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Editorial

Hanan Balkhy ¹

¹Regional Director, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt.

Citation: Balkhy H. Increasing access to healthcare in the Eastern Mediterranean Region. East Mediterr Health J. 2024;30(2):91–92. https://doi.org/10.26719/2024.30.2.91.

Copyright: © Authors 2024; Licensee: World Health Organization. EMHJ is an open access journal. All papers published in EMHJ are available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

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Lessons learnt from the COVID-19 pandemic have provided an opportunity to intensify efforts towards the health-related Sustainable Development Goals (SDGs) (1). Innovations in digital health and advances in science witnessed during the pandemic can be harnessed to improve equitable access to healthcare and build resilient health systems. We also have stark reminders that without addressing the needs of the most vulnerable groups and societies, a simple expansion of service delivery efforts may even exacerbate existing inequities in healthcare (2).

The WHO plays its leading role in global health by promoting, providing and protecting health, while empowering health systems (3,4). However, several challenges that have profound implications for public health place limitations on the capacity of health systems to deliver effectively, especially in the Eastern Mediterranean Region (EMR) (4,5).

In 2023 alone, the EMR witnessed large-scale health and humanitarian crises: the devastating earthquakes in Syria and Türkiye (6,7); the political crisis in Sudan; the floods in Libya; the earthquakes in Morocco; and most recently the Israeli-Palestinian conflict in Gaza and West Bank, which has caused the death of over 28 000 people, the displacement of millions, a widespread damage to the health system, and death of healthcare workers (8–11). This was in addition to already existing challenges in several other countries and the impact of climate change on water and air quality (12). The heightened frequency of emergencies in the EMR, exacerbated by severe climate events, has impacted health systems in almost every country in the region (13).

These challenges underscore the undeniable interconnection between health, environment, development, peace, and political stability. They remind us that every humanitarian crisis is, at its core, a health crisis, and that achieving the health-related SDGs remains a distant prospect without peace (3).

The EMR is a diverse region with countries in different income categories as well as varying health and healthcare priorities and areas of action (4). Tackling the healthcare challenges and putting EMR back on track to achieve the SDGs requires accelerated commitment by all players at the regional and country levels.

In the past 5 years, remarkable progress has been made in strengthening health systems in the region. The “Report on the implementation of Vision 2023 for the Eastern Mediterranean Region”, presented to the Seventieth Session of the WHO Regional Committee for the Eastern Mediterranean highlights some of the key achievements (4).

During the next 5 years, WHO will intensify efforts to advance “Health for All by All” in the EMR. In alignment with the WHO Global Programmes of Work 13 and 14 (14,15), priority will be in 5 areas: (i) increasing access to healthcare, (ii) enhancing country capacities to respond to emergencies, (iii) strengthening health systems, (iv) expanding partnerships for financing as well as knowledge and skill sharing, and (v) strengthening country capacities to boost cooperation and influence global health (14).

In my first year as the Regional Director, we will pursue 3 flagship initiatives that encompass the regional priorities. First, on increasing access to healthcare, we will pursue an end-to-end supply chain approach that aims to establish a full cycle of actions for addressing priority needs of countries, using the best available evidence (16–18). Second, acknowledging the enormity of the health and social burden caused by substance abuse in the region (3), we will amplify our efforts in supporting countries to respond to this global challenge. Third, we will amplify efforts in addressing the challenges constraining the availability, distribution, retention, and quality of services provided by healthcare workers (19).

We will work with Member States and partners towards achieving Universal Health Coverage in the EMR by strengthening health governance capacity, monitoring policy implementation, promoting investment in resilient health systems, ensuring that essential medicines and supplies reach all populations, and enhancing service delivery and quality (13,20). We will promote public health, socio-behavioural, clinical, and experimental research and support the translation of the knowledge and evidence from our research into policy at the regional and country levels (21). This is essential if we must achieve the health-related SDGs.

Our success hinges on the collective efforts of all relevant stakeholders, therefore, we will foster collaborations and partnerships within and beyond WHO to build skilled and sufficient healthcare workforce and strengthen health systems sustainably to meet the needs of populations across the region.

References

1. European Observatory on Health Systems and Policies. Health systems resilience during COVID-19: Lessons for building back better. Health Policy Series 56. Copenhagen: WHO Regional Office for Europe, 2021. https://eurohealthobservatory.who.int/publications/i/health-systems-resilience-during-covid-19-lessons-for-building-back-better.
2. World Health Organization. Health inequities in the Eastern Mediterranean Region: selected country case studies. Cairo: WHO Regional Office for the Eastern Mediterranean, 2014. https://applications.emro.who.int/dsaf/emropub_2015_1863.pdf.
3. World Health Organization. Progress on the health-related Sustainable Development Goals and targets in the Eastern Mediterranean Region, 2023. Cairo: WHO Regional Office for the Eastern Mediterranean, 2023. https://applications.emro.who.int/docs/Progress-health-related-SDGs-targets-EMR-2023-eng.pdf?ua=1&ua=1.
4. World Health Organization. Advancing health for all by all: Report on the implementation of Vision 2023 for the Eastern Mediterranean Region. Cairo: WHO Regional Office for the Eastern Mediterranean, 2023. https://applications.emro.who.int/docs/Advancing-Health-For-All-by-All-Report-eng.pdf?ua=1
5. World Health Organization. Health and well-being profile of the Eastern Mediterranean Region: an overview of the health situation in the Region and its countries in 2019. Cairo: WHO Regional Office for the Eastern Mediterranean, 2020. https://applications.emro.who.int/docs/9789290223399-eng.pdf.
6. Al Mandhari A. Earthquakes as triggers for public health disasters: WHO and health systems response. East Mediterr Health J. 2023;29(3):165–167. https://doi.org/10.26719/2023.29.3.165.
7. UNHCR. Earthquake emergency response, 30 August 2023. Geneva: UNHCR Regional Bureau for Europe. https://data.unhcr.org/en/documents/download/103119.
8. World Health Organization. Sudan health emergency. Situation Report No 4, 15 December 2023. https://www.emro.who.int/images/stories/sudan/WHO-Sudan-conflict-situation-report-15-December_2023.pdf?ua=1.
9. World Health Organization. Morocco earthquake. Cairo: WHO Regional Office for the Eastern Mediterranean, 2023. https://www.emro.who.int/eha/who-in-emergencies/morocco-earthquake.html.
10. World Health Organization. 101 health workers killed in Libya in the aftermath of Storm Daniel. Cairo: WHO Regional Office for the Eastern Mediterranean, 2023. https://www.emro.who.int/media/news/101-health-workers-killed-in-libya-in-the-aftermath-of-storm-daniel.html
11. World Health Organization. Gaza hostilities 2023/2024 – Emergency Situation Reports. oPt Emergency Situation Update, Issue 22, 30 January 2024. https://www.emro.who.int/images/stories/Sitrep_-_issue_22.pdf?ua=1.
12. World Health Organization. Climate change, health and environment: a regional framework for action, 2023–2029. Cairo: WHO Regional Office for the Eastern Mediterranean, 2023. https://applications.emro.who.int/docs/Climate-change-RC70-eng.pdf.
13. Ihalainen M, Pasha Q, Rashidian A, Mataria A, Rofail R, Hajjeh R, Al-Mandhari A. All in for Universal Health Coverage and global and national health health security – reinforcing partner engagement in the Eastern Mediterranean Region. East Mediterr Health J. 2023;29(11):835–836. https://doi.org/10.26719/2023.29.11.835.
14. World Health Organization. The WHO 13th General Programme of Work (GPW 13). Geneva: World Health Organization, 2018. https://extranet.who.int/sph/13th-general-programme-work-gpw13#:~:text=The%20WHO%2013th%20General,emergencies%20and%20promoting%20healthier%20populations.
15. World Health Organization. Draft fourteenth general programme of work. Geneva: World Health Organization, 2024. https://apps.who.int/gb/ebwha/pdf_files/EB154/B154_28-en.pdf.
16. Wirtz VJ, Hogerzeil HV, Gray AL, Bigdeli M, de Joncheere CP, Ewen MA, et al. Essential medicines for universal health coverage. Lancet. 2017 Jan 28;389(10067):403-476. doi: 10.1016/S0140-6736(16)31599-9. 
17. World Health Organization. WHO’s strategy for the Eastern Mediterranean Region, 2020–2023: Turning Vision 2023 into action. Cairo: WHO Regional Office for the Eastern Mediterranean 2019. https://applications.emro.who.int/docs/EMRPUB-RDO-014-2019-EN.pdf.
18. World Health Organization. Regional strategy to improve access to medicines and vaccines in the Eastern Mediterranean, 2020–2030, including lessons from the COVID-19 pandemic. Cairo: WHO Regional Office for the Eastern Mediterranean 2019. https://applications.emro.who.int/docs/EMRC676-eng.pdf?ua=1.
19. World Health Organization. Health workforce in the Eastern Mediterranean Region: from COVID-19 lessons to action. Cairo: WHO Regional Office for the Eastern Mediterranean 2023. https://applications.emro.who.int/docs/Health-workforce-EMR-COVID19-eng.pdf?ua=1.
20. World Health Organization. UHC service coverage index. Eastern Mediterranean Health Observatory. Cairo: WHO Regional Office for the Eastern Mediterranean, 2023. https://rho.emro.who.int/index.php/Indicator/TermID/82.
21. World Health Organization. Regional action plan for the implementation of the framework for action to improve national institutional capacity for the use of evidence in health policy-making in the Eastern Mediterranean Region. Cairo: WHO Regional Office for the Eastern Mediterranean; 2021 https://applications.emro.who.int/docs/9789290229124-eng.pdf.