The Western Pacific is a diverse and ever-changing Region. Growth and change have brought many challenges which in turn threaten the Region’s health. Poverty is one of the most important determinants of health status. Within the Region many people still live in poverty and not only in the seven countries that are classified as Least Developed Countries. The transition to market economies in a number of countries and the impact of globalization had both positive and negative effects on health.
Rapid population growth continues in a number of countries of the Region. Another trend with huge implications for the health sector is ageing. Environmental factors associated with urbanization and industralization contribute to much of the disease burden. The links between the environment and health are becoming more defined. The island countries of the Pacific are increasingly under threat from environmental degradation and global warming.
Partly as a consequence of the trends identified above, disease patterns are changing. The “epidemiological transition” is resulting in noncommunicable diseases becoming increasingly important throughout the Region, although in many countries and areas communicable diseases still impose a heavy burden. For example, dengue fever is causing major health problems in several countries of the Region. Over the past two decades, 33 of the 37 countries and areas of the Region have reported dengue cases.
Upgrading the Region’s health systems is a major challenge. Health systems in many countries are underdeveloped and several are still struggling to deliver a minimum level of health services to all areas. In addition, the profound Asian economic turmoil that began in 1997 has affected many countries and has had a marked impact on their ability to build and maintain the quality of their health systems.
More and more agencies are becoming involved in health-related work. Development banks, other United Nations agencies, bilateral aid agencies and nongovernmental organizations (NGOs), have become significantly more active, both technically and financially, in international health. This offers great opportunities for the international community, but it also poses challenges of coordination.
WHO faces four main challenges
Improve understanding of the changing needs of Member States
The first challenge WHO faces is that the health needs of the Member States are changing. Rapidly ageing societies, the double burden of communicable diseases and noncommunicable diseases and the increasing influence of the environment on health are leading to increasing requests for both technical cooperation and policy guidelines which employ a holistic approach to capacity building and health sector development.
Therefore, its task is to further strengthen and institutionalize the capacity of WHO to conduct more thorough analysis and evaluation of countries’ health situation and needs, in collaboration with Member States. This is a prerequisite for technical cooperation.
Reform WHO
The second challenge is that WHO and the international health community should become more accountable and transparent, less bureaucratic and formal and that there should be greater harmony between the objectives of the Member States and those of WHO.
The efficiency of WHO will be improved by reducing bureaucracy and simplifying procedures at the Regional Office and at country level.
Strengthen partnerships
The third challenges is that the field of international public health is becoming ever more complex. There is a growing recognition that health is much broader than disease prevention and control. Public health involves intersectoral dimensions and integrative approaches that demand greater and more effective collaboration and coordination. A more systematic approach to forging partnerships is needed.
Therefore WHO will strengthen partnerships with Member States, UN and other agencies including those involved in other sectors, development banks, bilateral aid agencies, NGOs and the private sector at international and national levels to help build capacity for sustainable integrated development.
Achieve more with fewer resources
The fourth and final challenge is shrinking resources. A World Health Assembly resolution (WHA51.31) reduced regional allocation for the next three biennia. For the proposed budget for 2000-2001, the budget allocation for the Region has been reduced by US$4 390 000 or 5.5% compared to the previous biennium.