12 January 2015
Vientiane - The Lao People’s Democratic Republic is in a period of robust economic growth and dynamic change. One would applaud the remarkable progresses in socio-economic developments and poverty reduction; with annual average growth of 8 per cent since 2006 and a US$12.79 billion economy, Laos is certainly enjoying one of the highest growth rates in the region.
This has enabled the country to halve poverty since 1992, and the government has set the target to reduce the poverty rate further from 23.2 per cent in 2012 to 19.17 per cent in 2015. The per capita income is estimated to reach US$1,700 for 2015.
Much of this progress can be attributed to large increases in foreign direct investment (FDI), and the transformation of the country as a supplier of natural resources in the region, mainly energy, minerals, timber, forestry and hydropower which comprise more than half of Laos’s total wealth.
However, the vast increase in FDI and corresponding economic growth have not been harnessed sufficiently for food security, poverty reduction, job creation, inclusive growth, better education and health care services for the population, particularly those living in remote rural communities.
The key challenge is to ensure that natural resource wealth can be transformed into government investments in public infrastructure, health and education and other basic services; address the deepening disparities among urban and rural communities, improving access to basic service making growth equitable and inclusive.
In term of progress in health, life expectancy in Lao PDR has increased from 63.9 years in 2009 to 68 years in 2012 (World Bank Statistics); and we only need to look around us to see that people are living healthier and longer lives.
But un‐regulated FDI and accelerated economic growth can be double-edged, improving the livelihoods of the people, but also creates some negative impacts on environment and society. One in eight of total global deaths or around 7 million people in 2012, died as a result of air pollution exposure, making air pollution the world’s largest single environmental health risk.
Lung cancer is the most commonly diagnosed cancers worldwide, total cancer burden has also increased from 7.6 million cancer deaths in 2008 compared to 8.2 million cancer deaths in 2012. We only have to observe the number of motor vehicles on the road in Lao PDR; which has exploded tremendously over the last couple of years to consider the impact on the environment. Carbon dioxide emission is on the rise, and air pollution is a common problem seen in most developing countries which directly impact health.
Another environmental factor is water and sanitation, the country has increased the rural population access to an improved water source to 65% in 2012; we see the narrowing of the urban-rural gaps. Overall, 82.2 per cent of population in Lao PDR has access to water sources, and 63.2 per cent for sanitation in 2013-4; the country is currently on track to achieve the 82.5 per cent for water and 63.5 per cent for sanitation target set respectively for MDG 7.
Water, sanitation and hygiene and air pollution have direct impact on childhood deaths related to diarrhea and pneumonia, which are leading causes of deaths for children under five in the country.
In WHO Western Pacific Region, about 12 000 women die each year while giving birth. Laos is one of only 19 countries in the world to have already achieve the MDG 5 maternal mortality target at 220 per 100 000 live births. Severe bleeding during childbirth is the most common cause of pregnancy-related deaths. Improving access to safe blood and blood products is vital to save mothers’ lives.
In 2014, Lao PDR celebrated the achievement of maternal-neonatal tetanus elimination. Laos has indeed come a long way, given that in 2001, it had one of the world’s highest neonatal tetanus rates accounting for more than 40 percent neonatal deaths.
Recording every birth and death, making every life counts is essential for evaluating progress and improving a country’s national system to record births, deaths and cause of deaths. In 2014, Lao PDR completed its first ever maternal deaths review and findings were used to review maternal health service delivery and why mothers die. It is important to improve access to hospital services so that mothers can receive the treatment care they need.
Improving immunization services has also been proven to be a cost effective tool to control and eliminate life-threatening infectious diseases, averting 2 to 3 million deaths globally each year. Measles and rubella vaccine are given to children aged 9 months to less than 10 years of age in 2014 through a nationwide campaign.
MDG 6 relating to halving HIV/TB/Malaria targets have been met; Laos remained a low prevalence country for HIV, but WHO has warned of failure to provide adequate HIV services for key high risk groups; men who have sex with men, people in prison, people who inject drugs, sex workers and transgender people will threaten the global progress on HIV. These people are most at risk of infection yet are least likely to have access to HIV prevention, testing and treatment services.
An estimated 9 million people globally developed TB in 2013, of which 1.5 million have died. Efforts are intensified to improve collection and reporting of data on tuberculosis and this has revealed that there are almost half a million more cases of the disease than previously estimated.
In 2014, WHO published its “World Malaria Report 2014” which revealed that the number of people dying from the disease has fallen dramatically since 2000 and cases are steadily declining. The malaria mortality rate decreased by 47% worldwide from 2000 to 2013; the disease took 44 lives in Lao PDR in 2012 and 28 lives in 2013. Artemisinin resistance was found in Champassack Province making Lao PDR the fifth country in the Greater Mekong Sub-region with partial artemisinin resistance.
Laos has made great strides in economic growth and this should translate into more investment in health development by the Government of Laos on health infrastructure and health service delivery. Graduating from the LDC in 2020 is achievable given the current economic growth, and achieving universal health coverage by 2025 can definitely be realized with the sustainable growth and investment.