1. Life Impact | The University of Adelaide University of Papua New Guinea Economic Development Lecture 11: Health

2. University of Papua New Guinea Slide 1 Lecture 11: Health Michael Cornish Overview Introduction Why increasing income is not enough… Education and health: The case for joint investment Measuring health Women and health Disease burden –Case Study: HIV/AIDS in PNG Policy options

3. University of Papua New Guinea Slide 2 Lecture 11: Health Michael Cornish Introduction Safeguard against productivity losses Again: tool or objective? Moral imperative? Deaths before age 5 –1950: Developing world: 28% –2005: Least developed countries: 11.4% Middle income countries: 3.7% Developed countries: 0.7%

4. University of Papua New Guinea Slide 3 Lecture 11: Health Michael Cornish Under 5 Mortality Rates

5. University of Papua New Guinea Slide 4 Lecture 11: Health Michael Cornish Top 10 Causes of Death in Low-Income Countries Source: World Health Organization, 2008

6. University of Papua New Guinea Slide 5 Lecture 11: Health Michael Cornish Life Expectancy

7. University of Papua New Guinea Slide 6 Lecture 11: Health Michael Cornish Why increasing incomes is not enough… Income / health: causality runs in both directions Income effects on nutrition and preventative healthcare Simultaneous focus? Spillover effects –Endogenous growth model; K ̄

8. University of Papua New Guinea Slide 7 Lecture 11: Health Michael Cornish Education & health: The case for joint investment Investment in health increase return to education: –School attendance –Concentration levels –Development of the adult mind –Child mortality –Life expectancy –Using education productively

9. University of Papua New Guinea Slide 8 Lecture 11: Health Michael Cornish Education & health: The case for joint investment Investment in education increases return to health: –Understanding health issues –Tuition on health issues –Health professionals

10. University of Papua New Guinea Slide 9 Lecture 11: Health Michael Cornish Measuring health World Health Organization [WHO] Life expectancy Disability-adjusted life year (DALY) Distribution of health Rural/urban divide Height as proxy Measuring returns...

11. University of Papua New Guinea Slide 10 Lecture 11: Health Michael Cornish Women and health Child health outcomes The ‘missing women’: 100 million women –Poor treatment –Less investment in education –Physical labour –Less healthcare spending

12. University of Papua New Guinea Slide 11 Lecture 11: Health Michael Cornish The Gender Gap

13. University of Papua New Guinea Slide 12 Lecture 11: Health Michael Cornish Disease burden Similar to dependency burden Diseases of the poor: –HIV/AIDS –Malaria –Tuberculosis (‘TB’) –Lower respiratory infections –Cholera –Dengue fever –Parasites

14. University of Papua New Guinea Slide 13 Lecture 11: Health Michael Cornish Total: 33.3 million [31.4 million – 35.3 million] Western & Central Europe 820 000 [720 000 – 910 000] Middle East & North Africa 460 000 [400 000 – 530 000] Sub-Saharan Africa 22.5 million [20.9 million – 24.2 million] Eastern Europe & Central Asia 1.4 million [1.3 million – 1.6 million] South & South-East Asia 4.1 million [3.7 million – 4.6 million] Oceania 57 000 [50 000 – 64 000] North America 1.5 million [1.2 million – 2.0 million] Central & South America 1.4 million [1.2 million – 1.6 million] East Asia 770 000 [560 000 – 1.0 million] Caribbean 240 000 [220 000 – 270 000] Adults and children estimated to be living with HIV Source: World Health Organization, 2009

15. University of Papua New Guinea Slide 14 Lecture 11: Health Michael Cornish Disease burden Why don’t these diseases exist in the developed world? –Climate –Eradication programs –R&D focus

16. University of Papua New Guinea Slide 15 Lecture 11: Health Michael Cornish Case Study: HIV/AIDS in Papua New Guinea Current estimate: approx. 2% population with AIDS 2025 prediction: –10% population with AIDS –Workforce reduced by 12.5% –GDP reduced by 1.3% –70% of medical beds used for people with AIDS Disease vectors Access to information on AIDS Condom usage

17. University of Papua New Guinea Slide 16 Lecture 11: Health Michael Cornish Case Study: HIV/AIDS in PNG

18. University of Papua New Guinea Slide 17 Lecture 11: Health Michael Cornish Case Study: HIV/AIDS in Papua New Guinea Economic effects: –Lower domestic savings – important? –Shift in expenditure focus – opportunity cost –Reduction in size of labour force –Increased cost of employment

19. University of Papua New Guinea Slide 18 Lecture 11: Health Michael Cornish Policy options Role for government R&D Health services Health education International responses –International aid –International eradication (e.g. smallpox)

20. University of Papua New Guinea Slide 19 Lecture 11: Health Michael Cornish “I’m not afraid.... I have a shield...”