Editorial 1: WHO, an anniversary year, and sharpening the ‘Health for All’ goal
Introduction:
- On World Health Day (April 7) this year, the World Health Organization (WHO) celebrates 75 years of improving public health and well-being in the South-East Asia region. Globally, WHO is fully committed to achieving ‘Health for All’ through ‘universal health coverage; (UHC) — when all people can access essential health services, without financial hardship.
Universal health coverage (UHC):
- For decades — and even before the 1978 Declaration of Alma-Ata — high-level leaders and policymakers from across the region have recognised the critical role that access for all to quality, affordable and comprehensive primary health care (PHC) can play in achieving UHC, and therefore ‘Health for All’. This has been reflected in the region’s renewed, decade-long push to achieve UHC, which, since 2014, has been one of eight flagship priorities of the region.
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Progress and challenges
- Between 2010 and 2019, the region increased its UHC service coverage index from 47 to 61. Between 2000 and 2017, the region reduced the number of households that have been impoverished or further impoverished from out-of-pocket spending on health, from 30% to 6%. Since 2014, the density of doctors, nurses and midwives in the region has improved by over 30%.
- Five countries of the region have already achieved the Sustainable Development Goal (SDG) targets for under-five and neonatal mortality. Between 2000 and 2020, the region achieved a 34% decline in tuberculosis incidence rates, and by the end of 2020, had met each of the Global Technical Strategy for Malaria milestones for mortality and morbidity.
- Impressively, the region has maintained its polio-free status and continues to have eliminated maternal and neonatal tetanus as a public health problem. Five countries of the region have eliminated measles, two have eliminated rubella, and four have controlled hepatitis B through immunisation.
Lessons following the pandemic
- As highlighted by the region’s 2021 Strategy for Primary Health Care, as well as the region’s vision to build back better from the COVID-19 pandemic, action by the whole-of-government and whole-of-society is needed to drive rapid and sustained progress towards UHC and ‘Health for All’. We must all contribute to this.
- Policymakers and programme managers must continue to implement the region’s Strategy for PHC. Of specific focus should be a strengthening of the public health infrastructure, workforce and financing, while at the same time increasing equity for those at risk of or who are already being left behind.
People must be heard
- People and communities must increasingly assert their voice and right to health, which includes directly engaging in local health decision-making processes. As highlighted by the 2021 WHO handbook on social participation for UHC, as well as the region’s recently adopted resolution on enhancing social participation in support of PHC and UHC, individuals and communities can play a key role in monitoring health service performance and holding health providers and policymakers to account.
Conclusion:
- On WHO’s 75th founding anniversary, let us unite in purpose and be driven by action to achieve UHC and ‘Health for All’, ensuring that all people have good health for a fulfilling life in a peaceful, prosperous and sustainable world.
Editorial 2: Science for all: On the road ahead for the LIGO-India project
Context:
- Union Cabinet recently approved a gravitational-wave detection facility in Maharashtra that will consist of a detector called the LIGO, to be built in the image of the twin LIGO instruments already operational in the U.S.
About LIGO:
- Laser Interferometer Gravitational-wave Observatory (LIGO) is a large-scale physics experiment and observatory designed to detect cosmic gravitational waves and to develop gravitational-wave observations as an astronomical tool.
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LIGO in India:
- A third detector is being built in India as part of the LIGO-India collaboration in order to improve the detectors’ collective ability to pinpoint sources of gravitational waves in the sky.
- The Cabinet’s approval throws up two opportunities:
- India could become a global site of gravitational physics research, aiding training and the handling of precision technologies and sophisticated control systems, ultimately, cementing a reputation for successfully running an experimental Big Science project.
- LIGO-India can demonstrate an ability to reckon intelligently with Indian society’s relationship with science, using the opportunities that Big Science affords. India has had a contested relationship with such projects, including, recently, the Challakere Science City and the stalled India-based Neutrino Observatory (INO).
Assessment of the LIGO project in India:
- They need large land tracts, with inevitable implications for land-use change. Contests over land rights, against the backdrop of the sustainable use of natural resources, carbon sequestration targets, just transitions, and human rights.
- A similar criticism has trailed experimental Big Science undertakings, including the INO, in the economically developing world: that they are far removed from the concerns of the majority.
- Shakier though this latter argument may be, such undertakings still have a responsibility to define their public value, beyond benefits to national industry and research.
Conclusion:
- This is the second opportunity LIGO-India has, amplified by the context of the present moment: to build a facility that contributes to the communities from which it requires sustenance and knowledge, engage in good faith on concerns about access to land and other resources, and conduct public outreach on a par with the international LIGO Scientific Collaboration. The starting requirement is to contemplate what all LIGO-India can do for India.