Associate Professor, Dr Phouthone Meuangpak, Vice Minister of Health; Colleagues from the Ministry of Health and development partners; ladies and gentlemen. Sabaidee, good afternoon.
This Joint Program review has taken place at an important time for Lao PDR. The country’s economy, society and health system are changing rapidly. This review aims to identify priorities for new National Strategic Plans on Tuberculosis and HIV running from 2021 to 2025. But what will this country and its health system look like in 2025? Probably quite different to today.
By 2025, the health sector will have been through some major changes. There will have been a necessary transition to greater reliance on domestic financing for at least some key programs. The 2020 – 2025 Health Sector Development Plan will have been largely implemented. And we all hope the result will be:
- Universal Health Coverage, with
- High quality health services for all communities; and
- A strengthened role for Primary Health Care
By 2025, on average, Lao people should be richer and in better health. But there will still be some groups doing less well economically. Or lacking social protection and proper access to health services. These can include, for example, migrant workers and their families, or remote communities.
I had the opportunity to talk to the leaders of the joint review team yesterday. What struck me is the similarity between the challenges faced by the TB and HIV programs and those faced by the Lao health system as a whole.
I saw three cross-cutting themes running through the Joint Program Review team’s findings about the challenges to address. These are:
- Firstly, improving the quality of testing, treatment and support services;
- Secondly, making sure high-quality services are easily accessible for people living in every village. Which is another way of saying developing high-quality Primary Health Care; and
- Thirdly, and closely related to that, making sure no-one is left behind.
I therefore see an excellent fit between where the TB and HIV programs needs to go, and where the Lao health system as whole needs to go.
This being the case, it seems to me that it should be both easy and important to build strong links between the next TB and HIV programs and the new Health Sector Development Plan. And, indeed we should also build strong links between the TB and HIV programs.
I believe the case for making TB and HIV services part of Universal Health Coverage is very strong. A recent study showed that 60% of TB patients in Lao PDR, and 80% of TB-HIV coinfected patients, incurred catastrophic costs. As well as driving these people into poverty, it also risks patients not being fully treated, putting their health, and the health of their families and the broader community at risk. The review team will, I understand, say more on the need for social protection for people living with these infections.
I would like to end by saying a few words about leaving no one behind. The goal of the TB and HIV joint program should be the earliest possible prevention services, testing, treatment and care of all people with these infections, or at risk of these infections. Achieving this means having effective outreach to some of society’s most vulnerable groups.
Programs must reach female sex workers, men who have sex with men, prisoners, remote and non-Lao speaking communities, and also mobile and migrant workers, including those working on large construction projects. And these efforts need to be both sustainable and sustained.
This is not just a mark of high quality health care – and indeed universal health coverage. It is the best protection for everyone.
I look forward to hearing more about the findings of this review, and I wish the Ministry of Health every success in moving forward to sustainably and effectively tackle this important threats to health. WHO will continue to collaborate closely with Lao PDR on prevention and control of TB and HIV. THANK YOU – KHOP CHAI LAI LAI