Investing In Health Is Vital For Sustained Economic Development

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A new book demonstrates the enormous costs for many eastern European and central Asian countries of insufficient efforts to meet their huge health challenges.

By means of a set of new analyses, it demonstrates how ill health leads to reduced productivity and earnings and how, in the future, the poor state of health in this region will be likely to delay economic growth.

Whereas most countries are seeing an increase in life expectancy, this region stands out as having many countries with stagnating or declining life expectancy. For example, male life expectancy in Belarus in 2004 was 62.7 years, down nearly 1.5 years since 1960. Russian males fare even worse, with life expectancy now below 59 years. Yet the region is largely overlooked in the global health arena, receiving much less development assistance for health than would be expected given its levels of health and income. Nor have the governments concerned given sufficient priority to health: what funds have been made available have done little to reduce the substantial, and often increasing, disparities in health and access to health care between the rich and the poor within countries.

Martin McKee, a professor at the London School of Hygiene & Tropical Medicine and one of the book's authors, says: "There has long been tremendous scope for improving health in this region. What we add here is evidence that doing something about it would bring tangible, and substantial, economic benefits on top of the obvious health benefits."

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The book quantifies the various ways in which individuals, households and economies pay a heavy price for the largely avoidable burden of disease. Chronic illness, for instance, reduces the probability that a person will work by between 7% (Georgia) and 30% (Kazakhstan). Even the most conservative estimates indicate that, if we could reduce a country's adult mortality by only 2% annually over 25 years, the economic gain would account for 25-40% of its current total income.

Marc Suhrcke, an economist with the WHO Regional Office for Europe and another of the authors adds: "Sustained economic growth over decades is sorely needed in the region to raise the 60 million people out of absolute poverty and protect its more than 150 million from economic vulnerability. Investing in health offers a hitherto neglected opportunity to help achieve just that, although it is of course not a panacea. What we see as an upsurge of economic growth in recent years in several of these countries is more a correction of the earlier huge economic decline and cannot be sustained. There is thus no reason at all for complacency."

The book points to a way forward by discussing the role of government and by reviewing the available evidence on interventions to improve health in the region. In particular, it lays out the economic rationale for a government role in tackling chronic diseases, which account for the greatest share of the disease burden in this region. It also highlights the potential for addressing health determinants outside the conventional health system by, for instance, improving the quality of governance and by fostering social capital, two areas where most countries in the region have much scope for improvement.

Health: a vital investment for economic development in Eastern Europe and Central Asia

by Marc Suhrcke, Lorenzo Rocco & Martin McKee. Published by the WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies, 2007 (Observatory Studies and Occasional Series)

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