Local action and partnerships for more
resilient people and communities
(IFRC, UNDP, World Bank)
2010 was a watershed year. The mega-disasters in Haiti and
Pakistan opened the eyes of the world to the impact of natural
disasters on vulnerable populations. Despite massive international
assistance, neither country has fully recovered.
Those events had three main consequences
1. International assistance must become much faster, better
coordinated, and more closely aligned with priority needs,
with constant quick adjustments in strategies and
approaches. It must be prepared to gear up quickly to
respond to the unexpected, like the cholera outbreak in Haiti.
2. Efforts must be made to strengthen resilience and reduce
vulnerability. Earthquakes and floods that same year in other
places, with well-functioning infrastructures, also for health,
were far less destructive, deadly and socially disruptive.
3. The international community must anticipate more of these
mega-disasters as the climate changes. It must also
anticipate large population displacements and the likelihood
of “environmental refugees”: people who cannot return home
because the land is scorched or flooded.
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Fortunately, many of the newer initiatives for international health
development have capacity-building as a built-in objective, with
well-designed strategies for channeling assistance in ways that
strengthen existing infrastructures and services, including the
capacity to generate and interpret basic health data.
Accountability means counting. Without basic health information,
we are pouring money into a black hole. At a time when money is
extremely tight, the momentum for better health will continue only
when we can clearly demonstrate that investments bring results.
Another trend, that became starkly obvious last year, compels the
health and development community to invest in the strengthening
of basic health infrastructures, ideally with the goal of reaching
universal health coverage.
Last year’s events included the Arab spring and protests all around
the world expressing intolerance of vast and growing social
inequalities.
These events opened the eyes of the world to the dangers of
inequality. It can topple governments and destabilize large
geographical areas.
As we also learned last year, discontent is contagious, fuelled in
part by easy access to social media.
Universal health coverage is a powerful equalizer.
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A well-functioning health system, with equitable financing that
protects against catastrophic medical bills, promotes social
cohesion and stability.
As numerous studies show, health outcomes are best when equity
and fairness are explicit policy goals, regardless of the level of per
capita spending on health. In other words, money alone will not
buy better health. Policies that aim for fairness have a much better
chance.
Equity must also extend to schemes for social protection and
health insurance. Lack of access to health services impoverishes
people because they cannot work when ill or debilitated by
disease.
Using health services impoverishes people because, lacking any
form of health protection, they pay bills out of pocket or by selling
off a household asset, sinking them even deeper into poverty.
460 words
Facts
 Annual government expenditures on health range from as
little as $1 per person to nearly $7,000.
 The difference in life expectancy between the richest and
poorest countries now exceeds 40 years.
 An estimated 2.7 billion people live in countries with no
safety net to cover medical costs.
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 Some 85 countries, representing 65% of the world’s
population, do not have reliable cause-of-death statistics.
This means that causes of death are neither known nor
recorded, and health programmes are left to base their
strategies on crude and imprecise estimates.
 In 2012, more than 50 million people in 16 countries are
expected to require humanitarian assistance.
 Hospitals and clinics are the backbone of community
resilience when disaster strikes.
 Access to new “clean energy” technologies can help these
facilities continue to function during emergencies, when they
are needed most.
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