DRAFTECOSOC

Health Ministers Meeting

Challenges for Health Systems following Crisis

Colombo16-18 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 diseasesDirect 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