, or DTP3, showed mixed results from 2000 to 2023: coverage increased in 15 countries, while four countries experienced no change and eight saw a decrease.
In the Western Pacific region, average health spending has increased substantially, tripling from around US$383 per person in 2000 to US$1336 in 2021. On average, health spending accounted for 6.6 percent of gross domestic product (GDP) at country level in 2000, and rose to 8.2 percent by 2021. However, despite efforts to increase public spending for health, the proportion of people in the Western Pacific experiencing catastrophic health expenditure − defined as spending more than 10 percent of their income on health-care − has nevertheless doubled, rising from 9.9 percent in 2000 to 19.8 percent in 2019.
Critical action needed to achieve SDGs
“While we celebrate the significant health gains that the Western Pacific Region has achieved, we must also acknowledge urgent challenges in sustaining progress,” said Dr Saia Ma’u Piukala, WHO Regional Director for the Western Pacific. “We are living longer than ever, and more than any other region of the world, but this isn’t enough. We’re off-track to meet many of the SDG targets, and the COVID-19 pandemic exacerbated health disparities. Now is the time for concerted action to address these issues. We look forward to working with health leaders from across the region next week to finalise our new vision to weave health for families, communities and societies.”
New vision for health in the Region
Ministers of health and other senior officials are preparing for discussions at the seventy-fifth session of the WHO Regional Committee for the Western Pacific in Manila on 21−25 October 2024. The meeting will focus on the most pressing health needs in the Region and chart a course to address them.
Weaving health for families, communities and societies in the Western Pacific region (2025-2029): Working together to improve health, well-being and save lives is the proposed new vision for the region. The vision centres on the analogy of weaving a mat – a traditional activity across Asia and the Pacific – symbolising the collaborative efforts required by WHO, governments and partners to improve population health and well-being. The vision centres on five vertical strands of action led by governments interwoven with three horizontal strands of action by WHO.
The five vertical strands of action led by governments, working with WHO and other stakeholders include:
*Transformative primary health care for UHC
*Climate-resilient health systems
*Resilient communities, societies and systems for health security
*Healthier people throughout the life course
*Technology and innovation for future health equity.
The three horizontal strands of action by WHO are:
*Country offices equipped with skills for scaling up and innovation
*Nimble support teams in the Regional Office
*Effective communication for public health.
These strands reflect the reality that the Western Pacific Region faces complex health challenges that cannot be addressed by the health sector alone. Achieving the goals of SDG 3 − Good health and well-being – will require a concerted effort from multiple sectors. Social determinants of health, including education, housing, employment, social protection, gender equality and the environment, significantly impact health outcomes. Therefore, collaboration between the health, education, urban planning, agriculture and environmental sectors, to name but a few, is crucial. Collaboration can create synergies and co-benefits for all these sectors while accelerating progress towards achieving SDG 3.
“The commitment of governments, WHO and partners to achieving the Sustainable Development Goals by 2030 is a commitment to health and well-being for all,” added Dr Piukala. “We must work together to ensure that no one is left behind as we weave a healthier future.”
In addition to the vision, the Regional Committee will also consider new regional action frameworks on digital health and on health financing to achieve UHC and sustainable development. There will be panel discussions on climate-resilient health-care facilities, transformative primary health care and oral health, as well as a special event on the Investment Round to resource WHO’s work for 2025–2028.
