DRAFT ECOSOC Health Ministers Meeting

1. DRAFTECOSOC 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

18. Financing Recovery Con’t

19. 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 capacitygap: • 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