Communicable diseases will remain a source of worry
Dr Md Rajja
A possible impact on health funding for communicable diseases might, in turn, affect national disease control programmes. Increased poverty and unemployment and declining incomes will lead to unfulfilled demand for treatment and poorer health outcomes. Nepal have been successful in raising resources for health over the years, whereas most other countries have been less successful. India has been able to increase health spending slightly. The overall level of health spending, in turn, determines how much spending will potentially be available for communicable diseases. Therefore the data strongly suggest that financing for communicable diseases will remain a source of worry, especially for countries most severely affected by the financial crisis. For countries that depend on external funding, the decrease in aid is a major worry. Aid diminishes during economic crises and sometimes does not recover fully to earlier levels. A large part of the funds for communicable diseases come from international donors and private foundations based in developed countries. Disproportionate impact on communicable diseases programmes. Countries such as Nepal need to prepare for the effect of decreasing aid on their health sectors. Bhutan is somewhat less dependent on external funding and may therefore be able to escape the impact of declining aid. Although the current crisis has not significantly affected overseas development assistance in Nepal. Impact on communicable diseases linked to or aggravated by poverty and poor living conditions is likely to be severe enough to warrant serious attention from aid agencies. Maldives a much smaller country, is in a better position to cope with the impact of the crisis since it has already received stimulus measures from domestic and international organizations. The impact of shrinking economic growth and aid on vulnerable populations has direct implications for communicable diseases programmes. Financing to fight communicable diseases is not always aligned with the disease priorities of developing countries, and since donors tend to imitate each other’s funding decisions, the real needs of developing countries need to be look. Applying the concept of global public good to health funding decisions would help reprioritize financing for communicable diseases and eliminate the distortions caused by disease specific funding. These priority issues are more relevant now that economic growth, especially in many donor countries, has slowed significantly. The global response to the financial crisis has been to maintain the quantity of aid to the extent possible, so as not to jeopardize progress towards the MDGs. The issue of aid effectiveness has now received serious attention from development agencies, and among the concerns are the lack of harmonization and alignment, problems with predictability and the need for common arrangements and procedures. Inefficiencies and inadequate management within the health sector in many countries of the region reduce the effectiveness. Identified the need to make health spending more effective and efficient and to ensure adequate levels. As has been powerfully stated, every change in demography, vegetation, land use, technology, economics and social relations is also a potential change in the ecology of pathogens and their reservoirs and vectors and therefore a change in the pattern of infectious disease epidemiology. Preventing and responding to traditional, emerging and re emerging communicable diseases is therefore a complex endeavour that will not succeed if it is limited to simply increasing the funds available to fight selected diseases. Countries of the region are on different trajectories of growth and development, their struggle to eliminate underdevelopment and poverty has driven them to a high growth strategy. High growth policies are increasing the population vulnerable to communicable diseases. Economic growth alone is not the solution. Potential increase in vulnerable populations may delay progress in the fight against communicable diseases. Much more carefully matched to disease and health system priorities in each country. Although the MDG health goals are important benchmarks, programme goals should be more relevant, inclusive and realistic. They should be multisectoral and take into account both the realities of the health sector and the development path chosen by the country. Health and development initiatives need to expand their focus to include diseases and conditions that are less well known or less discussed, while at the same time addressing socioeconomic and health sector constraints in each country. Policy makers have to become more aware of traditional vaccine preventable childhood diseases, traditional and emerging vector borne diseases and respiratory infections, which remain among the most important contributors to high disease burdens. Countries should set their own priorities for the prevention, control and treatment of communicable diseases. It is up to each country to convince the world of where its priorities lie. The global public good character of some communicable diseases warrants concerted world action. Nevertheless, significant gaps in funding as well as regional variations require a more diverse set of national and international aid measures. Although regional and global collaboration is critical, future policies for reducing the burden of communicable diseases in the region will only be affective if they are based on evidence.
Dr Md Rajja