All the ten ASEAN countries will likely lag behind the health-related Sustainable Development Goals (SDGs) by 2030, according to a new analysis published in PLOS Medicine. The analysis, using data from 1990-2021, identifies gaps in managing infectious and non-communicable diseases (NCDs), and weakness in the health system's infrastructure and in equity.

No ASEAN country is on track to meet the target for the elimination of infectious diseases such as HIV/AIDS, tuberculosis, hepatitis B, and the neglected tropical diseases by 2030. While some countries are progressing towards eliminating malaria, increasing HIV/AIDS prevalence and poor accessibility to diagnostic and treatment facilities remain a point of concern for ASEAN. The Philippines has also been the worst in backsliding for its health performance with high and continuing levels of TB, HIV, and hepatitis B.

The study also observes unprecedented disparity in non-communicable disease control. Singapore is the only exception among the ASEAN countries likely to meet SDG targets for cancer, road traffic injury, and diabetes. All the other countries are not reversing accelerated rates of unhealthy alcohol, tobacco, and diet disease. Cambodia, Laos, and Vietnam all saw 40–90% boosts in alcohol consumption to become global leaders.

Researchers also observed significant barriers to progress such as rural poor, poor health literacy, and weak public health infrastructure. Countries such as Cambodia and Laos are also stuck in persisting challenge due to nonexistent health workforces and poor quality diagnostic capacity. In the Philippines, researchers identify a broken health system as one of the largest barriers to effective and fair provision of services.

Fragmentation of the health care system, particularly between nations with distinct public and private providers, has influenced the quality as well as the price of care. In a few instances, patients are forced to move through unrelated systems for various services, leading to delayed treatment and higher cost.

The ASEAN group of over 667 million people also risks a growing health threat from climate change and environmental degradation. Weather-related extreme threats, disease re-emerging and spreading, and environmental pollution are also becoming overwhelming hurdles for public health response. These are further compounded by socio-economic disparity, especially in poor and poorly governed states.

Although the overall picture is grim, some regions have seen very impressive improvement. All the ASEAN countries have made quantifiable progress in nutrition-related targets like reductions in stunting among children under age five. Such trends suggest that with concerted investment, health gain in other SDG targets is still possible.

The specialists believe that the challenge is not ambition or political desire but with finite resources and structural disequilibria foreshadowing step-by-step change. They propose that instead of pushing forward timetables, ASEAN member states push action quicker through equity-based interventions and collective regional efforts.

Investment in primary health care, increased inter-sectoral coordination, and stronger public health education are identified as high-priority interventions for closing gaps. The best performing countries in a region of health are also being encouraged to lead best practice within the region in order to enable weaker performing health systems.

The study affirms that socio-economic development is the driver of effective health objectives. The countries with more political stability, education, and social equity will be well placed to maintain improved health. A step towards SDG 3 — healthy lives and wellbeing for all at all ages — should be accompanied with broader development aspirations such as poverty eradication, quality of education, and environmental conservation.

SDG 3 aims for the elimination of HIV/AIDS, TB, and malaria epidemics, reduction of maternal deaths, access to sanitation and safe water, and reduction of deaths from hazardous chemicals and pollution. Only five years are left before the 2030 deadline, and experts believe that postponing deadlines would reduce the sense of urgency needed to address these challenges and weaken responsibility.

The study points out that better governance and prudent investment will still enable ASEAN nations to reaped substantial health gains until 2030. Infrastructure for health, increased access to healthcare in rural areas, and management of environmental and lifestyle determinants of risk are required to turn trends around.

Source:
SciDev.Net | Based on research published in PLOS Medicine