Concern over the lingering global crisis and its implication for the formal sector of the economy, especially the alarming reduction of investments in key social services like health, infrastructure, among others, various experts who weighed the pros and cons of the current economic recession at a week-long conference in Bamako, Mali, proffered multi-prong solutions toward addressing the crisis.
Echoes of the old era of structural adjustment programmes, an IMF policy regime designed to impose fiscal austerity on developing countries during the debt crisis which hit most of these countries in the mid to late 80's, continue to exert a restraining influence on virtually all aspects of the social sector, including essential services like national healthcare systems and infrastructure.
However there are fears that the current global financial meltdown, which has consumed a lot of hitherto big businesses in the United States, United Kingdom, other European countries and Asia and Africa, even poses clear and present dangers on the social systems across the globe, especially in developing countries in Africa.
The foregoing were some of the concerns raised at the Global Ministerial Forum on Research for Health, held at Bamako, Mali last week.
Over 1,000 participants including ministers of health and their counterparts from the ministry of science and technology, donor agencies, civil rights groups, among others attended the week-long forum, which ended with a communiqué reading session with a mandate to implement the Bamako Call for Action, among other targets.
For the majority who raised their voices above the din, what was uppermost in their minds was what the future holds for the world in the area of equitable distribution of resources to address social needs, especially among medium and low income economies in the continent of Africa and beyond in the face of the recurring economic crisis assailing the world.
At different panel sessions and separate interviews with The Nation, a cross-section of experts spoke on the adverse effects and possible impacts of the global financial crisis on the socio-economic systems in the world, especially within the continent of Africa.
Firing the first salvo was Dr. Timothy Evans, a Canada-born assistant director-general of the World Health Organisation (WHO), observed that the era of structural adjustment may be over, but the effects of earlier damage continue to cast a long shadow on possible fears of what could happen if the social sector is made to bear the burden of an incurably defective fiscal policy.
Evans, who described the Structural Adjustment Programmes (SAP) as "a fiscal policy lacking a human face" recalled that the introduction of the IMF-driven initiative further led to the collapse of the social systems with grave implications for the poor, majority of whom require social security to survive.
Way forward
To forestall a repeat of past experience, he said it was necessary for the world leaders among other decision makers to seek to expand resources meant for social services like healthcare rather than sacrificing it on the altar of economic expediency.
"There are lots of measures to adopt when there is economic recession like we are experiencing around the world now. Rather than making essential services like the health systems to suffer the burden of such crisis, it is best to seek a middle way," he said.
Expatiating, he said "There are lots of alcoholic products and beverages, tobacco products and what have you being produced and sold on a large scale. The government can decide to get more vats and taxes from such products and so on. It can do this successfully backed by legislation and enforcement."
Echoing the same views, Professor Rolf Korte, Chair, Technical Evaluation Reference Group of the Global Fund, an organization which funds intervention programmes for malaria, tuberculosis and HIV/AIDS, maintained that nothing untoward should be done to reduce resources meant for healthcare delivery programmes, due to potential grave consequences for the overall well-being of the people.
"We should not repeat the mistake of the 80's which led to the introduction of SAP. By all means we must strive to balance the budgets, particularly for health services you cannot cut down, especially research budget because without research for instance, you cannot do ATS combination therapy for pregnant women, among others," said Korte.
Korte, who heads the Institute for Hygiene and Environmental Health at the Giessen University, said if belt-tightening measures were not best for minimizing cost of health services because of the implications such measures could have on other sectors which depend on a virile health system to survive.
He would rather the government expand the coverage of health at times of economic recession because of what he described as "the immense benefits" to both the micro and macro economy as a whole.
For Ok Pannenborg, a US-based Chief Health Financier for the World Bank, there is a linkage between productive outcomes and health, hence there is a need to boost the health budget, especially among African countries.
Corroborating Pannenborg, the President of the Republic of Mali, Amadou Toumani Toure, said one way to galvanize action towards addressing the imbalances in the health sectors in the continent of Africa is by investing in science and technological research knowing full well that research remains the key driver of sustainable socio-economic, political development.
President Toure made this clarion call while formally declaring open the forum said there is a strong need for the establishment of "a culture of research for health in Africa", adding "strategies of public health and care in this 21st century are based on scientific evidence and Africa must control science and technology.
"The experience of developing and emerging countries indicates that investing in scientific research and technological innovation, is a way of insuring the future in the health, political, economic, social and cultural sectors."
In a chat with The Nation, Garance Upham, a multi-disciplinarian who is also the general secretary, Safe Observer International, a non-profit, non governmental organization involved in advocacy for safety in the diagnosis of HIV/AIDS, said she was among a team of experts who had foresaw the current global financial crisis and subsequently advised on measures to avert same, but nobody heeded the advice at the time.
Upham, an American-born social activist and economist, stated that the global financial crisis is already having a toll on the social systems in the United States, a development she said is not a cherry news at all.
According to her, "As at August, the crisis has led to job losses affecting over 20 million people and that figure could increase to 30 million by the end of the year. In the world today there are still 2.5 billion people who have to get by on less than $2 a day. And this is the most challenging social problem of our times."
The way to go, she said is for governments across the world to take pragmatic steps towards mitigating the effects of the crisis rather than exacerbating it.
Role of donor agencies
Christiana Zarowsky, Programme Manager, Canada -based International Development Research Centre, IDRC, one of the world's leading institutions in the generation and application of new knowledge to meet the challenges of international development, said her organization is addressing itself to the global financial crisis with regards to funding various country interventions.
"One of the programmes of research in IDRC," she said, " is around globalization, growth and poverty and we would be working with researchers in the South to see what are the issues that are facing different countries in the South, how can they protect themselves and engage with the setting more effectively."
"Recently you may have seen the IDRC's book called 'Safeguarding the health sector during times of economic instability' so, that was the work that was done to forestall the SAP and I think it is equally valid now. So, we seek to bring back evidence from earlier times of economic and financial crisis the impact to be brought to bear on decision making."
She continued, "But in terms of our own funding, we would in the first instant ensure that the multi-grant commitment would be protected. And this would be applicable for every grant agreement that we sign."
"We can say we hereby approve a grant of $500,000 for five years subject to the end of the parliamentary year. But if parliament shot us down because economy collapses then that's all. We think that it is very unlikely to happen. We would look first to see whether savings that can be made. Or find out do we need to focus on some countries, what issues should be addressed on a broad level on a project which makes more sense. So, it's really around efficiency."
On what Global Fund is planning to do at this point in time of the global financial crisis, Korte said: "With regard to the global crisis, I think we are all knowledgeable from the newspaper. However I had the privilege of being a part of the Global Fund meeting and issues with regards to funding were discussed. And I sensed from that meeting that there is a very strong move to retain the level of fund and not that it should get rippled away by the economic crisis now because the Global Fund has developed a momentum and I think there is a strong intent of the board of the Global Fund to keep that momentum going. Whether this would be successful or not I think this is for all of us to determine. But the sums of money that are currently being discussed at international fora are so huge than the little bit of money going to the Global Fund and really missing in the international community."
Advice to donor organizations
While nothing that one of the trend in the health sectors, is the tendency by donors to want to scale down on budgetary expenses for health, Zarowsky however argued that many of the development agencies were not completely averse to operational research knowing full well that it remains the core support for health system.
"You can't run a health system if you have no way of checking in on whether it is working or not. For us at the IDRC, emphasis is on funding more research."
She however made a passionate appeal to the media to support advocacy in that direction "to stimulate debate, to find out is it the case that we can do without research for health and all of that."
ORIGINAL ARTICLE (The Nation website)
