To learn more about the many impressive milestones achieved for health in Lao PDR, view our timeline of health, and the progress made.
This week we mark World Health Day and the 75th anniversary of WHO and have a chance to reflect on the gains secured, and what is needed to sustain and build on these.
The grave threat of malaria has almost been eliminated in Lao PDR. Cases here have fallen from an estimated 460,000 in 1997 to 2,305 last year.
In 2017, the National Health Insurance scheme was rolled out to all provinces (except Vientiane Capital), aiming to provide access to healthcare for everyone without financial hardship.
And, the most recent and memorable achievement, a strong, fast whole-of-country response to COVID-19 ensured one of Asia’s lowest losses of life.
Ongoing challenges, and our shared drive for nothing less than health for all, mean it can be easy to forget the achievements of decades of hard work.
In Lao PDR, since joining WHO in 1950, this work has meant supporting patients, their families, communities, healthcare workers, and the government to help achieve these impressive milestones.
These could not have been achieved without tireless efforts from health workers and officials behind the scenes, national leadership by the government, and continuous support by development partners. I’m proud WHO has played a lead role.
As we look forward and decide the actions necessary to sustain and build on these achievements – particularly when Lao PDR faces inflation and rising costs, declining health budgets, and emerging threats like climate change – we must remember to look back.
The challenges we face now may seem insurmountable, but these historic problems likely seemed equally impossible.
Four areas of remarkable health progress in Lao PDR
As late as the
1990s, malaria cases were in the hundreds of thousands. The resulting disruption to employment and education brought significant economic
consequences. Thousands of lives were lost, and tens of thousands were
devastated by the disease’s long-term impacts.
Immense progress by the Ministry of Health
and partners – focusing on village-level treatment and surveillance – means Lao
PDR is on track to eliminate the deadliest of the five malaria parasites by
2024.
A second
area of progress is maternal and child health.
In 1978, a
tragic 218 children of every 1,000 would pass away by the age of five. In 2020,
following massive, continued investments and prioritization by the government
and partners, this has fallen to 44. This is an enormous achievement.
Over the same period, the number of pregnant women who died per 100 000 live births fell 78.7%, from 579 in 2000 to 126 in 2020 – one of the fastest falling rates in the world.
Improvements
to the national health system are another area of dramatic change.
In 2016, Lao
PDR rolled out the National Health Insurance scheme to all provinces except
Vientiane Capital. It aims to ensure equitable access to health care without
financial hardship, particularly for the poor. This is remarkable progress
towards health equity, and based on recent analysis, the scheme has positively impacted financial protection and
access to care.
Finally, the government
has undertaken commendable work on tobacco control.
Now is the time to accelerate
progress
These are outstanding achievements – but
there is more to be done.
Momentum and lessons from the COVID-19
response create an opportunity for Lao PDR to continue strengthening its capacity
to prepare and respond to public health emergencies.
The remaining malaria cases are almost
entirely in remote, hard-to-reach communities. Reaching the unreached will be
tough, and we need to ensure similar progress on tuberculosis and HIV.
Mortality rates for children under 5 and mothers
lost during childbirth are still higher than the global average.
The National Health Insurance scheme is a
powerful tool, but gaps remain.
Finally, tobacco use remains an immense burden in Lao PDR, killing
approximately 7,000 children, women and men each year and costing 3.6
trillion Lao Kip. Contributing to this are the lowest tobacco tax rates in the ASEAN
region.
The hard-earned gains can be sustained and
gaps addressed, but only with committed action that also accounts for new
threats: COVID-19’s
socioeconomic impacts and disruptions to routine vaccination, global economic
challenges, and climate change.
Addressing
them will require sufficient funding for health. The funding gap is too large –
including for the National Health Insurance scheme and essential
health services.
First, development partners must sustain and
increase funding to maintain essential health services during this period when
health budgets are insufficient. Indeed, we urge partners to consider Lao PDR
for emergency funding – the economic situation here is challenging.
Second, to be effective, development
partner efforts must closely align with the Ministry of Health’s priorities, to
strengthen the country’s health system, support the delivery of essential
health services, and respond to community needs.
Third, we urge an increase in the national
budget allocation to health as pledged at the National Assembly from 6.7% to at
least 9%. To be sustainable, this should be direct government contributions,
not donor contributions.
Finally, we must focus on increasing
revenue for things that matter by ensuring compliance of taxes on alcohol and tobacco,
as well as eliminating tax exemptions and increasing taxes for these harmful
products.
These steps require the government to take decisive
action, directing health development funding to best serve people.
During the pandemic, we have seen that without health, we cannot achieve national development goals.
While the task may seem enormous, the history of health gains in Lao PDR is an excellent reminder that it can be done.