DRAFT
ECOSOC
Health Ministers Meeting
Challenges for Health Systems
following Crisis
Colombo
16-18 March
Presentation Outline
• Introduction
• Trends in Asia-Pacific
• Impact of Crisis on MDG
• Financing Recovery
Introduction: Crisis Prevention & Recovery
• 1998 UN General Assembly mandate
• 2001 -- Crisis Prevention and Recovery as
one of UNDP’s practice areas
• 2008-2011 UNDP strategic plan includes
crisis reduction and recovery as key result
Asia-Pacific Development Trends
• Dynamic, diverse and fast economic growth
• Region is on track to achieve some MDG
targets:
– Reducing income poverty
– Providing universal Primary education
– Gender parity in primary school enrollment
• Slower progress in others:
– Health: underweight children
– Water and sanitation
– Deforestation
Asia-Pacific- Crisis Trends
• Number, frequency and severity of natural disasters
in Asia-Pacific
• Some of the oldest and newest conflicts are in this
region
– 16 Countries in the region are facing internal or external conflict
– Conflict dynamics are context specific but underlying causes are
similar ( uneven distribution of wealth, land, resources, identity
etc)
• Region not immune to global shocks
– Financial, food, oil crises
– Epicenter of Avian flu
CRISIS impacts on MDG
Achievement
Impact of Crisis on MDG Achievement
Regional impacts:
• Regions not just nations are vulnerable:
– war, conflict mainly intra-state with spill-overs to
neighboring countries
– Negative impact on all MDG achievement Demographic
changes, losses economic levels, loss of services,
infrastructure, social capital as well as social infrastructure
• Cumulative economic effect of conflicts:
– impact on current and future budgets with decreased
public investment in health, education, poverty reduction
and weakens the machinery of government
Eradicate extreme poverty and hunger
• Direct impacts
– Damage to housing, service infrastructure, saving, productive
assets and human losses reduce livelihood sustainability.
• Indirect impacts
– Negative macroeconomic impacts including severe short-term
fiscal impacts and wider, longer-term impacts on growth,
development and poverty reduction.
– Forced sale of productive assets by vulnerable households
pushes many into long-term poverty and increases inequality.
Achieve universal primary education
• Direct impacts
– Damage to education infrastructure.
– Population displacement interrupts schooling.
• Indirect impacts
– Increased need for child labour for household work, especially
for girls.
– Reduced household assets make schooling less affordable, girls
probably affected most.
Improve maternal health
• Direct impacts
– Pregnant women are often at high risk from death/injury in
disasters.
– Damages to health infrastructure.
– Injury and illness from disaster can weaken women’s health.
• Indirect impacts
– Increased responsibilities and workloads create stress for
surviving mothers.
– Household asset depletion makes clean water, food and
medicine less affordable.
Combat HIV and AIDS, malaria
and other diseases
Direct impacts
• Poor health and nutrition following disasters
weakens immunity.
• Two-thirds of the global burden of HIV infection
occurs in complex crisis contexts
• Creates vulnerable situations for HIV among
women and girls :
• HIV/AIDS is a cross cutting issue and should be
addressed during the humanitarian response phase
Combat HIV and AIDS, malaria
and other diseases
• Need to provide un-interrupted HIV-related
services and goods (condoms, HIV medicines,
prevention information etc) to populations of
humanitarian concern
• It is fundamental to build an HIV response in
crisis management plans, particularly at the
early recovery phase to generate recuperative
processes for post-crisis recovery.
Areas of Support
• Conflict prevention
– address the structural causes of violent conflict through
programmes that promote participation, dispute resolution
and gender equality, transparency and accountability.
• Armed violence prevention:
– supports armed violence prevention by focusing on both
structural factors (socio-economic inequalities, weak
governance systems) and the weapons themselves.
• Natural disaster risk reduction:
– supports disaster-prone countries in integrating risk
reduction into human development.
Areas of Support
Recovery:
– focuses on restoring recovery capacities of
institutions and communities
– Restoring Security: de-mining of farms and fields,
reduce small arms and reintegration of former
combatants
– Social cohesion and reconciliation: Transitional
justice mechanisms are an initial step to
restoration of citizens' faith in a justice system
and rule of law.
Financing Recovery
Global Review Financing Recovery
• 2006-2008 –Flash Appeals
–
–
–
–
17% of early recovery funding requirement was met,
Unfunded gap of 83%.
53% of humanitarian funding assistance was met
Unfunded gap of 47%.
• 2006-2008 CAPs
–
–
–
–
44% of early recovery funding requirement met
unfunded gap of 56%.
78% of humanitarian requirement met,
unfunded gap of 22%.
Financing Recovery Con’t
Global Review Financing Recovery
• 2006-2008 CERF
– A total US$1,002,863,476 was approved for 20 projects in
natural disaster and conflict countries
– Of which US$ 29,856,408 was approved for early recovery i.e.
3% of total funding for the period of the sample under review
Financing Recovery Con’t
Financing Recovery Con’t
Financing Recovery Con’t
Financing Recovery
• An analysis of the early recovery financing revealed:
– Economic recovery and infrastructure sector attracted the
greatest level of funding - 30% of the total received.
–
–
–
–
–
Health (2%),
Education (1%),
Logistics (1%),
water and sanitation (4%)
Mine action (2%), protection (6%), shelter (1%)
Other Gaps in Early Action
• A strategic gap:
– Lack of an early recovery strategy process that integrates political,
development and humanitarian tools.
• A financing gap:
– Lack of timely and flexible funds for activities that fit neither in
humanitarian windows narrowly defined nor development windows
traditionally operated.
• A capacity gap:
– Inability to consistently build national capacity early on to lead recovery
efforts; and
– Inadequate multilateral capacity to bring the international community
together; and get the right people on the ground at the right time
(including civilians).
Financing Post-Crisis Recovery
In post-disaster and conflict contexts:
• Fast, flexible and predictable funding for early recovery
planning and programmes to bridge the relief - recovery
longer-term development financing;
• In post conflict settings - early support to stabilization
and inclusive access to services to pave a prgrammatic
path to peace building
• Yet the financing gaps render any talk of sustainable
recovery impossible