Proceedings of Annual Switzerland Business Research Conference 12 - 13 October
2015, Novotel Geneva Centre, Geneva, Switzerland
ISBN: 978-1-922069-86-3
Public Health Expenditure, Climate Changes and Corruption in
the MENA Region: A Granger Causality Approach
Dr. Hanan Hamed M. Sileem*
The growing literature on studying climate change has increased awareness
among governments to act on mitigation and adaptation measures; however
the target is still far from done. Thus, the current study contributes to
understanding granger causal links between environmental degradation and
public health costs by analyzing the relationship between health (as
measured by public health expenditure per capita) and environmental
degradation (as measured by CO2 emissions per capita) for a panel of 19
MENA developing countries using annual data covering the period 1996
through 2013. In particular, can government health costs contribute to
environmental degradation? Using panel data specifications, the paper
identified a two way relationship between public health expenditure and CO2
emissions. These empirical results signify the contribution of CO 2 emissions
accumulation to the increase of public health expenditure. In addition, the
current paper explores causal relationship of public health expenditure to the
level of corruption. To do so, a robust Granger causality test on the direction
of the relationship between public health expenditure and corruption is done.
The empirical results highlight the presence of a two way relationship
between public health expenditure and corruption. Corruption is a channel
through which environment impacts health costs. This shows that corruption
could be considered as a constraint for environmental quality. Surprisingly,
combining the interesting results for corruption impact on public health
expenditure has significant policy implications for maximizing the benefit of
both mitigating climate change effects in general and achieving effective
health expenditure for the MENA economies in specific. Evidence and
anticipation of adverse health effects will strengthen the case for
preventative policies, and will also guide priorities for planned adaptive
strategies.
JEL codes: O13 and Q5.
1. Introduction
Over the last few decades, the continuous rise in the global temperature due to
anthropogenic activities had accumulated Green House Gases (GHGs) in what is known
by global warming. Theoretical and practical evidence suggests that the Middle East and
North Africa (MENA) region will face several Health hazards due to climate change. The
expected adverse impacts of global warming on sustaining life will include lowering fresh
water per capita, shrinking arable land, increasing heat waves, reducing rainfall, declining
productivity of crops and decreasing food security, declining air quality and increasing
frequency of dust storms, damaging vulnerable coastal zones. World Health Organization
(WHO) estimates that the MENA Region is the second most affected area in the world
next to the African Region (Al-Yousfi and Malkawi, 2014).
*Lecturer at Economics Department, Sadat Academy for Management Sciences, Cairo, Egypt,
email: hanan@sadatacademy.edu.eg, mailing address: 108 El Mahata St., Giza, Egypt, +202-01220472747
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Proceedings of Annual Switzerland Business Research Conference 12 - 13 October
2015, Novotel Geneva Centre, Geneva, Switzerland
ISBN: 978-1-922069-86-3
Environmental determinants have a crucial role in more than 80 of the major diseases and
injuries worldwide with diarrheal diseases and respiratory infections heading the list; for
instance almost 4 billion infections and 2.2 million deaths are due to diarrhea around the
world, mostly children in developing economies (Sanglimsuwan, 2010). However, the
economic factors remain the main challenge facing the region. In particular, the rapid
increase in GHG emissions costs MENA region an estimated annual environmental
damage around US$ 9 billion. Over recent decades, the MENA region has witnessed new
developments that are consuming the region’s environmental stock. The region contributes
with 7% of global GHG emissions; more importantly, in the last 20 years, MENA's
emissions grew by 88% (Economic Research Forum, 2010). Environmental degradation is
responsible for about 24% of the burden of disease, leading to more than 1 million deaths
(Al-Yousfi and Malkawi, 2014). This in turn can further delay the MENA economies and
imposes significant harm to livelihoods, public finances. In particular, the public health
expenditure is expected to increase with the growing climate change problems.
The current paper focuses on the relationship between public health expenditure (as
indicator for the cost of environmental degradation) and environmental variables in
different economies. In addition, this paper addresses the impacts of corruption on public
health expenditure. The problem with corruption is that it only affects vulnerable and poor
segments of the community. Corruption especially impacts public health services because
of the involvement of several public sector funds. This corruption can take many forms, for
instance, higher costs and longer wait-times result in significant barriers to health care and
increasing immortality rates. In this sense, Poor groups are exposed to broader
inequalities at the point of service delivery, with small hope to influence policy (Nawaz,
2010). Given “differentiated and greater needs for health services”, developing and low
income economies are particularly impacted by health sector corruption, by limiting their
access to resources and their rights as well as imposing higher costs especially if
accounting for climate change costs (Sileem, 2015).
This paper examines how corruption can be a substantial factor for climate change
adaptation in the MENA region. This research defines corruption in terms of poor
governance, lack of accountability for informal payments. Acknowledging the adversarial
implications of corruption, the research reframes solutions to this issue by promoting
accountability and good governance in heath sector. The empirical findings of the current
research contribute to the environment quality management literature by identifying the
causality relationship between controlling corruption and the CO2 emissions costs for
health using Granger casualty test for the MENA economies. The next section discusses
the link between environmental degradation and health expenditure in the region. Then,
the paper provides literature review, followed by the methodology and model of granger
casualty test for Public health expenditure and CO2 emissions; finally the research
presents recommendations to reduce climate change costs on health.
2. The costs of climate changes on health in the MENA region
The global warming triggers adverse effects on health, particularly in the form of higher
death rates caused by: (i) lower access to fresh drinking water; and (ii) more transmitted
infectious diseases. The WHO identified four major climate-related health problems
(malnutrition, diarrhea, flooding and malaria). In particular, the MENA economies suffer the
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Proceedings of Annual Switzerland Business Research Conference 12 - 13 October
2015, Novotel Geneva Centre, Geneva, Switzerland
ISBN: 978-1-922069-86-3
most substantial human loss as estimated by the WHO in Table (1). In particular, WHO
estimates 38 million disability-adjusted life years (DALYs) lost each year in the region. In
economic terms, this DALYs loss can be translated into an estimated annual loss of US$
144 billion (Al-Yousfi and Malkawi, 2014)
Table 1: The Impact Of Climate-Related Health Threats
Region
Annual number of DALYs*
Low- and middle-income countries of the
2320000
South-East Asia Region
Low- and middle-income countries of the
2029000
African Region
Low- and middle-income countries of the
745000
Eastern Mediterranean Region
Low- and middle-income countries of the
190000
Western Pacific Region
Low- and middle-income countries of the
80000
Americas
High income countries Developed economies
16000
*DALYs are the number of expected life loses due to premature mortality, in addition to years of productive
life lost due to disability. Source: World Health Organization, 2015.
Fresh water is critical source for production, poverty elevation and sustainable
development. One third of the global population is expected to be water-stressed, if sealevel increases and floods the rivers. In general, People would feel the water disturbances
in seasonal and annual basis, where some regions would face droughts, while other will
face floods with any increase in temperature. More specifically, the stress on water
resources is expected to double in areas that already dry in south and Central America,
Southern Africa and MENA region (Al-Yousfi and Malkawi, 2014). In particular, the MENA
region is dominated by the Sahara and Arabian deserts, two of the world’s driest zones
Many of these economies have no adequate infrastructure to face more droughts; Higher
temperature induces more pressure on the growing population's demand for fresh water
and food. This will be a severe threat to human life in these economies; they will be more
vulnerable with less fresh water associated with less rainfall triggered by higher
temperatures (Stern, 2006).
Furthermore, the global warming will impose further threats on human life. The altered
weather patterns affect the latitude, altitude, intensity and seasonality of many infectious
diseases. In addition, human health and welfare would also affect, because of pest-borne
diseases, e.g. malaria, yellow fever, and cholera (Downie, Brash and Vaughan, 2009).
This is because warmer temperatures associated with longer growing seasons, and in the
absence of pest-killing sub-zero temperatures, extend the habitant ranges for diseases
and their carrier insects (Dow and Downing, 2006). Already over one million person are
dying from malaria every year. Malaria is carried by mosquitoes, which are sensitive to the
rise in temperature, humidity and soil moistures. Thus, diseases such as malaria are
expected to reach new regions, such as Northern America, and Europe. Moreover, people
will suffer from heat stress and fever with the increase in temperature (Stern, 2006).
Finally, the loss of cold weather that keeps germs at bay, according to some studies would
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Proceedings of Annual Switzerland Business Research Conference 12 - 13 October
2015, Novotel Geneva Centre, Geneva, Switzerland
ISBN: 978-1-922069-86-3
decrease people vulnerability and immunity to resist diseases (Gore, 2006; Al-Yousfi and
Malkawi, 2014).
More than 75% of the MENA area's population is mainly dependent on rain-fed agriculture.
As most African areas, this area does not have many sustainable water infrastructures,
with few exceptions, e.g. the Nile delta and Nile valley. By 2050, water scarcity will be a
major issue because of the estimated reduction in Delta flows associated with the
expected growing population (Downie, Brash and Vaughan, 2009). Thus, water problems
combined with higher levels of temperature will decrease agricultural productivity and
trigger several other economical, financial and social consequences in the region. In
particular, crops such as maize, which is the main source of food in the MENA region, will
decrease by 15-25% with the continuous rise in temperature (Stern, 2006).
Furthermore, air pollution from transportation is costing Arab economies annually 5 billion
US$. In particular, pollution costs Egypt almost 5 % of its GDP. Both Morocco and Algeria
are next in line with a loss equals 3.7% and 3.6% of their GDP; followed by Syria (3.5%),
Lebanon (3.4%) and Jordan (3.1% of GDP), and finally Tunisia lost around 2.1% of its
GDP (Economic Research Forum, 2010). WHO estimates that in each year, indoor and
outdoor air pollution kill about 145 thousand and 117 thousand people respectively (AlYousfi and Malkawi, 2014). In terms of human loss, Table (2) presents actual deaths in
MENA economies in year 2010.
Table 2: Deaths Due To Air Pollution Per 100 000 Population In
The MENA Economies in 2010
country
Indoor pollution
Outdoor pollution
Bahrain
0
0.00
Iran, Islamic Republic
0
0.49
Kuwait
0
0.03
Morocco
2
0.59
Qatar
0
0.08
Syrian Arab Republic
4
0.21
UAE
0
0.04
Bahrain
0
0.00
Lebanon
0
0.05
Saudi Arabia
0
0.25
Libya
1
0.32
Tunisia
1
0.08
Iraq
2
1.83
Yemen
33
0.82
Djibouti
6
3.90
Oman
0
0.07
Jordan 0
0.41
Egypt
1
0.25
Source: World Health Organization (2015)
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Proceedings of Annual Switzerland Business Research Conference 12 - 13 October
2015, Novotel Geneva Centre, Geneva, Switzerland
ISBN: 978-1-922069-86-3
3. Literature Review
The published literature estimates for future health effects of climate change over next
decades, so far, have mostly focused on heat stress, extreme weather events, and
infectious diseases, as well as estimates of future decrease in food production and hunger
prevalence. An emerging trend addresses a wider range of health risks due to the social,
demographic, and economic costs of climate change.
3.1. Environmental Health
Almost every human disease is triggered by an environmental exposure, i.e. breathing
contaminated air, drinking contaminated water, or eating a contaminant. Environment and
health have been examined at the micro-level studies. There are very limited studies at the
cross country level. This is primarily due to the lack of a coherent data and consistent
measures describing the extent and frequency of bad health across economies.
Nevertheless, Katsouyanni et al. (1997) found that increases in SO2 and particulate matter
are associated with total mortality by using panel data for twelve European cities.
However, using time series analysis, Neuberger et al. (2003) found that Particulate matter
is consistently associated with respiratory problems in Austrian urban and rural areas. On
the other hand, Chay and Greenstone (2003) results showed that 1% reduction in total
suspend particulate can reduce 0.35 percent infant mortality rate.
Sanglimsuwan (2010) studies the interrelationships between health status, environmental
quality and economic growth for 80 economies in 1990, 1995, and 2000. Using panel data
with fixed effects specification, the study found the positive relationship between life
expectancy rate and economic growth. Particulate matter has negative impacts on life
expectancy rate; whereas demographic factors such as population density and the
percentage of people in urban area have positive impacts on life expectancy rate.
3.2. Granger causality
There is a limited literature on examining Granger causality tests in a panel context
((Hoffmann et al., 2005); (Lee, 2009)). An interesting study was conducted by Wright and
Craigwell (2011). They examined Granger causality between corruption and economic
growth in 42 developing economies using linear and non linear panel techniques for the
period covering 1998 to 2009. Their findings show that the outcome of the causal
association depends on the method used; corruption appears to Granger-cause economic
growth when the linear panel causality tests are applied and economic growth seems to
Granger lead corruption with the non-linear panel methods.
Sileem (2015) examines the existence of the Modified EKC relationship between CO2
emissions per capita and Human Development Index in the MENA economies for the
period 2004-2013. Using panel data with Fixed Effects specification, the empirical results
indicate the existence of MEKC for the MENA region economies. In addition, empirical
results support the significance of controlling corruption on decreasing CO 2 emissions. A
robust Granger causality test on the direction of the relationship between corruption and
CO2 emissions per capita is examined. The results of the Granger causality test confirm
the presence of a unidirectional relationship between CO 2 emissions per capita and
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Proceedings of Annual Switzerland Business Research Conference 12 - 13 October
2015, Novotel Geneva Centre, Geneva, Switzerland
ISBN: 978-1-922069-86-3
corruption, and that corruption seems to Granger-cause CO2 emissions in MENA region.
These findings are consistent with the growing trend suggesting the sensitivity of granger
causality test to the size of the sample or the technique of estimation.
Chen, Clarke and Roy (2014) contribute to understanding dynamic links between wealth
and health by analyzing the relationship between health (as measured by infant mortality
rate) and wealth (as measured by GDP per capita). Using cross-country heterogeneity with
temporal homogeneity slope, the study examines the granger causal links between wealth,
income and infant mortality rate using panel data for 58 developing economies for years
1960 to 2005.
3.3. The choice of Environmental variables
An indicator for environment degradation has to be among the six identified GHGs
pollutants to account for accumulation in GHGs, such as CO2. The early climate change
literature focused mainly on local air pollution emissions (Olsen, 2007). This was later
extended to include global emissions, solid wastes and natural resources extraction
(Kallbekken, 2000). However, climate literature used other pollutants as well, such as
Sulfur Dioxide (SO2). Some studies used Particulate matter, sulfur oxides, nitrogen oxide
(NOX), and carbon monoxide (Sanglimsuwan, 2010).
However, using CO2 as a more valid and reliable proxy for climate change is more
common across climate literature (Olsen, 2007). This is due to many reasons: (i) CO2
concentrations remain for a longer time in the atmosphere; (ii) Second, CO2 constitutes
almost the majority percentage of GHGs accumulations that are contributors to global
warming as indicated in Table (2) (Houghton, 2005); (iii) CO2 is highly correlated with other
pollutants; the correlation coefficient of CO2 with NOX and SO2 in 111 countries was
estimated in 1990 to be 0.9529 and 0.9536 respectively (Hoffmann et al., 2005).
Table 3: The Main GHGs And Their Contribution Ratio In Global Warming
Name
Gas
GWP
Contribution in Lifetime
GHGs
Carbon dioxide
CO2
1
72 %
5-200 years
Methane gas
CH4
23
18%
12+/- 3years
Nitrous Oxide
N2O
296
9%
114 years
perfluorocarbons
CF4120Low percentage
100 years
C2F6
12000
hydrfluorocarbons
HFCs
5700Low percentage
12 years
11900
sulphur hexafluoride
SF6
22200
Very low
32000 years
percentage
Source: Based on Houghton (2005); Dow and Downing (2006).
4. The Methodology and Model
The public health expenditure is expected to increase when there are climate change
problems; however, projecting the other way around remains to be untested and has many
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Proceedings of Annual Switzerland Business Research Conference 12 - 13 October
2015, Novotel Geneva Centre, Geneva, Switzerland
ISBN: 978-1-922069-86-3
vague areas. Using panel data for granger causality test can assist in increasing the
degrees of freedom to overcome the sensitivity of the test to the size of the sample; as well
as it can help in reflecting the cross-country heterogeneity with temporal homogeneity
slope.
4.1. Econometric Framework
The methodology of Granger causality depends on testing a two way relationship between
two variables in two separate regressions. The first regression is to test whether X
Granger-cause Y and the second regression examines whether Y Granger-cause X. The
test itself examines how much of the current values of Y are explained by previous values
of Y and whether taking lagged values of X into account would improve the explanation or
not. X is said to Granger-cause Y if the forecast for Y is improved when lagged values of X
are included in the estimation, i.e. the coefficients of lagged values of X are statistically
significant. However, Granger causality measures only the effect of X in predicting or
forecasting Y, and it is not necessary to be the only cause of Y. Accordingly, the equations
estimated take the following forms:
Y i ,t  (lagged(Y i ,t 1 ,  X i ,t 1)) 1i ,t
 X i ,t  (lagged( X i ,t 1 , Y i ,t 1)) 2i ,t
(1)
(2)
4.2. Research Hypothesis
.
 There exists a two way relationship between CO2 emissions and public health
expenditure.
 There exists a two way relationship between public health expenditure and
corruption.
4.3. Data Construction and Sources
To examine these hypotheses, the sample of the research is the MENA region economies
over the period covering the years from 1996 to 2013. The Appendix lists all the
economies included in the sample. The total number of observations is 324. The data
collected are:
Carbon Dioxide Emissions per Capita: it measures the environmental degradation;
measured in ton per capita. The data on CO2 were obtained from the World Bank Open
Data Base, for years 1996 to 2013.
Health expenditure: it measures total government expenditure in health sector per capita.
Total health expenditure is the sum of public and private health expenditures as a ratio of
total population. It covers the provision of health services (preventive and curative), family
planning activities, nutrition activities, and emergency aid designated for health but does
not include provision of water and sanitation. Data are in current U.S. dollars. The data is
obtained from the World Health Organization website from 1996 to 2013.
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Proceedings of Annual Switzerland Business Research Conference 12 - 13 October
2015, Novotel Geneva Centre, Geneva, Switzerland
ISBN: 978-1-922069-86-3
Corruption: It reflects perceptions of the extent to which corruption is controlled. The data
on Corruption ranges from the value of -2.5 to 2.5. The value of "-2.5" is assigned to weak
governance while the value "2.5" is assigned to strong governance performance in
controlling corruption. Data obtained from the Worldwide Governance Indicators website
from year 1996 to year 2013.
4.1 Granger Causality Test specifications
4.4.1 Granger causality test for CO2 emissions and public health expenditure
The Granger causality test related to CO2 emissions and health expenditure relationship
for MENA economies includes the estimation of the following two equations.
 HEXP
i ,t
 (lagged( HEXP i ,t 1 ,  CO
)) 
2 i ,t 1 1i ,t
 CO  (lagged( CO
,
)) 
2 i ,t
2 i ,t 1 HEXP i ,t 1 2i ,t
(3)
(4)
where HEXP is public health expenditure per capita in MENA economies, CO2 is carbon
dioxide emissions per capita to reflect environment degradation in MENA economies, and
ε it is the error term for this OLS estimation at time t for country i. The first regression is to
test whether CO2 emissions Granger-cause health expenditure; and whether health
expenditure Granger-causes CO2 emissions for the MENA economies is tested in the
second regression.
4.4.2 Granger Causality Test for public health expenditure and corruption
The Granger causality test related to health expenditure and corruption relationship for
MENA economies includes the estimation of the following two equations.
 CORR i ,t  (lagged( CORRi ,t 1 ,  HEXP i ,t 1))  2i ,t
 HEXP
i ,t
 (lagged( HEXP i ,t 1 ,  CORRi ,t 1))  1i ,t
(5)
(6)
where HEXP is public health expenditure per capita in MENA economies, CO 2 is carbon
dioxide emissions per capita to measure environment degradation in MENA economies,
and ε it is the error term for this OLS estimation at time t for country i. The first regression
is to test whether health expenditure Granger-causes corruption; and whether corruption
Granger-causes health expenditure for the MENA economies is tested in the second
regression.
5. The Findings
5.1. The empirical results of CO2 emissions and public health expenditure
The main estimation results of Granger causality test to identify the relationship between
CO2 emissions and public health expenditure are reported in Table (4).
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Proceedings of Annual Switzerland Business Research Conference 12 - 13 October
2015, Novotel Geneva Centre, Geneva, Switzerland
ISBN: 978-1-922069-86-3
Table 4: Granger Causality Test Results for MENA Countries*
Null Hypothesis
F-Statistic
Probability Decision
CO2 does not Granger-cause HEXP
HEXP does not Granger- cause CO2
3.18083
39.3631
0.0430
0.0000
Reject Null
Reject Null
*The results are for all coefficients jointly to test for Granger Causality in the case of a two period lags.
At 5% level of significance, the null hypothesis of the first estimation which is CO 2 does not
Granger-cause HEXP is rejected; this means that CO2 Granger-cause health expenditure
in the MENA region. The null hypothesis of the second estimation which is HEXP does not
Granger-cause CO2 is rejected at 1% level of significance. It means that health
expenditure Granger-cause CO2 emissions in MENA region. These results indicate that
there is a two way relationship between public health expenditure and CO2 emissions in
MENA region. The results are evidential in climate policy implications. It provides
additional evidence on the environment degradation impact on health costs.
5.2. The empirical results of public health expenditure and corruption Granger
causality test
The main estimation results of Granger causality test to identify the relationship between
public health expenditure and corruption are reported in Table (5).
Table 5: Granger Causality Test Results for MENA Countries*
Null Hypothesis
FProbability
Decision
Statistic
HEXP does not Granger- 28.2004 0.0000
Reject Null
cause CORR
CORR does not Granger- 43.6771
0.0000
Reject Null
cause HEXP
*The results are for all coefficients jointly to test for Granger Causality in the case of a two period lags.
At 1% level of significance, the null hypothesis of the first estimation which is HEXP does
not Granger-cause CORR is rejected; this means that HEXP Granger-cause corruption in
the MENA region. The null hypothesis of the second estimation which is CORR does not
Granger-cause HEXP is rejected as well. It means that corruption Granger-cause health
expenditure in MENA region. These results indicate that there is a two way relationship
between corruption and public health expenditure in MENA region. These results
significantly provide strong evidence for the need of preventive policies to guide the
adaptation measures in low income economies.
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Proceedings of Annual Switzerland Business Research Conference 12 - 13 October
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ISBN: 978-1-922069-86-3
6. Conclusion and Policy Implications
This paper has summarized the recent climate impacts on health in the MENA region,
exploring the high burden of environmental risks from diseases in the Region, and at the
same time highlighting the two way relationship between health costs and corruption. A
dedicated strategy for health and environment in the region should compact corruption to
ensure a cost-effective environmental health associated with prevention as well as
mitigation measures.
The first interesting outcome of the estimation is the two-way relationship between
environmental degradation (measured by CO2 emissions) and public health expenditure; in
particular, the relationship indicating that public health expenditure seems to Grangercause CO2 emissions in MENA region. It depicts that lack or the incompetence of public
health services can actually contribute to environmental degradation; especially for poor
and vulnerable population who have not been informed or educated about the healthy
techniques of cooking or heating because of their inability to pay for good health services.
This is consistent with WHO estimates concerning the reasons causing air pollution
deaths. The WHO projected that air pollution deaths are mainly triggered by due indoor
pollution, where about 170 million people still burn solid fuels for cooking and heating
especially in low income economies (Al-Yousfi and Malkawi, 2014). In addition, a growing
research trend in examining health economics supports the proposition that only healthier
people can reduce cost of treating disease reflected in lower expenditure of both
household as well as public health sector (Sanglimsuwan, 2012). Recognizing the
significant relationship between public health expenditure and environment quality, is
possible through a regional framework action.
Thus, the right health strategy should also be designed to support economies of the
Region in their efforts to reduce the disability and premature mortality caused by
environmental risks. An integrated and comprehensive management approach for the
adverse health effects of climate change is crucial. A collective health action plan would
include both prevention measures associated with mitigation climate change measures, for
example:







Developing health adaptation strategies to climate;
Enhancing the capacity of the health sector to evaluate, monitor, regulate and
manage environmental risks;
Allowing an effective and transparent system for measuring, reporting emissions is
crucial to reduce GHG emissions at the national level and ultimately to the success
of financing mitigation strategies.
Building the institutional capacity of the health sector to confront extreme weather
events,
Reinforcing surveillance in the areas of infectious and respiratory diseases, food
insecurity, and malnutrition
Establishing early warning systems on climate-sensitive diseases.
Taking advantage of the solar resources in the MENA region provides an excellent
basis to build a renewable energy market and a healthy environment with clean
techniques.
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Proceedings of Annual Switzerland Business Research Conference 12 - 13 October
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ISBN: 978-1-922069-86-3
Another interesting outcome of the paper estimation is the significant two-way relationship
between corruption and public health expenditure. Acknowledging this relationship
redefines corruption in terms of individuals experiencing its adverse effects in their daily
lives. Corruption is, thus, a channel through which environmental degradation affect health
costs. This could mean that corruption can be a constraint or environmental quality.
Therefore, a cost-effective and comprehensive public health strategy would analyze
corruption based on poor service delivery, informal payments and poor accountability. To
this end, a comprehensive and active health action plan should take in account good
governance that promotes accountability as well as combats corruption from prevention to
mitigation measures. This outcome adds to the analysis by highlighting the need to the
involvement of both the ministries of health in the Region with other governmental actors
to set the priorities of a consistent health policy with two pillars: ensuring accountability
and adopting clean development techniques. This can involve the following measures:






Monitoring and assessing strategic actions and procedures jointly by all interested
parties to insure accountability;
Strengthening partnerships both inside and outside the public health sector to
address the emerging challenges;
Equipping the health sector with environmental norms and assessment tools for
motivating stakeholders to integrate health protection measures into their
development processes;
Prioritizing health strategy at the centre of sustainable development policies through
measuring and promoting health gains for development targets;
Strengthening partnership and leadership roles of the health sector for mobilizing
resources and coordinating actions of relevant sectors and providers of
environmental health services;
Careful monitoring, quick learning and active responding to close entry points for
corruption are essential to ensure that strong good governance generates
supportive conditions for climate mitigation at this critical stage.
To sum up, promoting accountability and implementing anti-corruption efforts, will enable
and prioritize sustainable development. It is essential that a collaborative multiagency
approach is adopted, emphasizing the leadership role of the health sector in terms of good
governance and accountability responsibilities, as well as motivating other specialized
environmental health service providers.
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Proceedings of Annual Switzerland Business Research Conference 12 - 13 October
2015, Novotel Geneva Centre, Geneva, Switzerland
ISBN: 978-1-922069-86-3
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Proceedings of Annual Switzerland Business Research Conference 12 - 13 October
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Appendix
The MENA list includes 19 economies: Algeria, Bahrain, Egypt, Jordan, Kuwait,
Lebanon, Morocco, Oman, Qatar, Tunisia, United Arab of Emirates, Syrian Arab Republic
and Saudi Arab kingdom, Yemen, Iraq, Djibouti, Libya, Iran and West Bank and Gaza.
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