Seventy-fourth Session of the WHO Regional Committee for South-East Asia - Day4

Today the Regional Committee addressed one item in Policy and Technical matters ( School Health, Item 8.6), Governing Body matters (Item 10) and Progress Reports on selected Regional Committee Resolutions (Item9.1-9.8). The progress reports tabled were ranging from measles and rubella elimination, polio eradication, essential medicine, civil registration and vital statistics, SEAR Health Emergency Fund (SEARHEF), patient safety, and Colombo Declaration on accelerated delivery on NCD services at the primary health care. The agenda items were based on several working documents; vis

A team of senior officials from Ministry of Health including,

01. Dr. S. Sridharan – Deputy Director General – Planning,

02. Dr. Susie Perera - Deputy Director General (Public Health Services II),

03. Dr. D.R.K.Herath Deputy Director General Medical Supplies Division,

04. Dr. H.D.B Herath actg DDG and coordinator Disaster Preparedness and response uni,

05. Dr. Samitha Ginige – Chief Epidemiologist, and  

06. Dr. Palitha Karunapema, Director Health Information,

participated the session and  presented their interventions and comments for the thematic areas comes under their purview. Some interventions were presented during the sessions and a few others were submitted as written documents.  

Further, during the today’s session the regional committee accepted  and endorsed the invitation by Royal Government of Bhutan to host the 75^th Regional Committee Meeting of South East Asian Region  in September 2022. 

Revitalizing school health and health-promoting school in the South-East Asia Region

(Agenda item 8.6)

South-East Asia is home to about 627 million children under the age of 18 years( 36% of the total population). The Regional Office and Member States recognized the need to revitalize comprehensive health-promoting schools (HPS) to support Member States to prepare schools for recovery, restore health-promotion activities, and scale up the health-promoting schools and  meet the Global Standards for Health Promoting Schools launched in 2021.

The agenda was discussed at the High-Level Preparatory Meeting in July 2021 and member states were requested to review the Draft Resolution proposed by Thailand on “Revitalizing school health and health-promoting schools in the South-East Asia Region” and provide feedback.   WHO prepared the working paper on scaling up school health programmes and HPS practices to meet the Global Standards and to recommend COVID mitigation measures in schools. 

The resolution proposed by Thailand and the HLP Meeting recommendations were discussed at the Seventy-fourth Session of the WHO Regional Committee for South-East Asia on the 09 September 2021.

Intervention from Sri Lanka was presented by Dr Susie Perera, Deputy Director General-Public Health Services II-Ministry of Health

Dr Perera highlighted that SRL fully endorse the resolution proposed by Thailand and appreciate collaborative efforts by the member states and UN agencies to revitalize Health promoting school initiative in the region. She further stressed on the importance of whole of government approach and requested WHO support in leveraging other UN agencies and developmental partners for collective and comprehensive effort. She reiterated the need for building back education system better in relatively controlled COVID-19 situation and expected further technical WHO guidance on  better customized stringency indices for safe school re-opening.

Measles and Rubella elimination by 2023

(Agenda item 9.1)

Summary of the intervention from Sri Lanka was presented by Dr.Samitha Ginige, Acting. Chief Epidemiologist of Ministry of Health

Sri Lanka has achieved elimination of Measles and Rubella one year ahead of the regional agenda and Sri Lanka reassured the certification status of endogenous measles elimination in 2019.

The chief Epidemiologist Dr.Samitha Ginige pointed out that immunity is provided by 2 doses of MMR at the age of 9 months and 3 years during the national immunization programme. Vaccination coverage is maintained at very high and sustainable level above 95% at national level over last 10 years ensuring high population level of immunity. Country has taken measure to ensure uniform high vaccination coverage throughout the country at all levels.

The temporary interruption of immunization clinics due to COVID-19 pandemic situation has successfully resumed and measures have already been taken to catch up with children ensuring maintaining vaccination coverage.

However, country has identified the critical issues that can be evolved with COVID-19 pandemic and taken appropriate measures to minimize immunity gaps at subnational levels to spillage of possible outbreaks. Appropriate tailors of strategies of opportunistic vaccination and making zero dose children vaccination is fully implemented at all levels to address immunity gaps.

Even though the country has achieved the certification status of endogenous Measles and Rubella, possible risk of importation has been identified as a challenge with global outbreak. However, measure is taken in place to minimize internal transmission. Sri Lanka is ready to mobilize political, societal and financial support extended to National Measles, Rubella and CRS programme to ensure sustaining achieved success in Measles and Rubella elimination status.

All components in Regional Strategic Plan in achieving and sustaining Measles, Rubella and congenital Rubella Syndrome elimination of WHO SEARO 2020-2024 are being fully implemented  as it is applicable to the country.

Delhi Declaration on Improving access to essential Medical Products in the Region and beyond

(Agenda item 9.3)

Presented by Dr.D R K Herath, Deputy Director General (Medical Supplies Division), Ministry of Health

As a country, we totally agree with recommendations of the Delhi declaration. Following describe the progress to achieve our commitment  

• In Sri Lanka, all the medicines and vaccines are provided free of charge to public sector
• Standard and quality medicinal products availability is ensured by National Medicines Regulatory Authority and National Medicines Quality Assurance Laboratory adhering to WHO protocols and guidelines. 
• Pre-shipment and post-shipment sample checking have been planned, by initiating expansion of lab capacities to monitor quality and efficacy. 
• A new policy of promoting local manufacturing through & private sector companies, have been implemented to improve the ready access to medicines within the country. Local production of a number of essential medicines, normal saline has already been commenced.
• Patient accessibility to rarely used drugs has been increased by introducing a fast-track procurement systems through SPC, such as direct contracting or through International or UN Procurement Agents such as Global Fund, UNICEF, WHO, and Crown Agents.
• All cancer drugs have been provided cancer drugs free of charge with unlimited allocation.
• Adequate and timely supply for use on patients has been strengthened by computerized forecasting system. 
• The proper storage of medicine and medical items are done through   improving store capacities and properly conditioning of store facilities.    
• The National Essential Medicines list is updated in every 3 years.  Regular updating & publishing of the Essential Medicines List has helped to rationalize the selection of medication, at the government medical institutions.
• Collaboration of all relevant authorities of other relevant sectors (Atomic Energy Authority, Departments of Import Control and Agriculture, etc.), are obtained to maintain a good regulatory network to ensure safe, efficacious and quality medications reaching the market

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Patient Safety Contributing to Sustainable Universal Health Coverage

( Agenda item 9.6)

Patient safety is critical to the delivery of health care in all settings. This aims to achieve the maximum possible reduction in avoidable harm due to unsafe health care. Patient safety has been recognized as a public health problem for many years in the SEA Region.

With regards to agenda item 9.6, Patient safety contributing to sustainable universal health coverage (SEA/RC68/R4), presenting the intervention, Sri Lanka appreciated the efforts of WHO in ensuring global and regional patient safety including development of Global Patient Safety Action Plan 2021–2030 and “Regional strategy for patient safety in the WHO South-East Asia Region (2016-2025)” which help to implement patient safety interventions at all levels. Sri  Lanka also has  contributed  to those efforts include providing inputs to the global and regional level Patient Safety Action Plans and sharing country experience related to patient safety at inter-country meetings.

The patient safety activities in Sri Lanka are conducted under the National Policy on Healthcare Quality and Safety (2015). Currently, the Ministry of Health is in the final stage of revision of the Policy and development of a strategic plan for 2021-2025. In this revision the country requirements under the prevailing situation have been considered carefully and has referred to the WHO guidelines and strategic framework. Similarly, monitoring and evaluation plan has been developed to assess the progress of implementation of the said strategic plan and for the purpose of reporting to WHO. National Action Plan on medication safety has been finalized and will be launched at the national event to celebrate World Patient Safety Day, on 17th of September 2021.

In the intervention, Sri Lanka has emphasized the importance in strengthening the patient safety measures in PHC settings as well. Further, the county’s commitment towards realizing the WHO goal of  achieving maximum possible reduction in avoidable harm due to unsafe healthcare has also been highlighted.

Colombo Declaration on strengthening health systems to accelerate delivery of NCD services at the primary health care level

( Agenda item 9.8)

Presented by Dr. Vinya Kumarapeli, Director (NCD), Ministry of Health

Sri Lanka endorsed the Colombo Declaration in 2016 and has progressed towards to accelerate NCD service delivery through the primary health care approach.

Drawing on the lessons of success from the well-established preventive primary care system, Sri Lanka launched the policy on Healthcare Delivery for UHC in 2018. 

In 2019, Sri Lanka embarked on to re-organize the primary care services with a special focus on NCD. This is supported financially and technically by the World Bank,  Asian Development Bank and WHO. The SL essential service package to be delivered as a cluster model is a related product,  launched in the same year.

The model clusters several primary care hospitals with a secondary or a tertiary level apex hospital for specialist referrals and back referrals. The empaneled population are screened for NCDs and risk factors at the Healthy Lifestyle Centers. The clients are issued a Personal Identification Number, and a Personal Health Record to ensure continuity of NCD care at primary level.

Management guidelines and protocols have been developed for major NCDs at primary care level. Access to essential investigations at primary care is increased by providing on-site testing or by sharing of laboratory facilities within the cluster. Availability of essential medicines at primary care level is ensured.

A new cadre of Public Health Nursing Officer recruited in 2018 are trained for NCD screening, lifestyle modification counselling and home-based palliative care. Yet another new cadre of a Health Promotion officer is planned for population-based promotive activities for NCDs.

Sri Lanka proposed to initiate a Knowledge Hub to be the center of learning and sharing of experiences and best practices, to advance the agenda of PHC-orientated systems strengthening for COVID-19 recovery. With WHO’s support, the Knowledge Hub will provide the countries in the South East Asia and beyond, a platform for innovative joint solutions, to strengthen primary care, and to explore means to sustain them, to reach our common goal, health for all, at all ages.