Health Ministers of the WHO South-East Asia Region today adopted the Dili Declaration on Human Resources for Health: Equity in Specialized Care, committing to strengthen the health workforce and ensure that all people, including those living in rural, remote and underserved areas, have access to quality specialized health care.
The Declaration, adopted at the Seventy-ninth Session of the WHO Regional Committee for South-East Asia, recognizes that while access to quality specialized care is critical to achieving universal health coverage, it is far too often limited for those most in need.
While the Region has made major gains in expanding its health workforce, significant challenges remain in ensuring equitable access to specialists. Shortages persist across many specialties. Moreover, specialists are often concentrated in urban centers, tertiary and private-sector facilities, leaving rural, remote, poor and underserved populations with limited access to essential specialized services.
“Our challenge, therefore, is not simply to produce more health workers. It is to ensure that the right skills are available in the right places, responding to the health needs of our populations,” said Dr Nilesh Buddha, Officer-in-Charge, WHO South-East Asia Region.
The Dili Declaration calls for Member States to align health workforce planning, education and financing with current and future population health needs, and to strengthen policies for the attraction, recruitment, deployment, retention and performance of specialist health workers, particularly in rural and underserved areas.
It also calls for better use of existing health workforce capacity through multidisciplinary teams, task-sharing, family medicine, specialist outreach, mentoring and strengthened referral systems.
Member States committed to accelerate safe, equitable and regulated use of digital health technologies, including telemedicine, teleconsultation, teleradiology, telepathology, electronic referral systems and artificial intelligence-supported clinical tools.
“Innovation must extend quality care, not create a lower standard of care for people living in underserved communities,” said Dr Buddha.
The Declaration identifies the need to strengthen national capacity for high-priority specialized services – including cancer, cardiovascular care, trauma, maternal and newborn care, mental health, geriatric, rehabilitative and long-term care. It also calls for strengthened health workforce information systems, implementation research and evidence generation to guide policy and investment.
Recognizing that many workforce and health-system challenges transcend national borders, Member States also committed to facilitate regional collaboration through information exchange, sharing of good practices, joint specialist training, clinical mentorship, professional exchanges and telemedicine collaboration.
The Declaration calls for the establishment of a regional network of health professional regulators and policymakers to strengthen cooperation and support countries in addressing shared challenges.
“The proposed regional network of health professional regulators and policymakers can provide an important platform for that cooperation – enabling us to share evidence and experience, strengthen regulatory capacity, learn from successful innovations and build solutions together,” the Officer-In-Charge said.
The Declaration emphasizes that equitable access to specialized care must go hand in hand with strong primary health care. It builds on the 2023 Delhi Declaration on strengthening primary health care, recognizing that primary health care and specialized services are mutually dependent parts of an integrated health system.
“There is no choice to be made between strong primary health care and equitable access to specialized care. Rather, they are mutually dependent parts of the same health system,” the Officer-in-Charge said, adding, “Our task is to connect them.”
“Ultimately, equity in specialized care will be measured not by the number of specialists we train or the technologies we deploy. It will be measured by whether a woman facing an obstetric emergency, a person living with cancer, a child requiring surgery, or a family living far from a major city can get quality care when they need it,” said Dr Buddha.
The Dili Declaration is a commitment by Member States to make specialized care more equitable, people-centered and accessible – and to ensure that progress in health workforce development translates into better health for everyone.