1. DRAFT ECOSOC Health Ministers Meeting Challenges for Health Systems following Crisis Colombo 16-18 March

2. Presentation Outline Introduction Trends in Asia-Pacific Impact of Crisis on MDG Financing Recovery

3. 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

4. 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

5. 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

6. CRISIS impacts on MDG Achievement

7. 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

8. 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.

9. 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.

10. 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.

11. Combat HIV and AIDS, malaria and other diseases Direct 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

12. 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.

13. 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.

14. 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.

15. 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%.

16. 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

17. Financing Recovery Con’t

20. 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%)

21. 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).

22. 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