South-East (SE) Asia regional Roadmap for results and resilience – WHO

Disclaimer: This post is for academic purposes only. Please read the original document if you intend to use them for clinical purposes.

Current landscape and vision for a healthier region:

The South-East Asia Region faces significant health challenges, and current evidence indicates a delay and deviation from the targets, particularly related to health and the health-related SDGs. Factors contributing to this include demographic shifts, climate change and environmental degradation, conflicts and humanitarian crises. Fragile health systems exacerbated by chronic under-investment, resource inadequacies, workforce shortages, and limited capacities, struggle to provide essential services.

The vision for the region, is to create a healthier, more equitable and sustainable region that encompasses empowering individuals and communities, both physically and mentally, to adopt a holistic approach to health and well-being, allowing them to reach their full potential through local solutions that address local realities. This vision is built upon four core approaches: Holistic, Equitable, Innovative, and Sustainable, with WHO acting as an Effective Enabler.

Strategic shifts and programmatic priorities:

The Roadmap builds upon past successes, such as the eight SE Asia regional flagship priority programmes (2014-2023), which demonstrated that prioritization works. Lessons from these flagships, including regional and national adaptation and ownership, dynamic policy adjustment, costing and administrative interventions, focusing on vulnerable populations, whole-of-society approach, resilient primary health care and health system and use of digital technology, inform the new approach.

A 2022 programmatic prioritization exercise with member states identified key technical priorities, such as Essential services, Emergency preparedness, Infectious hazards prevented, etc. These align with the new WHO GPW14 (14th General Programme of Work) 2025–2028, which emphasizes Promote, Provide, Protect, Power and Perform actions to accelerate SDG achievement.

Why change is Necessary?

The document stresses that a healthier region requires new ways of working for better results. Health systems need major reform to address evolving challenges such as demographical shifts, epidemiological transitions, climate change impacts, the rise of emerging and re-emerging diseases and other health emergencies. The COVID-19 pandemic highlighted the centrality of health and well-being in social and economic development ecosystems and the concept that no one is safe until everyone is safe.

Crucially, the Roadmap argues that a healthier Region requires more than targets and guidelines; it needs Action, Accountability and Capacity. Merely adding new programmatic targets will have minimal impact on the ground. Instead, the focus is on strategic tactical enablers and concerted efforts from stakeholders to bring the region “back on track”. This involves strengthening implementation know-how and building capacities across all stages of public health interventions.

Tactical Approaches for enhancing results and resilience:

The Roadmap is a strategic framework that aims to harness the synergistic contributions of WHO to support governments and partners in addressing key public health priorities and achieving sustainable health impact. It is explicitly defined as:

• Tactical approach, focusing on how WHO, governments, and partners will work.
• Catalyser for sustainable changes and better, fairer people-centred health systems.
• Enhancer for WHO’s value and contribution, leveraging its comparative advantages as the only intergovernmental UN agency for health.
• Shared framework developed through participatory consultation and jointly owned Member States, partners and WHO
• Ideological principles to guide implementation and accelerate achievements.
• Mainstreaming approach to contextualize global policy initiatives with regional demands.

The Roadmap does not replace technical/programmatic commitment, priority, strategy or plan, but acts as a catalyser and enhancer applicable across all technical program areas.

Roadmap components

The Roadmap consists of five interconnected components, designed to be universally applicable:

1: Reinforcing mental health, well-being and quality of life for all (HOLISTIC)

• Why: Mental health and well-being are often lost-in-translation concepts and receive less priority in public health programme despite their significance. There’s a need to move beyond solely focusing on mortality and morbidity to include quality of life.
• How: Integrate a mental health, well-being, and quality-of-life lens across all public health endeavours. This requires a paradigm shift and increased investment in infrastructure of mental health systems. It also encourages multisectoral actions and incorporating insights from social sciences and humanities.
• What Success will look like: Adequate consideration of the implications of mental health, well-being and quality of life in all health policy planning and strengthened mental health infrastructure that can be integrated into health system components and programmes.

2: Reaffirming investment in women, girls, adolescents and vulnerable populations (EQUITABLE)

• Why: These populations are drivers of sustainable development, and powerful agents of change. Addressing gender inequities and investing in adolescent health has multiplicative and multigenerational effects.
• How: Promote fairer health systems, by addressing health inequity, treating the ones who need the most first. This involves leveraging experiences from the Gender, Equity, and Human Rights (WHO GER) program, promoting community health models, working across health-affecting sectors, and ensuring the availability of accurate disaggregated data.
• What Success will look like: Thoughtful deliberation on the potential roles of and impact on women, children and vulnerable population groups in the design of health programmes, disaggregated health data available to trace health inequities, and meaningful collaboration with health-affecting sectors.

3: Realizing access to technology and innovations (INNOVATIVE)

• Why: Innovation is about the practical implementation of new approach(es); new ideas, methods, devices or services. Technology and other innovations (policy, management, social) are game-changers. Problems arise when access, capacity, or affordability is not realized, perpetuating inequities.
• How: Develop a comprehensive ecosystem approach for technology and innovation, with WHO playing a role in strengthening governance mechanisms and capacities to regulate and promote optimal and ethical use of technology in health. This includes leveraging big data, AI (Artificial Intelligence), social innovations, and innovative financing.
• What Success will look like: Exploring and addressing the potential of digital technology and other innovations and ensuring an enabling ecosystem for innovations in health programmes, including innovation sandbox model (i.e a safe environment that encourages stakeholders to collectively build creative, innovative concepts and solutions, without risks associated with barriers)

4: Raising capacity, knowledge management and research (SUSTAINABLE)

• Why: Capacity-building is not a disposable expense, but an investment in the bedrock of health systems. Human resources are the backbone. Knowledge management is the process of gathering, storing, and leveraging knowledge and wisdom for the betterment of health and well-being.
• How: Emphasize collective system capacity-building beyond individual training. Foster collaboration across institutions, South–South collaboration, networks of experts and change makers, communities of practice, and knowledge hubs. Strengthen WHO’s normative function by ensuring quality, timeliness, and utilization of research outputs and technical products. Promote implementation research and knowledge sharing.
• What Success will look like: Providing enough consideration to sustainable capacity-building and meaningfully engaging WHO collaborating centres and academic sectors in addressing implementation know-how.

5: Refining WHO leadership and performance (ENABLER)

• Why: WHO’s performance must be efficient and fit-for-purpose for it to fulfil its mandate. There’s a pressing need for WHO to enhance its agility, accountability, operational efficiency, and value for money.
• How: Focus on Partnership and collaboration, Strategic resource mobilization, Applying delivery strategies for country support and Participatory engagement in progress monitoring and reporting. WHO should harness its convening power for multisectoral collaboration and mobilize diverse resources beyond financial. It needs to work more end-to-end, strengthening communication and supply chain management.
• What Success will look like: WHO able to mobilize human/technical/financial resources and partnerships with academic/development/implementation agencies to support Member States.

Theory of Change and its implementation:

The Roadmap’s Theory of Change posits that its implementation, through country system capacity and country actions, will lead to the achievement of health-related SDGs and other targets. It aims to strengthen health system capacity and preparedness; strategized evidence-based and targeted public health interventions; enhanced health system resilience, monitoring accountability, collaboration, sustainability and efficiency.

Implementation will require contextualizing the concept to each public health programme and setting, as the Roadmap is a conceptual framework rather than a prescriptive set of activities. Monitoring will link to existing SDG and other agreed targets, complemented by qualitative assessments. Key success factors include ownership and engagement from Member States and partners, regular policy discourse, clear and coherent policy direction from WHO senior management, regular feedback from Member States and partners.

_{Citation: WHO South-East Asia Regional Roadmap for Results and Resilience (ROADMAP): the shared strategic framework towards a healthier Region. New Delhi: World Health Organization, Regional Office for South-East Asia; 2024. Licence: CC BY-NC-SA 3.0 IGO.}