Health
Improving health outcomes through improved governance and public expenditure management; through infrastructure including water and sanitation; and by promoting regional public goods including the mitigation of the spread of communicable diseases such as HIV and influenza
| Challenge | Good health is desirable in itself and promotes productivity, learning capacity, and incomes. Expenditure on health in Asia is very low, and what little is spent is often poorly allocated and inequitable. Health expenditures are an important source of impoverishment. Regional integration increases people mobility and exchange of goods, but may facilitate the spread of infectious diseases. |
| Strategy | ADB is committed to improve health outcomes in the region by focusing on our core areas of expertise—infrastructure, good governance and public expenditure management, and support of regional public goods—and by working with partners. |
| Response | We contribute to health improvements primarily through governance work that focuses on public expenditure management for cost-effective delivery of health programs and services to all population groups and through infrastructure projects such as water supply and sanitation. We also provide targeted assistance to countries subjected to internal and/or cross-border migration to reduce the risk of spreading communicable diseases, and particularly support regional cooperation to address communicable diseases. |
Good health improves educational achievement and worker productivity. It is essential to development. But in Asia and the Pacific, ill health, including malnutrition, reduces productivity, learning capacity, and long-term income.
Improving economic governance and public expenditure
Financing of health care is a major—and growing—policy challenge for many countries in Asia. Despite being the fastest-growing and most dynamic region in the world for decades, many governments in Asia spend less than $10 per person per year on health care. High levels of out-of-pocket expenditures pushed more than 78 million people below the absolute poverty line in Asia. Aging populations and expensive to treat—but often preventable—noncommunicable diseases such as diabetes and cancers linked to tobacco will impose very large cost burdens on households and public health budgets alike, further squeezing fiscal space for governments. Asia's health care systems need to improve their effectiveness, efficiency, access, equity, and quality. Effective public–private partnerships are strategically important.
Improving health outcomes through infrastructure
Under the long-term strategic framework 2008–2020 (Strategy 2020), ADB continues to actively support infrastructure development in the region, including water supply and sanitation, which can significantly improve health outcomes, especially for the poor.
Assistance includes ensuring urban and rural development projects address health issues systematically, such as including health indicators that measure decrease in diarrhea as a result of improved water supply, or behavior change programs in water and sanitation projects. Transport projects carefully consider the risks of traffic accidents, and the risk of spreading communicable diseases such as HIV and AIDS.
We also work to improve drug and food safety; avoid duplication and waste of health resources; and in some countries establish the rules for sound competitiveness among health providers to benefit patients. Assistance also goes to public and private health institutions to upgrade facilities and equipment, enabling them to meet quality standards.
Regional integration leading to increased mobility of people brings many benefits. But it also expands risk for spread of communicable diseases, such as avian flu (or other types of influenza), tuberculosis, cholera, dengue, and HIV/AIDS, all of which can impose heavy financial and economic burdens on individuals, households, and governments.
Partnering for regional public goods, and the fight against communicable diseases
ADB supports regional pandemic preparedness, and identification, monitoring, and response capacity in the region to the threat of emerging and re-emerging infectious diseases.
In partnership with technical agencies, we support regional collaboration to mitigate and control the spread of communicable diseases linked to increased regional mobility and climate change–related health threats.
Through regional collaboration, ADB fosters exchange of information and strengthens monitoring, contingency planning, and response capacity to emerging health problems at the national and regional levels.
Working with the World Health Organization (WHO), the Food and Agriculture Organization (FAO), and the Association of Southeast Asian Nations (ASEAN) Secretariat, ADB has provided emergency assistance to member countries to fight severe acute respiratory syndrome (SARS) and avian flu; improve pandemic preparedness; and develop regional capacity and coordinate collaboration to monitor, respond, and control infectious disease outbreaks.
We also team with nongovernment organizations to develop community capacity to control avian flu outbreaks, work with countries to help them reinforce their own communicable disease control activities, and facilitate coordination and collaboration among neighboring countries at the central and provincial levels.
ADB additionally provides emergency assistance as well as special bridging support to address crises at their inception and until support from formal donor and government programs are able to address them.
Partnering in the fight against HIV/AIDS
ADB works closely with The Joint United Nations Programme on HIV/AIDS (UNAIDS) and member countries to help the region control HIV and AIDS by developing strategies and programs better adapted to the HIV/AIDS epidemics in the region. We established an HIV/AIDS Cooperation Fund to support HIV/AIDS prevention linked to road and infrastructure projects in consultation with governments and development partners concerned.
The fund also finances regional studies: our socioeconomic impact studies have helped the Commission on AIDS in Asia define a new regional strategy to fight the spread of the disease.
In addition, we are partnering in HIV/AIDS interventions for migrants and ethnic communities by helping UNAIDS. We also finance training activities implemented jointly with UNAIDS, such as training workshop for costing of national programs.
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