Posts Tagged ‘Health’

The demographic landscape in South Asia

19 June, 2012

Recent changes in the demographic landscape of South Asia are producing handsome gains. Fertility and mortality are declining, survival chances are better and there is prolongation of later life. Demographers and public policy analysts attribute this to improved economic performance, the growing outreach of public healthcare services, and reductions in absolute poverty.
Sri Lanka has secured notable achievements, especially in its socio-demographic and health indicators.  Maldives, Nepal, Bhutan and Bangladesh are not far behind. India has reduced its fertility and mortality levels significantly. More than half of its major states have already achieved replacementlevel fertility and it is fast shaping a bulge in favour of working age youths and older adults.
Pakistan is projected to converge soon to joinothers. Afghanistan, unfortunately, remains the exception.
A growing bulge in the region’s younger population has two important economic repercussions.

• A youth bulge leads to a rise in new job seekers. Adopting appropriate economic policies to create more employment
opportunities for them holds the promise of a demographic dividend.
• A growing older population raises issues of income security and health provision.

Much of South Asia has yet to develop policies that explicitly target both these issues. Old age income security still needs to be fully addressed. Employment opportunities, particularly in the organised sector, are also severely lacking.
A South Asia regional conference was organised by the Institute of Economic Growth (Delhi) in 2008, to examine these challenges. It brought together international scholars, including demographers, economists, labour market specialists, poverty analysts and medical doctors. A selection of papers has recently been published in an edited volume,1 highlighting four dimensions of the research and policy challenge:
• Changes in country demographics of the region: opportunities and challenges.
• Bulge of the younger cohorts and meeting employment needs of the growing number of labour market participants.
• Rapid ageing and missing pillars in income and health security provision for the old.
• Achieving population and health MDGs in India and South Asia.

Two clear messages emerge from this research.

Firstly, South Asia is ill-prepared to face the challenges of ageing that will become increasingly visible over the coming years.
Second, the demographic dividend might not be fully realised, due to the failings of South Asian countries in ensuring broad-based opportunities for education, skill formation and decent work.

Read the full article at


Parks for the Poor

11 November, 2008

Yes, having some greenery around you can improve your chances in life. A new study in the Lancet finds that living near parks or woodland improves life expectancy and health, regardless of income class. People living in poorer areas are more likely to die earlier and to suffer more ill-health than the UK average. This income-related inequality in health is less pronounced in populations with greater exposure to green space, according to the study by Richard Mitchell and Frank Popham from the universities of Glasgow and St Andrews (see this BBC report).

Victorian Britain saw great efforts to bring green space to the poor. The first children’s playground was created in a Manchester park in 1859. Many of Britain’s inner city parks went into decline from the mid-twentieth century, and their regeneration began in earnest in the late 1980s. Manchester’s St Michael’s Flags and Angel Meadow Park is an example. The area became notorious in the 19th century for the mass burial of the poor whose families could not afford a proper funeral.

The charity GreenSpace is now working to improve parks and green access in the UK. We also need more efforts in the mega cities of the developing world. On a recent trip to Dhaka I was struck by the lack of accessible greenery. Much appears to have been illegally built over – including one green space now occupied by a truly hideous ‘pleasure park’ which charges for admission.

Green space is also exceptionally important to managing the impact of climate change on urban areas, a theme in Manchester University’s research on sustainable cities (check out John Handley in the School of Environment and Development). So get planting.

A Ribbon for Safe Motherhood

22 September, 2008

Every minute another woman dies during childbirth – or soon after from easily preventable causes. Many die before childbirth, in pregnancy. Death takes mothers, daughters, and wives from their communities, leaving widowers and orphans.

Today in Manchester I heard Sarah Brown and Brigid McConville speak movingly of their work with the White Ribbon Alliance for safe motherhood. WRA is an international alliance with members in 91 countries and National Alliances established in 11 – ranging from Burkina Faso to Bangladesh to Zambia. It is taking the campaign to New York this week for the UN Millennium Development Goal summit to push on the maternal health goal (MDG 5). Improvement has been limited: DFID sums it up:

“. There are two targets: one to reduce maternal deaths and the other to provide universal access to reproductive health. Little progress has been made over the past two decades and MDG 5 is severely off-track”.

Poverty is a cause of maternal death. An African woman has a 1 in 16 chance of dying from a pregnancy while a European has a 1 in 1,800 risk. And maternal mortality is a cause of poverty. The household loses not only a human life, but the income that the woman’s livelihood provides. The Chronic Poverty Report cites health crises, and the associated impact on the household’s resources (including health fees), as a big initiator of the descent into chronic poverty. This makes for hungry and sick children. Orphans are more likely to die after their mother’s death – their chance of death is three times the average for children in the 1-5 age group. One mother’s death thereby ripples across the generations.

Do check out the WRA video for their Promise to Mothers Lost campaign, and read Sarah Brown’s letter in Elle.

Making New Medicines Accessible to All

29 August, 2008

The diseases of the poor constitute an immense amount of human suffering (see our recent post on George Bush meets the Guinea worm). And they are an immense economic burden as well — both for the poor and for poor economies (which will grow faster with a healthier workforce).

Privately funded pharmaceutical research responds to incentives: and the diseases of the wealthy world supply the biggest bucks. Not enough R&D is put into the diseases of poverty. So it is to the wealthy world that the drugs are supplied. Market failure has a deadly effect. Ill-health drives people into chronic poverty and traps them there — too often until a premature and painful death.

So we are impressed by the hard thinking that has gone into The Health Impact Fund: Making New Medicines Accessible to All a new report from Incentives for Global Health. Go here to download the entire report or listen to one of the report’s lead authors, philosopher Thomas Pogge, talk about the proposal at Public Ethics Radio.

So, what’s the new idea? In brief, the proposed Health Impact Fund (HIF) seeks to correct market failure by rewarding any new medicine, if priced at cost, on the basis of its impact on global health. Any pharmaceutical company can opt to register its product with the HIF. The firm must then sell its drug at an administered price near the average cost of its production and distribution. This price applies worldwide. What does the company get compared with exercising its usual patent rights and selling at a higher price? It gets a stream of payments from the HIF based on the assessed global health impact of its drug.

Lead author, University of Calgary economist Aidan Hollis says:

“We’re not asking for corporations to give their products away … If it is used correctly, the fund would reward those drugs that have the most impact on the world and companies should earn the same amount of money as they would if they didn’t take part.”

The advantage of the scheme is that it uses the market to work for poor people and those who help them — the drugs get developed and distributed at a low cost.

The report certainly resonates with us at Manchester. Last month Manchester’s new Institute for Science, Ethics and Innovation (iSEI) together with BWPI brought together BWPI’s chair, Joe Stiglitz, and iSEI’s chair, John Sulston to debate ‘Who Owns Science?’. You can download the interview with the two Nobel Laureates on the BBC Today programme here. And don’t forget to take a look at Incentives for Global Health.

What next for George Bush? De-worming, that’s the future!

29 August, 2008

George Bush is no doubt contemplating what to do in his well-deserved retirement. He might clear some more brush on his family ranch in Texas — an occupation which he is fanatical about apparently (at least according to Laura Bush and Jay Leno). And no doubt the presidential memoirs will need some hard work.

But he might want to take a leaf out of Jimmy Carter’s book, and get to grips with the Guinea worm, a nasty piece of nature’s work (pictures here). The thin white parasitic worm bores holes through you, before emerging — very painfully — to go on to infect others.  It is a major blight on the lives of poor people in West Africa. The disability caused by the disease is seasonal, often returning around harvest time, making it the “the disease of the empty granary.” Ex-President Carter, now in his 84th year, has been working to eradicate the Guinea worm for over two decades (see FT story).

Reducing the impact of the Guinea worm is one of development’s success stories (George: read this, it’s quite short). There were 50 million cases in the 1950s according to WHO. In 1986 some 3.5 million in 20 countries were still infected. That’s down to fewer than 13,000 today in the remaining five countries where the disease is still prevalent: Sudan (where Carter convinced belligerents to agree to a six-month “Guinea worm ceasefire” in 1995 to get eradication started) as well as Ghana, Mali, Nigeria and Niger.

So, George, it could be so much more interesting than clearing brush wood. Or editing those memoirs.