Evaluate the role of WHO technical assistance in building health-system capacity in developing countries of South Asia.

WHO technical assistance supplies expertise, norms, training and validation rather than large-scale finance. The Maldives shows both its strengths and its limits. Around 1976, a WHO assignment brought Dr. S. Kameswaran of Madras Medical College to Malé as the first ENT expert ever to visit [1]. Overall, WHO support is a strong catalyst, but the capacity lasts only where countries back it with their own money and staff.

Strengths: WHO as a capacity catalyst

• A template for building institutions: the 1976 mission went beyond treating patients. It surveyed ENT disease, held clinics, trained health personnel and helped set up ENT units in health centres [1].

Survey → Special clinics → Training of staff → Permanent ENT units

Fig.: WHO's technical-assistance chain, Maldives, ~1976

• Links to global networks: in 2023, WHO recognised Indira Gandhi Memorial Hospital (IGMH) in Malé as a National Influenza Centre [2].
• Setting and validating standards: in 2025, WHO validated the Maldives as the world's first country to achieve triple elimination of mother-to-child transmission of HIV, syphilis and hepatitis B. IGMH served as the national reference laboratory [3].
• Preparedness: in 2025, the Maldives launched its EMS Guidelines with WHO and the ADB. The work targets a core problem: islands spread across vast stretches of ocean [4].

Limitations: what technical advice cannot fix

• Care is still concentrated in one hospital: IGMH remains the only public-sector tertiary hospital, and six regional hospitals depend on it for referrals [5].
• Too little money for primary care: WHO's Regional Director said this has raised the cost of tertiary care and made hospitals more crowded [6]. Advice cannot replace domestic spending.
• Trained staff do not stay: the country relies heavily on expatriate doctors, and turnover is high, especially in the atolls [7].
• Gaps left to bilateral donors: large infrastructure needs come from bilateral help, such as the Government of India-funded renovation of IGMH [8]. This calls for coordination with WHO's work.

In sum, WHO has added real capacity in South Asia, from the first ENT units in 1976 to a world first in disease elimination. Its impact lasts when countries put more money into primary health care, keep their own health workers in service, and align WHO's technical work with bilateral partners such as India under Neighbourhood First. Doing so would advance SDG 3.8 (Universal Health Coverage) and confirm WHO's role as an enabler.