ADB’s New Vision for Health in 2015-2020: Why, What, and How

An ADB-supported health clinic in Mongolia.
An ADB-supported health clinic in Mongolia.

By Susann Roth

Here are a few highlights from ADB’s new Operational Plan for Health 2015-2020 launched today.

Good health is essential for individual wellbeing. It helps ensure learning, productivity, income, and happiness, and is at the core of sustainable development, as well as national and regional prosperity. Almost all countries in Asia and the Pacific, regardless of their level of development, have embraced universal health coverage (UHC)—quality health services for all without financial hardship—as vital to social and economic success.

ADB launched today its new Operational Plan for Health 2015-2020 to help achieve its goal of bringing UHC to developing Asia. Here are a few highlights:

What are the main challenges for UHC in Asia and the Pacific?

All countries face challenges to providing and financing health care for their people. And while the region’s developing countries have made efforts toward achieving UHC, critical issues remain. Aging societies, changing lifestyles, population mobility, urbanization, and natural disasters are health sector challenges. Complicating matters are widening economic inequities, constrained resources, escalating health care costs, and a more prosperous citizenry which expects better health services. In short, the region needs to provide more health services – but under sustainable financing conditions. ADB is committed to providing sustainable health financing solutions for quality health care.

What is ADB's new strategy for improving health care in the region?

ADB supports our developing members countries  in meeting the United Nations post-2015 goal of expanding public and private health services, and providing health care access for vulnerable groups. The midterm review of ADB’s Strategy 2020 called for increased action to increase health sector investments. After studying the needs of developing Asia, investments in health infrastructure, health governance, and health financing were recommended with a specific focus on areas such as human resources, regulation and licensing, social health insurance, underpinned by tools like  ICT and public-private partnerships (PPPs).

The plan supports 3 focus areas to address key challenges:

  1. Infrastructure. Optimize health outcomes and increase the reach of health care from infrastructure projects such as health facilities and hospitals, and ensure that infrastructure is integrated into health systems, managed and staffed efficiently, and properly operated with sustainable financing.
  2. Governance. Advance health care through good governance and regional public goods by strengthening institutions, planning, financial management, and health information and regulatory systems.
  3. Financing. Expand health care though innovative financing that promotes allocation and technical efficiency.

To fund health care efforts over the next 5 years, ADB will increase health sector investments from 1%-2% of the total portfolio in 2014 to 3%-5% (or an annual approval of $ 1 billion in health sector projects) by 2020.

What is ADB's plan of action for improving health care in the region?

ADB’s operational plan for health offers new and innovative ways to strengthen existing programs and implement new ones; ensures health care quality, efficiency and cost-effectiveness; and fosters collaboration with developing member countries, development partners, and centers of excellence to build responsive health systems that create the foundation for UHC.

Taking a new direction, the plan will:

  • Steer the region toward outcome-driven practices and away from output-based business as usual.
  • Support innovative, evidence-based approaches—underpinned by ICT—for building and managing health services.
  • Foster investments in integrated and cost-effective programs that expand the supply of public and private health services and offer financing to create health-services demand.
  • Promote PPPs that lead to larger lending amounts and reduced transaction costs.
  • Cultivate co-financing to develop new business and innovative activities.
  • Mainstream gender to take advantage of the role women play as a health care driver and ensure their health status increases in both rural and urban areas.

How will ADB roll out its new operational plan for health?

To achieve national and regional UHC goals, ADB will partner with governments and the private sector along 4 business lines, to deliver:

  1. Infrastructure for integrated health services delivery.
  2. Elderly health care for an aging region.
  3. ICT for accountability and decision-making.
  4. Health financing and public and private insurance to help governments move from input-based health budgets to output-based payment.

Across these 4 business lines, ADB will launch flagship programs that build on our existing health projects and decades of successful health sector operations. Rolled out in two phases in eight to twelve countries, these programs will provide lessons learned, support analytical work and knowledge sharing, and achieve concrete results.

Phase 1 (2015–2018) will build on proven areas within our current health sector portfolio. Flagship programs will include urban health in South Asia; equitable health insurance in East and Southeast Asia; efficient service delivery in the Pacific, and East and Southeast Asia; regional health security in Southeast Asia; and integrated hospital care in East Asia.

Phase 2 (2018–2020) will broaden the range of ADB health sector projects even further. Flagship programs will include elderly care in East Asia; e-health; integrated hospital care in Papua New Guinea; and private sector financing for health services.

How will ADB promote partnerships and collaboration?

Operational success will depend on maintaining strategic partnerships and alliances. ADB’s health sector group will:

  • Collaborate with the World Health Organization to develop monitoring frameworks with performance indicators that measure achievements toward UHC.
  • Develop and deepen alliances with multilateral and bilateral partners to strengthen programs; funds and foundations to identify cofinancing; and centers of excellence and technical agencies to improve the health capacity of ADB in developing Asia.
  • Reach out to other operational sectors within ADB to identify and monitor the contributions of non-health sectors to health outcomes, and create important health-related synergies.