Implementation of a universal healthcare system at the country level is crucial

South Asia has seen advancements in public health, but these improvements are notable primarily when compared to Sub-Saharan Africa, particularly in areas such as life expectancy, maternal mortality, and mortality rates. Sri Lanka’s comprehensive and high-quality healthcare system, offering free healthcare, stands out in the region. However, challenges persist, including a shortage of health professionals, limitations in infrastructure, and difficulties in enhancing public health quality.

To address these challenges, the implementation of a universal healthcare system at the country level is crucial, and regional cooperation becomes essential for meaningful integration. Collaborative initiatives, including telemedicine, joint research on infectious diseases, and regional pharmaceutical production, are identified as potential solutions. Pooling resources for research and development in medicine and vaccine development, as well as addressing financing issues and developing an emergency support system, are key considerations.

The lack of a dedicated healthcare vehicle system and the absence of a structured regional integration framework contribute to the difficulties faced in cross-border healthcare issues. The experience of COVID-19 revealed the need for enhanced regional collaboration, as demonstrated by the Association of Southeast Asian Nations (ASEAN) model. Integration efforts should extend to administrative processes, diplomatic facilitation, and official payment systems to ensure comprehensive regional integration in public health.

These are some of the insights that emerged at the parallel session C2 of the Fourteenth South Asia Economic Summit (SAES XIV) titled ‘Cooperation in Public Health’ held on 5 November, 2023.

The Chair of the session, Dr Hossain Zillur Rahman, Chairperson, BRAC, Executive Chairman, Power and Participation Research Centre – PPRC, Former Advisor to the Caretaker Government, Bangladesh, said that the discussion of the platform, needed for regional health system integration, should not be tied to the political dimension of SAARC office. There are more avenues of discussion for regional collaboration on other platforms such as education, private section involvement, instruments of incentives and so on.

‘Telemedicine plays a crucial role in establishing an inclusive healthcare system, particularly because rural areas often lack access to quality healthcare services’ highlighted Dr Ganga Tilakaratna, Research Fellow and Head of Poverty and Social Welfare, Institute of Policy Studies of Sri Lanka (IPS).

Dr Syed Abdul Hamid, Professor, Institute of Health Economics, University of Dhaka, Bangladesh, urged ‘We require a dedicated cross-country healthcare vehicle system integrated into the regional transportation network’.

‘Diseases know no borders, and this phenomenon has been occurring for years, with the COVID-19 outbreak serving as a recent example’ cautioned Dr Prabir De, Professor, Research and Information System for Developing Countries (RIS), India.

Dr Rudra Suwal, Lead/Coordinator, Economic Development Programme, Nepal Development Research Institute (NDRI), Nepal, suggested ‘Political commitment should play a pivotal role in facilitating regional integration in public health, as shortages of funding and human resources pose significant obstacles’.

‘Health education is a collaborative learning process that should not merely flow in one direction from the educator to the recipients. Instead, it should be intertwined with the community’ proposed Ms Sabina F Rashid, PhD, Professor, Mushtaque Chowdhury Chair in Health and Poverty BRAC James P Grant School of Public Health, BRAC University, Bangladesh.

The speakers at the session also said that education and knowledge-sharing are vital components of public health integration. There is a call for collaboration in research, universities, and education curricula within South Asian countries. Acknowledging the disparities among SAARC countries in child mortality rates, the importance of institutional capacity and the role of global organisations in addressing health challenges were emphasised.

The discussion underscored the need for political commitment, learning from successful national health insurance schemes, and developing a regional cooperation framework with horizontal and vertical integration. Overcoming funding and human resource shortages, sharing technology, and fostering political commitment are essential for achieving regional collaboration and ensuring quality healthcare in South Asia.

High-level policymakers, political leaders, academics, development practitioners, civil society activists from Bangladesh and the South Asian region attended the session and shared their valuable insights.