South-East Asia Regional Conference on Epidemiology

Economic crisis and health of the poor:
evidence matters
Jacques Jeugmans
Global economic slowdowns are likely to have adverse impacts on the education, nutrition and health
of the people. Governments, international organizations and donor agencies react to economic crises
by adapting policies and reallocating resources to mitigate these adverse impacts. But in a crisis, there
are many competing demands. Therefore, it is important that public health specialists must develop
strong advocacy skills to protect the interest of public health, particularly for the poor and other
vulnerable groups. Advocacy is much more effective when supported by evidence, data and sound
analyses. It is important for public health specialists to understand and use arguments that decisionmakers
understand. This paper, based on the work of <strong>Asia</strong>n Development Bank (ADB) colleagues
and others, will first describe how economic analyses and data can help develop better policies to
protect health, especially for the poor. Then, the preliminary results of a rapid survey led by Professor
Soonman Kwon, who tried to collect real-time data and information on the impact of the ongoing
crisis on the health of the poor in the <strong>Asia</strong> and the Pacific Region, will be presented. And, finally, I
will conclude with some recommendations.
1. Global economic crisis: channels of transmission
How does a global economic crisis eventually affect the health, education and nutrition of the people
locally (Fig.1) (1)? In a globalized economy, particularly in <strong>Asia</strong> and the Pacific, trade in goods and
services, foreign direct investments (FDIs) and remittances are driving the economic growth. In a
global slowdown, trade, remittances and FDIs decrease, which then reduce the economic growth
of many countries. In the present crisis, financial markets have also been disturbed, which has
further affected most economies. At the local level, unemployment increases and incomes decrease,
both at the household and public sector levels. Because of unemployment and reduced incomes,
household poverty increases and thus private spending on health and education diminishes. While
poverty increases, lower tax collection and bankruptcies reduce governments’ revenues. With less
revenue, governments have less fiscal space and face difficulty in maintaining social protection
programmes, sometimes even forced to consider reductions in public spending for education and
health. While demand for social services increases because of increasing poverty, supply (by
governments) is difficult to maintain because reduced government incomes limit governments’
spending. Reduced social spending by both households and governments has adverse impacts on
health and education.