While Lao PDR has faced and continues to face many challenges, a recent trip to its southern provinces demonstrated commendable progress towards eliminating life-threatening diseases like malaria, elephantiasis, and schistosomiasis, as well as achieving national COVID-19 vaccination targets.
Joining Minister of Health H.E. Dr Bounfeng Phoummalaysith, I participated in a seven-day assessment of healthcare facilities, progress and challenges in Salavanh, Xekong, Attapeu and Champasak Provinces.
What was immediately clear was the impact of hard work and commitment over many years by healthcare staff, provincial officials, communities, and development partners.
Across the four provinces, total confirmed malaria cases fell 94 percent in the last ten years, from 33 372 in 2012 to 1 992 in 2022 following dedicated efforts and support by the Ministry of Health, sub-national officials, WHO, the Global Fund and other partners.
Lymphatic filariasis (Elephantiasis) is almost eliminated in Attapeu Province – the only province in Lao PDR where the disease was regularly found – with no cases reported since 2017.
Similarly, Champasak Province has seen cases of schistosomiasis – a disease caused by parasitic worms – fall from a prevalence of 3.2% 2018 to 0.5% in 2021 and is aiming to eliminate the disease by 2025.
But we also saw the many challenges and work that remains.
With disruptions from the COVID-19 pandemic, routine measles and rubella vaccination coverage in some of the provinces dropped between 2 to 15 percent. While COVID-19 primary vaccination coverage is high in some provinces, booster coverage among the elderly – the most at-risk – remains concerningly low across all locations.
Ultimately, this serves as a strong reminder. We can make progress. We can eliminate disease and protect health. But we risk losing progress without sustained commitment.
COVID-19’s socio-economic impacts, the potential for malaria parasites to develop resistance to current antimalarial treatment, and economic challenges are just some of the factors that mean now isn’t the time to slow down - it’s time to accelerate.
The commitment of Lao PDR’s healthcare staff is evident, as is the progress they can achieve. Every doctor, nurse and public health official is working hard, and we can see the results.
So too, the commitment of international partners and the long-term impact. Support from the Global Fund has been instrumental in enabling much of the successes I mentioned earlier.
We saw first-hand the results of Japan’s long-term investment in health, travelling with the Japanese Ambassador to Laos, Mr Kenichi Kobayashi, including equipment and supplies for “Last One Mile” COVID-19 vaccine support, and the massive reductions in malaria cases as one of the top five Global Fund donors.
In Sanamxai District Hospital, a WHO-supported maternity house is continuing to deliver benefits after many years – providing a place for vaccination, maternal and child health checkups, nutrition programme delivery, and much more.
But, with limited infrastructure and human resources, and insufficient funding for basic health services, gaps will persist.
As WHO, we are supporting the Ministry of Health with a range of the disease elimination efforts currently underway – as well as working to do more with the resources that are at-hand: improving efficiency and capacity in service delivery with competent and well-distributed healthcare workers; improving access to quality essential medicines; health financing; enhancement and standardization of infection prevention and control; and health information systems to build a sustainable and resilient national health system. However, more public investments and an overhaul on many areas will be necessary to close the gaps, particularly around basic infrastructure.
Without health, we have nothing, and as we saw during the pandemic, without health, we cannot achieve national development goals. While the task may seem enormous – it is an excellent reminder that it can be done.
