Poverty Alleviation Programme

Poverty Alleviation Initiatives Volume 13, No. 4, October – December 2003

ISSN 0 858-334 X

ESCAP

Economic and Social Commission for Asia and the Pacific – Poverty and Development Division

Committee boosts poverty reduction efforts

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he three-day inaugural session of UNESCAP’s Committee on Poverty Reduction took place from 8 to 10 October in Bangkok. H.E. Chaturon Chaisaeng, Deputy Prime Minister of Thailand, inaugurated the sessions.

Over 100 participants from Ministries of Finance, Planning, Rural Development, local government officials, national statistical offices and UNESCAP experts in poverty reduction attended the meeting. 24 member and associate members of ESCAP, 12 United Nations bodies and specialized agencies, and four intergovernmental agencies were represented. The aim of the Committee was to enable UNESCAP members to better design and implement pro-poor policies to attain the eight United Nations Millennium Development Goals (MDGs), particularly the first goal of eradicating extreme poverty and hunger by half by the year 2015. The sessions included a policy dialogue on resource mobilization for the eradication of poverty, an assessment on the statistics needed for poverty measurement and a review of poverty reduction practices by the secretariat. The predicted down-turn in economic growth in the region and the lack of reliable data about poverty levels emerged as major challenges for reducing poverty. In the final report the Committee asked ESCAP to pool together the development experiences of countries in the region and ensure greater cooperation and exchange of ideas and information. The secretariat should also assist and facilitate the strengthening of government and civil society partnership in poverty reduction efforts and help in sharing the experiences of countries that were taking decentralization reforms. Along with other multilateral institutions ESCAP should provide technical assistance to countries reforming their budgetary system to implement zero-based budgeting for increasing efficiency of resources spent by government. Such assistance could include provision of technical support and consultation services on the projects on unit cost estimation of public services and a regional adviser, if requested, on national budget reforms. The Committee urged the secretariat to place especial emphasis on capacity building and capability enhancement of the implementing agencies in the formulation and implementation of poverty reduction programmes. In particular it drew the attention to the need to strengthen the capacities of implementing agencies at the local level since it recognized that the most effective interventions are at the micro level.

ESCAP works towards reducing poverty and managing globalization

POVERTY ALLEVIATION INITIATIVES

Regarding statistics, the Committee noted that sound poverty measurement at the country level depended on the national statistical system as a whole. A regional action plan to improve poverty statistics and support the MDG goals was needed and suggested that the Subcommittee on Statistics be given the mandate to endorse such a draft plan.

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The meeting had the chance to discuss the resolution from the Civil Society Forum, held as a parallel event (see page 4). This was the first time that there was a civil society segment in ESCAP’s committee meetings and the general feedback from member countries taking part was that the event was useful and provided an additional input into the success of the meeting.

It was stated that good poverty analysis requires good quality data and called for increased international efforts to develop alternative measurements of poverty and to standardized concepts and methodology in this field.

For more information, please check ESCAP’s website www.escap.org or contact the Poverty and Development Division at [email protected].

INSIDE: ESCAP Poverty and Development Division ●

Committee boosts poverty reduction efforts

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Civil Society calls for a more comprehensive understanding of poverty and hunger

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Key Role for Cooperatives in Poverty Reduction Efforts

ILO

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FAO ●

Sub-regional organizations will discuss food security

UNICEF ●

Early Childhood Care and Development project offers a better start for Myanmar’s poorest children

UNIFEM ●

Thai weavers leave lasting impression in East Timor

WHO ●

WHO highlights the relation between health and poverty

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POVERTY ALLEVIATION INITIATIVES

OCTOBER – DECEMBER 2003

A world that is not advancing towards the Millennium Development Goals – a world mired in the deprivation of hunger, the prevalence of disease and the despair of poverty – will not be a world at peace. On this day, as we recall the link between poverty and hunger, let us also recall the link between development and peace. And in that spirit, let rich and poor alike rededicate themselves to achieving the Millennium Development Goals.

EDITORIAL

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n 17 October, with the occasion of the International Day for the Eradication of Poverty, Secretary-General Kofi Annan noted the close links between poverty and hunger. Approximately 1.2 billion people struggle to survive on less than a dollar a day. An estimated 840 million suffer the gnawing pain of hunger, and as many as 24,000 people, many of them children, die every day as a result. People who are hungry are more susceptible to disease, and find their capacity to work diminished as well. Hunger also impairs children’s ability to learn, with consequences that are felt long after childhood is over. There is no time to lose if we are to reach the Millennium Development Goal – agreed by all the world’s countries – of halving by 2015 the proportion of people who live on less than a dollar a day and the proportion of people who suffer from hunger.

This last issue of the year 2003 represents the end of a period for the Poverty Alleviation Initiatives Newsletter. In 2004 ESCAP will review its continuation in the current format and study the most effective ways of disseminating across the region initiatives in the area of poverty reduction. At the same time, the Poverty Reduction Section of ESCAP is upgrading its web page, where it will feature a description of their projects and activities in both urban and rural development. Readers of PAI are encouraged to turn to our web page for updated information on our initiatives in this field, as well as to the respective websites of the other organizations members of the thematic working group on poverty and food security. This working group is composed of the offices in Bangkok of UNICEF, UNDP, UNEP, UNFPA, UNIFEM, ILO, FAO, UNESCO and WHO.

The achievement of that goal – and all the other Millennium Development Goals – depends on many things. But none is more vital than forging a truly global partnership for development – which is itself one of the Millennium Development Goals. Such a partnership requires bold reforms from many developing countries. But it also requires bold action from developed countries.

http://www.unescap.org/pdd/prs

An essential component is a trading system that is both free and equitable. The failure of the recent World Trade Organization meeting in Cancún to reach agreement on reducing and ultimately phasing out tariff and non-tariff barriers is a source of great concern. These barriers shut out many developing countries from the markets of developed countries – stunting growth, stifling opportunity and starving millions of people who want to trade their way out of poverty.

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The Monterrey and Johannesburg conferences on financing for development and sustainable development also set out key parameters and commitments for building a global partnership for development. Some progress has been made, but much more needs to be done to meet those commitments.

Queries can be directed to: Mr Yap Kioe Sheng Chief, Poverty Reduction Section [email protected]

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ESCAP

Economic and Social Commission for Asia and the Pacific – Poverty and Development Division

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OCTOBER – DECEMBER 2003

Civil Society calls for a more comprehensive understanding of poverty and hunger

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he Asia Pacific Civil Society Forum was organized in Bangkok during 6-8 October 2003 as a side event of ESCAP’s Committee on Poverty Reduction (8-10 October 2003). Representatives from a range of civil society organizations (about 30 participants from 14 countries in the Asia and Pacific region) participated in the forum and discussed the MDGs and the eradication of extreme poverty and hunger.

advised to affirm and operationalize rights based approaches to poverty eradication. Civil society organizations have already adopted this approach in their fight against poverty. ❑

The Forum provided critical views on MDGs as well as a wide range of proposals and recommendations aimed at improving current poverty eradication strategies and policies. Following are the Forum’s concerns and recommendations, presented at a policy dialogue session of the Committee of Poverty Reduction: ❑

In its opinion, the MDG sidelines the more critical and important issue of human rights. Certain norms and standards are particularly pertinent in addressing the problem of poverty, such as effective non-discrimination, the recognition of vulnerable groups, the right to an adequate standard of living, the right to be free from hunger, the right to economic self-determination and the right to development. The Committee was

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The MDG itself formulates the problem of poverty too narrowly in terms of vision, scope and direction. It should not simply be just a numerical target to be achieved by a certain date and by technical fixes. Durable and sustainable solutions to poverty will require the active involvement of the poor and civil society, a more comprehensive understanding of the root causes of poverty and its multidimensional and diverse consequences and the right policies. In this respect, the practice of measuring poverty in terms of income and consumption levels is inadequate. The Committee was urged to take into consideration political, social, cultural and human rights dimensions, determined by factors like class, gender, race, geography and ethnicity. This broader definition is necessary in designing more sensitive

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and responsive policies and programs on poverty. ❑

In order for participation to be meaningful and genuine, responsibilities and roles in the fight against poverty should not be defined for civil society and the poor. The current process of formulating and implementing poverty reduction policies has not been successfully tackling the roots of poverty. This is due to the fact that the poor themselves are excluded in the whole process. The following principle guidelines are recommended to be adopted by UNESCAP and every individual government in the Asia-Pacific region.

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At macro level, decisions of poverty reduction policies and projects must seek the consultation of the civil society and organization of the poor prior to their implementation. The consultation and selection of participants must be transparent and accountable.

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At micro level, poverty reduction projects must seek the majority of the endorsement of the poor in the affected areas prior to approval.

POVERTY ALLEVIATION INITIATIVES ✦

The indicators of these processes should be reflected in the annual assessments.

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The MDGs do not provide an in-depth analytical review of policy reform and institutional change. Hence, to link the MDGs with a particular set of policy prescriptions would be the wrong approach, no matter which policies are prescribed, precisely because there is no single “correct” policy for all societies and circumstances. In this respect, externally imposed onesize-fits-all policies such as the way the current PRSP initiative of the World Bank and the IMF is being practiced is to be rejected. The Committee and UNESCAP should actively involve and recognize the poor as rightful participants in any formulation of poverty eradication strategies and policies.

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Successful development efforts require appropriate policies at domestic, regional and international levels. However, the international economic

structure is inequitable and currently antagonistic to the achievement of the MDGs themselves. The Committee should address the ramifications of globalization and facilitate the formulation of the necessary reforms. ❑

Attention and financial resources are diverted away from the priorities of directly addressing poverty and hunger and instead allocated to debt servicing and military spending. There is an urgent need to re-orient government expenditure. The Committee should identify clearly the resources needed for governments in implementing poverty eradication policies and programs. Moreover, given the multidimensional aspects of poverty, the Committee should consider the implementation of conscientious poverty-budgeting in all aspects of government expenditure. Finally, sufficient resources should be identified and channelled to facilitate the participation of civil society and the poor.

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OCTOBER – DECEMBER 2003

The Committee should adopt a more comprehensive understanding of poverty and hunger and intensify its work towards poverty eradication urgently. For more information, please check ESCAP’s website www.escap.org or contact the Poverty and Development Division at [email protected].

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ILO

International Labour Organization

POVERTY ALLEVIATION INITIATIVES

OCTOBER – DECEMBER 2003

Key Role for Cooperatives in Poverty Reduction Efforts

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he importance of cooperatives in terms of providing job opportunities and socio-economic solutions cannot be underestimated. According to the International Cooperative Alliance (ICA), cooperatives employ more than 100 million workers and boast 760 million members worldwide, with 450 million members in Asia and the Pacific alone. A new ILO Recommendation (No. 193) has advanced the thinking on cooperatives even further by advocating the need for governments to recognize the global importance of cooperatives in both economic and social development, encourage international cooperation, while at the same time reaffirming the cooperative identity based on values and principles. It underscores the equal treatment of cooperatives vis-à-vis other types of enterprises and social organizations, and defines the government’s role in creating a supportive policy and legal framework, and in facilitating access to support services and finance without undue interference. Cooperatives have a great tradition of helping the urban and rural poor to raise their social and economic conditions. With a membership of more than 200 million and working capital of US$ 57.9 billion, the cooperative sector in India is one of the largest in the world. Cooperatives can be found in 99 per cent of the country’s villages, where two out of three families hold membership.

Cooperative enterprises have provided the capacity to transform marginalized and poor communities, not just through their ability to raise physical capital based on self-help, but also because of their ability to build human and social capital through their emphasis on education and training. As an institution, a cooperative can play a vitally important role in reaching poor communities, where social services are weak. Countries within Asia and the Pacific have seen both ups and downs in terms of cooperative policy development. Viet Nam is actively involved in the transformation process of a number of old model cooperatives, while this year the Philippines has developed a policy on prudential standards for credit cooperatives called COOP PESOS. An ICA report cites this as being an excellent instrument for credit cooperatives to empower the enterprising poor, since financial discipline helps mobilize and secure meager savings of poor members, as well as micro finance clients they are reaching out to. In contrast, Cambodia has no cooperative legislation and the concept has a bad name due to previous failures. Unfortunately, this means the rural poor are cautious, and therefore lack motivation to form a cooperative organization. In Thailand, labour activists and officials introduced laid-off workers from the Bed & Bath garment factory to the cooperative

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idea. Labour activist Junya Yimprasert in a recent Bangkok Post article described the Samanchan Garment Coop as a ‘landmark’ in the Thai labour movement. “It’s an example of workers’ exercising their right to choose,” she says. Certainly challenges remain, not least in terms of lack of funds and the need to sharpen management, marketing and accounting skills, but as one faithful member describes, participation can be an enlightening experience. “It’s the feeling of pride and dignity which this coop has given us.” Among the ILO’s efforts in Asia on poverty reduction through cooperatives, the Inter-regional Programme to Support Self Reliance of Indigenous and Tribal Communities through Cooperatives and other Self-Help Organizations, known as INDISCO, has helped create employment opportunities for these marginalized groups in India, Laos, the Philippines, Thailand and Viet Nam. From a regional perspective, cooperatives are strongest in mobilizing savings from the lower income and poor communities and in catering to their needs for financial and other relevant services. The resilience of financial cooperatives, including insurance cooperatives, was demonstrated during the financial crisis that hit Asia in 1997. Whereas banks were faced with a rush of withdrawals from their

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FAO

Food and Agriculture Organization of the United Nations

POVERTY ALLEVIATION INITIATIVES

OCTOBER – DECEMBER 2003

Sub-regional organizations will discuss food security

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otwithstanding the success many countries in Asia and the Pacific have achieved in reducing poverty and improving food security, the region remains home to the majority of the world’s poor and hungry. At the same time the increasing interdependence of national economies asks for regional and sub-regional approaches to supplement national efforts in this field. ESCAP, FAO and ADB will jointly organize a regional roundtable to discuss food security and poverty reduction in the Asian region from the sub-regional

perspective. Participants will be high-level officials at the Departments of Agriculture/Food, Rural Development and Planning of national governments; Heads of the Sub-regional Economic Organizations such as ASEAN, PIF-FIC and SAARC; high level representatives of Regional Development Banks/Agencies, and representatives of international development agencies, IFIs, multi- and bilateral donors, selected regional civil society organizations, women’s organizations and other relevant institutions. It will be held in the United Nations Conference Centre in Bangkok on 23 and 24 February 2004.

The meeting is expected to identify the areas most amenable for regional collaboration and to strengthen the partnership between the sub-regional economic organizations and development banks, bilateral donors and other institutions.

solutions in relation to decent work and the development of Poverty Reduction Strategy Papers (PRSPs) in the region.

Mr Huseyin Polat, Senior Cooperative Devlopment Specialist, International Labour Office (ILO), www.ilo.org

For more information please contact Mr. Saifullah Syed, FAO Regional Office for Asia and the Pacific, [email protected]

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customers, financial cooperatives in Thailand, Korea and Indonesia, all hit hard by the crisis, have continued to generate savings since 1998 in an unprecedented way. Cooperatives offer a meaningful and reliable access point to the urban and rural poor, and dialogue between government representatives of ILO member States, apex cooperatives from the region and the ILO at a joint ILO-ICA Regional Workshop in Bangkok this week provides a useful opportunity to share experiences and lessons learned, while identifying pro-poor

Cooperatives clearly provide a unique entry point when addressing the needs of people living in poverty and therefore must rise to the challenges posed by poverty in the context of decent work, bringing the voices and needs of their members, especially the poor, to the table of public policy reform.

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UNICEF

United Nations Children’s Fund

POVERTY ALLEVIATION INITIATIVES

OCTOBER – DECEMBER 2003

Early Childhood Care and Development project offers a better start for Myanmar’s poorest children

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ya Thidar Aung had a rough beginning. Born to a mother in conflict with the law she suffered many growth problems as a result: she was born underweight and even after 3 years remained undernourished, unkempt and poorly clothed when her mother finally brought her to the Barma Aye nursery school located within the State High School 15 in Dawbon Township, near Yangon, the capital of Myanmar. She was sullen, quiet and withdrawn. But six months later, it is difficult to believe that this is the same child. Now Mya Thidar Aung has gained weight and she comes to the nursery school clean and neatly dressed. The scabies is gone and Mya Thidar Aung plays happily with the other children. Hers is only one of the many success stories from the UNICEFsupported integrated early childhood care and development (ECCD) programme in Myanmar.

The ECCD programme in Myanmar is aimed at changing this situation by mobilizing local communities particularly for the poorest children, Parent Teacher Associations and newly established ECCD support groups. In one particular location, UNICEF and a national nongovernmental organization (NGO), have collaborated with the Department of Educational Planning and Training (DEPT) to provide home-based early childhood care and development activities for the most deprived children with emphasis on the 0-3 age group; classes annexed to schools were also set up to care for those in the 3-5 yrs age bracket. In practical terms, the home-based approach consists of “mother’s circles”, each comprising groups of mothers and ten under-3 children, with support from local teachers trained in ECCD to encourage better health care,

ECCD is a new concept in Myanmar as it is in many other countries. Traditionally, children are raised by parents or relatives who have little knowledge about how to foster their children’s intellectual or emotional development. Parents tend to focus on making sure the children are physically well developed but are not aware of the other dimensions of child development. Children from poor families are more severely affected as they are usually left by their parents in the care of other siblings, or simply left unattended while the parents work.

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nutrition and psychosocial care and stimulation. Every day, the children also receive a nutritious 500 calorie meal as supplementary feeding. To further help child growth, the children are also de-wormed every six months and learn the basics of hygiene and sanitation. To ensure local sustainability of the educational components, community support groups have been set up to teach other parents about the basics of hygiene and sanitation and the importance of play and stimulation for their children. UNICEF Plans to expand this successful programme further into other areas to benefit many more vulnerable children. For further Information contact Maurice James Apted UNICEF Myanmar [email protected]

UNIFEM

The United Nations Development Fund for Women

POVERTY ALLEVIATION INITIATIVES

OCTOBER – DECEMBER 2003

Thai weavers leave lasting impression in East Timor

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he beautiful form and function of Thai traditional weaving has always been appreciated by visitors from abroad. Less well known is that Thai weavers have proven willing to share their knowledge and skills with others. In early 2003, the United Nations Development Fund for Women (UNIFEM) sent Thai weavers from the Ratchburi Jok Weaving Centre to East Timor to conduct training in three rural districts. The Timorese women had no experience with vertical looms, as they had only used very slow and cumbersome backstrap looms – literally using their backs as a brace. UNIFEM saw an opportunity to give Timorese women a new way to earn income, and they worked with the NGO Timor Aid to organize the training. Timor Aid project officer Antonio Coelho is now looking to expand the pilot into a formal training centre. “It normally takes women one month to weave only two metres of cloth”, Coelho says, “whereas with the Thai looms they can get the same result in half a day or less”. UNIFEM’s East and Southeast Asia regional office – based in Bangkok – has been working to support women in East Timor’s nation building process. When weaving appeared as a good means of raising incomes, UNIFEM contacted the Ratchburi Jok Weaving Centre and asked if they could teach their skills abroad. The Ratchburi Jok Weaving Centre was established in 1987 as a non-government organization aimed at conserving the traditional

Thai Jok weaving and developing a community of weavers. Currently, the Centre helps generate an income of around US$ 100,000 yearly for its members. The Centre also provides training in weaving skills to home-workers, and students in schools and colleges in Ratchburi province. The Centre’s director, Udom Somporn, was enthusiastic about the project. In the end, a team of four weavers left Ratchburi to spend six weeks in three remote district in East Timor. The training was conducted with the help of Timor Aid. In each district, three carpenters were trained to make looms, and at least six weavers, all women, were trained in how to prepare the yarn and use the vertical loom. Many other weavers observed the training. In one district, three looms were completed as planned and one 60-meter cloth was completed during the training. The trainees continued to complete the cloth on the other two looms after the training. As there was no translator available, and the Thai weavers spoke little English, the biggest obstacle was language. Some help came from a nearby Thai military battalion, but for the most part the trainers and their students coped by writing ideas and instructions on paper, and repeating lessons again when needed. “The Thai weavers were very patient and had a great capacity to teach”, Timor Aid’s Coelho says. The normal three-month learning programme was packed 9

into only two weeks in each district – but still the Timorese women picked up the skill and could weave on their own by the end. The products of the training attracted immediate attention, and the local government in one of the districts was so impressed they offered to contract the weavers to make uniforms for employees in the future. Like in Thailand, weaving in East Timor is traditionally the work of women. UNIFEM runs many development projects that seek to improve women’s economic position – but the work in East Timor had an importance beyond raising women’s incomes. The carpenters building the looms were all men – so the project benefited them as well. East Timor society is still bears the scars of war, and there is rampant unemployment among men. The social problems this can cause make any effort to bring women and men together a positive force. “It’s too soon to know the social impact of this project”, Coelho says, “but we see benefits for both women and men”. Coelho was surprised at first to see the village men were interested in weaving. Clearly, they could see the potential offered by the new looms. “We could change the traditional division of labour a bit because the looms were something new”, Coelho says. As carpenters building the looms, the men will also need to learn how to act as technicians, to maintain the devices and help load the yarn. Coelho says this means they must understand the entire weaving process – something they’ve never

POVERTY ALLEVIATION INITIATIVES

OCTOBER – DECEMBER 2003

paid attention to before. “Women will still be the weavers, but men building looms will have to teach their ‘customers’ how to use them, so they must know how to do it as well”. Timor Aid is now trying to find donor support to set up a weaving school that would teach Timorese women and men how to turn loom building and weaving into a sustainable business. The challenges are great, given the many limitations of the East Timor economy. There is no domestic supply of yarn, for example, so it has to be imported at a cost far above what the project can pay. “We have a donation of five tons of yarn from a German man, but we can’t even pay the tax to bring it into the country”, Coelho laments. The school Timor Aid hopes to set up will therefore need to cover the entire business cycle – from making or procuring yarn to creating new designs and marketing the final product. “We can’t just copy Thai or Indonesian designs,” Coelho warns, “We have to work with Timorese traditional designs and help with the creative process so the villagers can think of a new look”.

The first step in this long process is to solidify the basic lessons by having the Ratchburi Jok Weaving Centre return to East Timor for a longer stay. Coelho would like Udom and his team to teach for three or four months. “We need to find some young students who can learn quickly and then train others in the future”, Coelho says. The Thai weavers are more than willing to return to East Timor – and UNIFEM is now helping

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Timor Aid to find the financial support needed to make this happen. For more information please contact Michael L. Gray, Information Officer, UNIFEM East and Southeast Asia Regional Office; michael.gray@unifem. un.or.th

WHO

World Health Organization

POVERTY ALLEVIATION INITIATIVES

OCTOBER – DECEMBER 2003

WHO highlights the relation between health and poverty

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new Regional Framework on Macroeconomics and Health states the direct and indirect costs associated with ill-health, such as loss of personal and national income or underinvestment in children’s education. The draft document was the result of a Regional Consultation Meeting organized by WHO in New Delhi last August. The meeting, under the umbrella of the Commission on Macroeconomics and Health, reviewed the progress in this area in the South East and South Asian region and reached a consensus on a Regional Macroeconomics and Health Framework. It has been observed that health plays a multifaceted role in the economic development of a country. High and advance qualities of health trigger economic development as healthy individuals are more productive and live longer to generate high levels of incomes and savings. Childhood sickness results in disability in adulthood and thus the quality of future stock of human capital is adversely affected. An analysis of the Millennium Development Goals in the area of health in the region showed mixed results. While the performance of Bangladesh, Bhutan and Indonesia in reducing under-five mortality rates was good, that of DPR Korea and Thailand was moderate. Myanmar’s progress was not satisfactory while Sri Lanka showed good improvement on every health indicator with notably

high life expectancy. Particularly noteworthy was the reversal of about 80 per cent in the spread of HIV/AIDS in Thailand. Available data shows that prevailing per capita expenditure on health in the region is quite low. To be cost effective, public health expenditure should be directed towards diseases of the poor, i.e. on controlling communicable diseases. It was noted that US$ 15 per capita spent on health would reduce the disease burden by 25 per cent in developing countries. As a public good, health is subject to market failures and the financial risk should be covered by the government in times of crisis, especially for the poor. But a public-private compact is also essential, especially in insurance, production of drugs and training. To improve the quality of services poor patients receive, governments could contract to or purchase services from private sources or

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provide funds for diseases that disproportionately affect the poor. Governments can also enhance the quality regulations and professional ethics on informal providers or encourage community financing. Also, the number of health centers in rural areas should be increased and outreach facilities improved. Providing adequate incentives and allowances to the health personnel might be another way to improve health services in remote areas. High income countries should help the low income countries, as the latter’s priority needs cannot wait for their economic development, rather they need large injections of donor financing now and in the coming years. Globalisation has added to the disease burden of the people in the region but has also broadened the horizons of reducing it. Emphasis has been laid on research and development as a means to

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improve the quality of health care but the role of WTO agreements such as TRIPS and GATS in improving availability of drugs in low income countries is not clear.

to achieve a national consensus on the centrality of health in overall development. ♦

Governments in the region should continue identifying ways to improve the quality and efficiency of their health services so that the poor can optimize their use. The meeting concluded with a series of recommendations, among them: ♦

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Developed countries and development agencies should be sensitized to the main findings and recommendations of the Commission on Macroeconomics and Health (CMH). Their support should be in harmony with national policies and priorities. Advocacy of the CMH report to policy makers and other sectors needs to be reinforced in order

OCTOBER – DECEMBER 2003

♦

Existing structures, procedures and mechanisms should be strengthened to develop a MacroHealth Investment Plan. This focuses on the seven to eight diseases and health conditions that primarily account for the national health deficit and it will have adequate resources (financed internally and externally) and mechanisms to match its objectives. Acknowledging the competing demands on limited resources, it is nevertheless clear that the proportion of public spending on health is grossly inadequate. In this line, finance ministries should be made fully aware of the

productive nature of investment in health, and partnerships between the public and the private sector as well as between developing and developed countries should be established. ♦

The macroeconomics and health process should be integrated in the ongoing initiatives such as HIPCs, PRSP, SWAP or MDGs.

For more information please contact Borjn Melgaard, WHO Representative to Thailand, Tel: (662) 591 8198

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Poverty Alleviation Initiatives (PAI) is published quarterly, as an interagency endeavour to provide United Nations initiatives on poverty alleviation in Asia and the Pacific region. The inputs for the newsletter are provided by the members of the Thematic Working Group on Poverty Alleviation, Rural Development and Food Security. The designations employed and the presentation of the material in this newsletter do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries. Present membership of RCM, includes ESCAP, UNICEF, UNEP, UNFPA, UNDP, and FAO, ILO, UNESCO, UNIDO, UNIFEM, and WHO. Newsletters are issued without formal editing. For information please contact:

Mr Yap Kioe Sheng Chief, Poverty Reduction Section Poverty and Development Division ESCAP, United Nations Building Rajdamnern Avenue Bangkok 10200 Thailand

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