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Who Will Pay for Asia's Double Burden?

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Who Will Pay for Asia's Double Burden? July–December 2011 Also in this edition... Microfinance put to the test A foot soldier in the aid effectiveness battle Shopping to help the poor A publication of the Asian Development Bank WHO WILL PAY FOR ASIA’S DOUBLE BURDEN? Innovative financing is needed to address an unprecedented burden of communicable and noncommunicable diseases Cover.indd 1 10/21/11 2:45 PM Critical Thinking.. “Development Asia... comes across like Time or Newsweek in the good old days. Professional journalists research important subjects and report without being blinkered. “The magazine is not a mouthpiece for official ADB policy.... “ADB is not trying to inspire the kind of optimism that is typical of PR publications, but hopes to trigger serious debate.” Hugh Williamson Europe News Editor The Financial Times www.development.asia A publication of the Asian Development Bank Critical thinking AD.indd 68 10/20/11 4:47 PM PUBLISHER’S NOTE WWW.DEVELOPMENT.ASIA © 2011 Asian Development Bank ISSN 1998-7528 ASIAN DEVELOPMENT BANK PUBLISHER Ann Quon Getting Better SENIOR EDITOR Floyd Whaley EDITORIAL ADVISOR Indu Bhushan ASSOCIATE EDITOR sian and Pacific countries are facing unprecedented challenges Maria Liza Solano COPY EDITOR related to health care. While wealthier countries tend to suffer Caroline Ahmad RESEARCH DIRECTOR from noncommunicable ailments, such as cancer and diabetes, Shawn Pang ART DIRECTOR and poorer countries from communicable diseases, like malaria Andy Martin and dengue, many parts of Asia and the Pacific are plagued by both. This Development Asia features development issues important to Asia and the Pacific. It is published ADevelopment Asia edition of explores the double burden of disease that four times a year by the Asian Development Bank. The views expressed in this magazine are those of political leaders in the region are grappling to address. At the root of this the authors and do not reflect the views and policies of the Asian Development Bank and Haymarket problem is health financing. Simply put: how do governments and their Media Ltd. Use of the term "country" does not imply any judgment by the authors or the Asian private sector partners provide solutions that keep the poor from suffering Development Bank and Haymarket Media Ltd. as to the legal or other status of any territorial entity. catastrophic health care costs? Advertising of any specific commercial product, Underlying this situation is the specter of a pandemic. Many health experts, process, service by trade name, trademark, manufacturer, or otherwise, in this publication both within Asia and around the world, believe that the next pandemic will does not constitute or imply ADB’s endorsement, recommendation, or favoring of any of the originate in Asia. Since severe acute respiratory syndrome (SARS) swept product or the entity thereof. the region and much of the globe in 2003, countries throughout Asia and COMMENTS Send your feedback to the editor at the Pacific have banded together in an unprecedented display of regional [email protected] cooperation in the health sector to stop the next pandemic at its source. ADVERTISING To advertise in Development Asia, contact For the articles section, regular contributor Karen Emmons explores the [email protected] troubles facing microfinance. SUBSCRIPTIONS Contact [email protected] Other stories include an interview with one of the pioneers in the use of randomized control tests in development work, which some believe is the future of efforts by development organizations to establish the effectiveness of their work. In our Reconnaissance section, regular contributor Margo Pfeiff offers tips on how to shop in ways that benefit—or at least don’t hurt—the poor. In this edition, we welcome two new contributors. Jade Lee-Duffy, a longtime Hong Kong, China business writer and editor, joins our team, along REPRINTS Material published in Development Asia with Frale Oyen, whose reporting has taken her from the tiniest islands of the and on www.development.asia, including articles, photos, graphics, and other content, is Pacific to Viet Nam and the Middle East. copyrighted. Material may not be reproduced, republished, or redistributed without written After reading this edition, ask yourself: What can countries in Asia and permission of Development Asia. For reprint permission, please contact editor@development. the Pacific do to improve health care, particularly for the poorest and most asia. Photographs not owned by ADB require permission from the copyright holder for reprinting. vulnerable? Then send us your thoughts at [email protected]. Development Asia Stay well! n Department of External Relations Asian Development Bank 6 ADB Avenue, Mandaluyong City 1550 Metro Manila, Philippines [email protected] www.adb.org Cover photo: AFP Note: In this publication, "$" refers to US dollars Ann Quon Publisher A publication of the Asian Development Bank, designed and distributed by Haymarket Media Limited www.development.asia July-December 2011 Development Asia 1 P1 Publisher's note.indd 1 10/21/11 2:48 PM CONTENTS YEAR IV, NUMBER XI, JULY–DECEMBER 2011 21 STOPPING THE NEXT PANDEMIC 34 EXAMINING MICROFINANCE 42 SHOPPING WITH A CONSCIENCE FOCUS 21 HUMAN VS. BUG 40 PROFILES IN DEVELOPMENT HEALTH Most scientists believe that the next WHAT WORKS major pandemic will emerge from Asia. Yale University economist and 6 THE BIG READ Can the region pull together and stop it professor Dean Karlan is trying to CATASTROPHIC COSTS in its tracks? bridge the gap between academia As out-of-pocket medical expenses By Floyd Whaley and development to understand why threaten to drive millions of people _______________________________ projects succeed (or fail). in Asia back into poverty, innovative 25 ISLANDS OF HEALTH By Jade Lee-Duffy approaches to paying for health care Often isolated, sparsely populated, and _______________________________ are being sought. resource-poor, Pacific island countries 42 RECONNAISSANCE By Bruce Heilbuth face special challenges in terms of SHOP FAIR health care. Do you want to be an ethical shopper? Also, sidebar: VACCINE FUNDS By Frale Oyen Just look for the fair trade or similar CAN SAVE MILLIONS OF LIVES; label. Or is it that simple? BANGLADESH FLAGS A WAY Also, sidebar: LOVE PATROL By Margot Pfeiff FORWARD _______________________________ ___________________________________ 28 HEALTH FOR HIRE _______________________________ 14 THE BIG PICTURE Some developing countries are DEPARTMENTS BURDEN OF HEALTH COSTS experimenting with turning over the Out-of-pocket health care expenses provision of basic health care to outside 4 OFF THE PRESS can easily strain a household budget, contractors. Can one of a society’s Reprint-worthy snippets from and the financial shock of a single most important public functions be publications worldwide on expensive event can push a family into entrusted to external organizations? development issues poverty. For those already living in By Karen Emmons _______________________________ poverty, the effects can be devastating. _______________________________ 5 ON THE WEB By Mark Blackwell ARTICLES ___________________________________ Hidden gems and important landmarks on the worldwide web 16 DOUBLE BURDEN 34 TINY LOANS, BIG QUESTIONS on development An explosion in infectious and Microfinance—seen by many as a _______________________________ noncommunicable diseases represents revolution in grassroots development— 32 OFF THE SHELF a worsening crisis for developing is facing tough scrutiny. The must-read development books of economies and health authorities. By Karen Emmons recent release By Bruce Heilbuth 44 ON THE RECORD Noteworthy quotes on development and economic issues 2 Development Asia July-December 2011 www.development.asia P2_3 Contents/Contributors.indd 1 10/24/11 10:39 AM Letters to the Editor Access to Learning and Livelihood It is about engaging communities to Skills (EQuALLS2) Program, which is really embrace the notion that it does Empowering communities implemented by Synergeia Foundation take a village to raise a child. in that locality, helped finance two of I hope you will have many more Your recent issue on education in the classrooms with a minimal amount issues on education and bring out Asia is a must-read for development of funding, but the community put in the stories of how communities need workers and policy makers—and time and labor that allowed them to to stop thinking that this problem is should also be placed in the hands construct concrete rooms that would something only the government can of every public school teacher in house their children and make the solve. the region. Or at least one issue per young ones comfortable when they school. They need to look up from learn their Math and English. Ma. Salve Duplito their textbooks and from what they There are many such stories in this Information Officer intimately know on the ground, and part of the Philippines that makes one Synergeia Foundation appreciate the large issues on the think: what transformative force could macro side. be employed in the other corners of Email your comments to letters@ I have recently been to Tudok Mamot the nation to make the case of Tudok development.asia or mail your letter to: Elementary School, a 6-classroom Mamot commonplace, instead of a school on top of a breathtaking hill rarity? Is it possible? Development Asia, Department of External in North Upi, Maguindanao. The The gigantic efforts needed to avoid Relations, Asian Development Bank, 6 ADB Department of Education in ARMM losing generations of Asians because Avenue, Mandaluyong City, 1550 Metro built only one of those classrooms; of lack of access to quality education Manila, Philippines the other five were bankrolled by could perhaps be answered by that one the parents of the children and the question. Making this happen is not *Please include your full name and contact barangay leaders in that area. just about classrooms and textbooks information. Letters may be edited for space and The USAID’s Education Quality and and laptops in the hands of every child. clarity. Contributors Mark Blackwell has more than 20 years issues.
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