Q&A: WHO's new Western Pacific director on vaccine hesitancy, UHC

Takeshi Kasai, WHO’s new regional director for their Western Pacific office, briefs the media in Manila, the Philippines. Photo by: REUTERS / Romeo Ranoco

MANILA — A hotspot for infectious diseases, the Asia and Pacific region is currently facing a measles outbreak in parts of the Philippines and a re-emergence of polio in Papua New Guinea.

This is part of the reason Dr. Takeshi Kasai, the new regional director of the World Health Organization’s Western Pacific office, emphasizes preparedness as a key priority.

“We need to prepare together. Even if one country has a very strong capacity, if its neighbor is not strong, that will pose a risk to the region,” he told Devex at his WHO office in Manila, the Philippines.

Kasai has spent over two decades responding to and managing health security threats in Japan and the wider Asia-Pacific region. He has served in a variety of capacities during his 15 years with WHO, including as regional adviser on surveillance and response and as director of the health security division in Western Pacific.

“Our organization should be country-oriented or country-centered. So I wanted to keep that approach. But then I also wanted to bring strongly the focus back to people.”

— Dr. Takeshi Kasai, regional director, WHO Western Pacific office

But as Kasai takes over leadership of Western Pacific operations, Devex spoke with the Japanese medical doctor to learn more about his priorities and perspectives, including on vaccine hesitancy, human gene-editing, and universal health coverage.

This conversation has been edited for length and clarity.

A number of countries in the Western Pacific are shifting from low to middle income. How will you balance the goal of addressing health needs of countries with varying levels of income in the region, while making sure that you're not spreading the regional office too thin?

While campaigning for the position, I confirmed there are three things that almost all member states are interested in regardless of development stages. Number one is health security, which includes how to control outbreaks of infectious diseases and how to respond to national disasters. The second is noncommunicable diseases, such as hypertension and diabetes, but coupled with aging. Third is, when I visited the Pacific island countries, they've expressed the need to address the health impacts of climate change. But this is also the issue for other developed countries.

These are the three issues that I found that's common regardless of countries' status, and I think that's going to be very much in line with our director-general’s approach that we also work with high-income countries.

There are currently measles outbreaks in parts of the United States and Europe as well as in the Asia-Pacific region. This is often traced to vaccine hesitancy. Do you find that the challenge stems mainly from misinformation, or are there other factors?

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Have you been to a measles outbreak? If you see children dying ... you’ll really feel strongly [and ask] why we didn't do more to encourage people to get vaccines. [Vaccination] is one of the most cost-effective and safe interventions to prevent those kinds of incidents. And I personally have a very, very strong commitment to make sure those things will be understood [by] people.

But you are absolutely correct that it's not that easy. But the challenge is not necessarily misinformation. Sometimes the information hasn't really reached people, particularly those living in hard-to-reach areas. When people do not receive sufficient information, they will not come and receive the vaccine.

Last year there was news about human gene-editing from China, and as a result WHO sought experts to help develop global standards for the governance and oversight of human gene-editing. What sort of governance mechanism do you think WHO should manage in the meantime?

These gene technologies have already been applied to the food sector. And then there's ongoing trial for certain treatments of human diseases, which I'm very, very excited about. But this new technology also needs to be governed with certain ethics. In general, when we have this kind of issue, usually the action will be stopped until the result comes out. So we’re waiting for the expert committee to advise us as to what extent this technology can be applied.

Japan is a huge proponent of universal health coverage. It also has one of the most advanced health systems. What do you think can other countries learn from Japan to achieve UHC?

I think one, Japan didn't see UHC as one shot, but as a cycle. It evolves depending on a country's development stage. Japan in the 1960s was very different, and obviously, that's the time they introduced UHC, which was very, very different back then, and then it kept evolving with its own share of successes and failures. But what is important is that they see it as a cycle.

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The second point, I personally see they really pay attention to services close to the community.

Third is, of course, they always pay attention to make sure there is financing, but this is not that simple. They were lucky in the past, but now even Japan has started to face a big challenge because of the aging society. They were very good at managing what services can be included in their level of development that can be sustained and then financed. But people's expectation will continue to change and it increases with the aging society.

You've been with WHO for 15 years. But now as the head of the Western Pacific regional office, what are the things that you want to continue and things that you would like to change under your leadership?

Dr. Shin Young-soo, my predecessor, really emphasized our organization should be country-oriented or country-centered. So I wanted to keep that approach. But then I also wanted to bring strongly the focus back to people. At the end when we design many new things, the key is how we really deliver to people. And that also is very much in line with the SDGs.

Additionally, Dr. Shin successfully developed a culture of change, which, if I may translate in a different word, is about encouraging staff to always think if this is the best way of delivering, or is there any other way of doing things.

Two years ago, when we checked how many changes we introduced in the past eight years — including small things, like the color of the wall — it’s 800. So in a way change is already embedded, and it's very important for me to continue to encourage people to have that mindset. I was advised by Dr. Shin that if you don't pay attention, this kind of culture might disappear.

About the author

  • Jenny Lei Ravelo

    Jenny Lei Ravelo is a Devex Senior Reporter based in Manila. She covers global health, with a particular focus on the World Health Organization, and other development and humanitarian aid trends in Asia Pacific. Prior to Devex, she wrote for ABS-CBN, one of the largest broadcasting networks in the Philippines, and was a copy editor for various international scientific journals. She received her journalism degree from the University of Santo Tomas.