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

T
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 OCTOBER – DECEMBER 2003

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.
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.
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.
For more information, please check ESCAP’s
website www.escap.org or contact the Poverty and
Development Division at escap-pdd@un.org.

INSIDE:

ESCAP

Poverty and Development Division

● Committee boosts poverty reduction efforts

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

ILO
PAI
● Key Role for Cooperatives in Poverty Reduction
Efforts

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

2
 POVERTY ALLEVIATION INITIATIVES
EDITORIAL
O
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.
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.
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.
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.
3
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.
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.
http://www.unescap.org/pdd/prs
PAI
Queries can be directed to:
Mr Yap Kioe Sheng
Chief, Poverty Reduction Section
escap-prs@un.org

POVERTY ALLEVIATION INITIATIVES
Civil Society calls for a more comprehensive understanding
of poverty and hunger
T
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.
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 criti-
cal and important issue
of human rights. Certain
norms and standards are
particularly pertinent in
addressing the problem
of poverty, such as effec-
tive non-discrimination,
the recognition of vulner-
able 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
ESCAP
Economic and Social Commission for Asia and the Pacific – Poverty and Development Division
OCTOBER – DECEMBER 2003
advised to affirm and and responsive policies
operationalize rights and programs on poverty.
based approaches to
poverty eradication. ❑ In order for participation
Civil society organiza- to be meaningful and
tions have already genuine, responsibilities
adopted this approach and roles in the fight
in their fight against against poverty should
poverty. not be defined for civil
society and the poor.
❑ The MDG itself formu- The current process
lates the problem of of formulating and
poverty too narrowly in implementing poverty
terms of vision, scope reduction policies has
and direction. It should not been successfully
not simply be just tackling the roots of
a numerical target to be poverty. This is due to
achieved by a certain the fact that the poor
date and by technical themselves are excluded
fixes. Durable and in the whole process.
sustainable solutions to The following principle
poverty will require the guidelines are recom-
active involvement of the mended to be adopted by
poor and civil society, UNESCAP and every
a more comprehensive individual government in
understanding of the root the Asia-Pacific region.
causes of poverty and its
multidimensional and ✦ At macro level, decisions
diverse consequences of poverty reduction
and the right policies. policies and projects
must seek the consulta-
❑ In this respect, the prac- tion of the civil society
tice of measuring poverty and organization of
in terms of income and the poor prior to
consumption levels is their implementation.
inadequate. The Com- The consultation and
mittee was urged to take selection of participants
into consideration politi- must be transparent and
cal, social, cultural and accountable.
human rights dimen-
sions, determined by ✦ At micro level, poverty
factors like class, gender, reduction projects must
race, geography and seek the majority of the
ethnicity. This broader endorsement of the poor
definition is necessary in in the affected areas prior
designing more sensitive to approval.
4
 POVERTY ALLEVIATION INITIATIVES
✦ The indicators of these
processes should be
reflected in the annual
assessments.
❑ The MDGs do not
provide an in-depth
analytical review of
policy reform and institu-
tional 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 circum-
stances. In this respect,
externally imposed one-
size-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.
❑ Successful development
efforts require appropri-
ate policies at domestic,
regional and international
levels. However, the
international economic
OCTOBER – DECEMBER 2003
structure is inequitable The Committee should
and currently antagonis- adopt a more comprehensive
tic to the achievement of understanding of poverty and
the MDGs themselves. hunger and intensify its work
The Committee should towards poverty eradication
address the ramifications urgently.
of globalization and
facilitate the formulation For more information, please
of the necessary reforms. check ESCAP’s website
www.escap.org or contact the
❑ Attention and financial Poverty and Development Division
resources are diverted at escap-pdd@un.org.
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 imple-
menting poverty eradi- PAI
cation policies and
programs. Moreover,
given the multidimen-
sional aspects of poverty,
the Committee should
consider the implementa-
tion 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.
5

Key Role for Cooperatives in Poverty Reduction Efforts
T
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.
POVERTY ALLEVIATION INITIATIVES
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
6
ILO
International Labour Organization
OCTOBER – DECEMBER 2003
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
continued on page 7
 FAO
Food and Agriculture Organization of the United Nations

POVERTY ALLEVIATION INITIATIVES OCTOBER – DECEMBER 2003

Sub-regional organizations will discuss food security

N
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.
For more information please
contact Mr. Saifullah Syed, FAO
Regional Office for Asia and the
Pacific, Saifullah.Syed@fao.org
PAI

continued from page 6

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 a unique entry point when
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
solutions in relation to decent work Mr Huseyin Polat, Senior
and the development of Poverty Cooperative Devlopment
Reduction Strategy Papers (PRSPs) Specialist, International Labour
in the region. Office (ILO), www.ilo.org
Cooperatives clearly provide
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 PAI
needs of their members, especially
the poor, to the table of public
policy reform.

7

Early Childhood Care and Development project offers a better
start for Myanmar’s poorest children
M
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 UNICEF-
supported integrated early
childhood care and development
(ECCD) programme in Myanmar.
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.
POVERTY ALLEVIATION INITIATIVES
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 non-
governmental 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,
8
UNICEF
United Nations Children’s Fund
OCTOBER – DECEMBER 2003
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
mapted@unicef.org

Thai weavers leave lasting impression in East Timor
T
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
POVERTY ALLEVIATION INITIATIVES
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
UNIFEM
The United Nations Development Fund for Women
OCTOBER – DECEMBER 2003
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
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

PAI

10

WHO highlights the relation between health and poverty
A
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 under-
investment 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
POVERTY ALLEVIATION INITIATIVES
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
11
WHO
World Health Organization
OCTOBER – DECEMBER 2003
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
 POVERTY ALLEVIATION INITIATIVES OCTOBER – DECEMBER 2003

improve the quality of health care to achieve a national productive nature of

but the role of WTO agreements consensus on the investment in health,
such as TRIPS and GATS in centrality of health in and partnerships between
improving availability of drugs in overall development. the public and the private
low income countries is not clear. sector as well as between
♦ Existing structures, developing and devel-
Governments in the region procedures and mecha- oped countries should be
should continue identifying ways to nisms should be established.
improve the quality and efficiency strengthened to develop
of their health services so that the a MacroHealth Invest- ♦ The macroeconomics
poor can optimize their use. ment Plan. This focuses and health process
on the seven to eight should be integrated in
The meeting concluded with diseases and health the ongoing initiatives
a series of recommendations, conditions that primarily such as HIPCs, PRSP,
among them: account for the national SWAP or MDGs.
health deficit and it will
♦ Developed countries and have adequate resources For more information please
development agencies (financed internally and contact Borjn Melgaard, WHO
should be sensitized to externally) and mecha- Representative to Thailand,
the main findings and nisms to match its Tel: (662) 591 8198
recommendations of the objectives.
Commission on Macro-
economics and Health ♦ Acknowledging the
(CMH). Their support competing demands on
should be in harmony limited resources, it is
with national policies nevertheless clear that
and priorities. the proportion of public PAI
spending on health is
♦ Advocacy of the CMH grossly inadequate. In
report to policy makers this line, finance
and other sectors needs ministries should be
to be reinforced in order made fully aware of the

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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