Dear colleagues,

Since 1919, the ILO has been supporting countries to develop and implement social security systems for all. There has been tremendous progress since then. Then, in 1919, some forty countries were starting to build such schemes; today, all world countries have a social security system. 

Further, countries continue to expand social protection coverage and benefits, as reflected in the path-breaking ILO Recommendation Concerning National Floors of Social Protection (No. 202), approved in 2012. The Recommendation reflects the joint commitment of governments, employers and workers to building nationally-defined social protection floors which guarantee at least a basic level of social security to all, encompassing access to health care and income security throughout their lives and ensuring their dignity and rights. While social protection floors are essential, the Recommendation does not stop there: it also sets out detailed guidance on building comprehensive social protection systems.

Two years after the adoption of the Recommendation, the World Social Protection Report 2014-2015 offers a comprehensive body of evidence both on the impressive progress made over the last years and on the remaining gaps that need to be filled. Based on a life-cycle approach, the report provides an overview of the current organization of social protection systems, coverage, benefits and expenditures. With its global scope and valuable statistical annexes, the report is an essential reference for anyone interested in social protection.

In recent years, the ILO has provided technical assistance on social protection to 136 countries. And we are proud to continue our support all over the world, as more and more evidence shows that social protection systems play a key role in the functioning of modern societies  and are an essential ingredient of integrated strategies for economic and social development. Furthermore, experience since 2008 shows that countries with adequate social protection systems were able to respond more quickly and effectively to the crisis.

Yet about 73 per cent of the world’s population continues to live without adequate social protection coverage. In other words for the large majority of people, the fundamental human right to social security is not or is only partially realized. In 2014, it is clear that the global community needs to make greater efforts in realizing this right. This is an issue that the international community should embrace prominently in the post-2015 development agenda.  Social protection can ensure that all households have the security of knowing that if they lose their job or fall ill and when they grow old, they will not face the risk of poverty and insecurity.  Our modern society can afford to provide universal social protection everywhere.

I hope that this report will be a useful tool for practitioners, and provide the basis for better informed policy-making.
http://www.ilo.org/gimi/gess/ShowTheme.do?tid=3985

Yours sincerely,

Guy Ryder
Director General
International Labour Organization
4, Route des Morillons
CH-1211 Geneva 22 Switzerland

________________________________________

Please share your inputs by e-mailing: recoveryhumanface@socpro.list.ilo.org  To join or leave this e-discussion, send an email with subscribe or unsubscribe in the subject field. To see all messages http://www.recoveryhumanface.org/   This e-discussion is intended to facilitate the exchange of knowledge and ideas; the views expressed by contributors do not reflect the policies of ILO.  The moderator of the e-discussion is Isabel Ortiz, contact: ortizi@ilo.org

Thanks a lot to Robert and Joan for this very interesting conversation. It made me remember, with nostalgia when in in 1969-1971 I taught a three semesters course of Introduction to Economics to undergraduates in Mexico City.

As I had recently gone through a master's degree in Economics at El Colegio de México (as a student) I had the feeling of the uselessness of economics (especially of microeconomics) so aptly now called autistic economics. As I had full freedom to design the programme for three semesters, I decided to do it in a radically different way. So I designed the course as a combination of economic history and history of economic thought, so that by understanding the economic period in which the great thinkers lived, a more profound comprehension of their ideas would be generated. The materials for economic thought were mainly a selection of extracts from the great authors (Adam Smith, Marx, etc.). This was not possible in economic history, so I had to use contemporary books (relying  on contemporary authors like Robert Heilbroner and Leo Huberman). Only in the third semester would neoclassical and keynesian economics be introduced. 

This was part of a radical educational reform. Students had, in paralell two other courses, (based completely on extracts from great thinkers), one called History of the Political and Social Ideas, and the other called Contemporary Problems of Science and Technology.

Another way of teaching economics is indeed possible!

Julio Boltvinik   

Profesor-Investigador de El Colegio de México 

http://www.julioboltvinik.org/ 

Thank you, one additional avenue for a different teaching of economics would be to start with Ecological Economics, i.e. first to describe the human economy as a subsystem of a physical-biological system, exchanging energy and materials with it. The social metabolism. The entropy law and the economic process. Then one could explain different types of human society (from "Stone Age Economics" of Marshall Sahlins onwards). Introduce the rise of the market economy (peripheral markets and the generalized market system, following Karl Polanyi). Then the ideology of the market system, from A. Smith "invisible hand" its formalization in neoclassical economics in the 1870s. The Sraffian critique from the 1920s to the 1960s. Then the Keynesian critique against market equilibria since the 1930s and its revival in the 2008-09 crisis... and end up again with the ecological macroeconomics without growth (and without increase in the public debt) of Tim Jackson and Peter Victor. 

Yours, jma

Joan Martinez Alier

Professor Department of Economics and Economic History

Universitat Autònoma de Barcelona

Dear colleagues, 

In last month’s European Parliament election, euroskeptic and extremist parties won 25% of the popular vote, with the biggest gains chalked up in France, the United Kingdom, and Greece. These results were widely, and correctly, interpreted as showing the degree of disconnect between an arrogant European elite and ordinary citizens.

Less noticed, because less obviously political, are today’s intellectual rumblings, of which French economist Thomas Piketty’s Capital in the Twenty-First Century, a withering indictment of growing inequality, is the latest manifestation. 

We may be witnessing the beginning of the end of the neoliberal capitalist consensus that has prevailed throughout the West since the 1980s – and that many claim led to the economic disaster of 2008-2009.

Particularly important is the growing discontent of economics students with the university curriculum. Undergraduates’ discontent matters, because economics has long been the West’s political lodestar.

This discontent was born in the “post-autistic economics movement,” which started in Paris in 2000, and spread to the United States, Australia, and New Zealand. Its adherents’ main complaint was that the mainstream economics taught to students had become a branch of mathematics, disconnected from reality.

The revolt made little progress in the years of the “Great Moderation” of the 2000s, but was revived following the 2008 crisis. Two important links with the earlier network are US economist James Galbraith, the son of John Kenneth Galbraith, and British economist Ha-Joon Chang, author of the best-selling 23 Things They Don’t Tell You about Capitalism.

In a manifesto published in April, economics students at the University of Manchester advocated an approach “that begins with economic phenomena and then gives students a toolkit to evaluate how well different perspectives can explain it,” rather than with mathematical models based on unreal assumptions. Significantly, Andrew Haldane, Executive Director for Financial Stability at the Bank of England, wrote the introduction.

The Manchester students argue that “the mainstream within the discipline (neoclassical theory) has excluded all dissenting opinion, and the crisis is arguably the ultimate price of this exclusion. Alternative approaches such as Post-Keynesian, Marxist, and Austrian economics (as well as many others) have been marginalized. The same can be said of the history of the discipline.” As a result, students have little awareness of neoclassical theory’s limits, much less alternatives to it.

The aim, according to the students, should be to “bridge disciplines within and outside of economics.” Economics should not be divorced from psychology, politics, history, philosophy, and so on. Students are especially keen to study issues like inequality, the role of ethics and fairness in economics (as opposed to the prevailing focus on profit maximization), and the economic consequences of climate change.

The idea is that such intellectual cross-fertilization would help students understand recent economic phenomena better and improve economic theory. From this point of view, everyone stands to benefit from curriculum reform.

The deeper message is that mainstream economics is in fact an ideology – the ideology of the free market. Its tools and assumptions define its topics. If we assume perfect rationality and complete markets, we are debarred from exploring the causes of large-scale economic failures. Unfortunately, such assumptions have a profound influence on policy.

The efficient-market hypothesis – the belief that financial markets price risks correctly on average – provided the intellectual argument for extensive deregulation of banking in the 1980s and 1990s. Similarly, the austerity policies that Europe used to fight the recession from 2010 on were based on the belief that there was no recession to fight.

These ideas were tailored to the views of the financial oligarchy. But the tools of economics, as currently taught, provide little scope for investigating the links between economists’ ideas and the structures of power.

Today’s “post-crash” students are right. So what is keeping the mainstream’s intellectual apparatus going?

For starters, economics teaching and research is deeply embedded in an institutional structure that, as with any ideological movement, rewards orthodoxy and penalizes heresy. The great classics of economics, from Smith to Ricardo to Veblen, go untaught. Research funding is allocated on the basis of publication in academic journals that espouse the neoclassical perspective. Publication in such journals is also the basis of promotion.

Moreover, it has become an article of faith that any move toward a more open or “pluralist” approach to economics portends regression to “pre-scientific” modes of thought, just as the results of the European Parliament election threaten to revive a more primitive mode of politics.

Indeed, mainstream economics is a pitifully thin distillation of historical wisdom on the topics that it addresses. It should be applied to whatever practical problems it can solve; but its tools and assumptions should always be in creative tension with other beliefs concerning human wellbeing and flourishing. What students are taught today certainly does not deserve its imperial status in social thought.

Read more at http://www.project-syndicate.org/commentary/robert-skidelsky-knocks-the-scientific-halo-off-mainstream-economists--teaching-and-research#MRQoIfXGdd3Oc6G4.99

Robert Skidelsky
Professor Emeritus of Political Economy at Warwick University 
Fellow of the British Academy in history and economics
Member of the British House of Lords

Dear colleagues,

I am pleased to share with you the publication "Social protection assessment based national dialogue: A good practices guide" (ABND guide).

Building social protection floors (SPFs) is a long and continuous process. The ABND exercise is the first step towards the achievement of nationally defined SPFs. It helps formulate relevant and feasible policy options, based on an assessment of the social protection situation, cost estimations and national dialogue.

The ABND guide provides step-by-step support for conducting an ABND exercise. It can be used for self-learning, delivering training workshops and conducting full-fledged ABND exercises. The guide proves most useful for line ministries, social security institutions, social partners, civil society organizations, UN agencies and development partners, social protection taskforces and experts in the field.

The guide is now available as a textbook (publication available in low and high resolutions) and an e-box (interactive website with PowerPoint presentations, exercises and tutorials). You will find more information on the ABND guide in the brochure.

Valerie Schmitt
Chief Social Policy, Governance and Standards
International Labour Organization (ILO)
4 Route des Morillons
CH-1211 Geneva 22 Switzerland
Visit www.social-protection.org
Stay connected!
www.facebook.com/SPplatform
www.linkedin.com/groups?gid=6707223
www.twitter.com/soc_protection

Dear friends,

The principle of providing social protection for the underprivileged is on the rise, but some countries have cut welfare benefits due to recession.

A fortnight ago, the World Health Assembly of health ministers agreed to the principle of universal health coverage. This is taken to mean that everyone should be able to enjoy basic health services.

Last week, a World Social Protection Report 2014-15 that examines recent social security trends in the world was launched by the International Labour Organization.

It looks at how people are covered by social security at all stages of life from birth, as children and mothers, as workers (how they are covered by schemes involving work injury, maternity leave, disability, etc.), as the unemployed (whether there are benefits) and older persons (for example, whether they are covered by pensions).

It is a great aspiration for a society to guarantee or at least pledge that everyone has access to the basic elements needed for a decent life.

But is it feasible to implement such a high goal? It is often argued that countries that spend a lot to provide welfare and benefits for the lower-income groups may face unsustainable budget deficits.

The counter-argument is that governments can raise revenues in various ways, including different types of taxes, and that social security should be a high priority in public spending as it will boost the economy’s demand and social stability.

It was a kind of received wisdom that rich countries can afford social protection but poor countries just don’t have the funds.

Brazils recent experience showed that a middle-income country could channel government funds to the poor so there would be zero hunger, a pledge the former president Lula da Silva made to his people.

Brazil has also argued that the funds provided to the poor have boosted effective demand and contributed to economic growth. Thus, social redistribution not only alleviates poverty and hunger but also reduces inequality and aids growth.

An increasing number of developing countries, including Malaysia, have recently developed their own forms of income support for poor families. This has proven popular and is welcomed by the beneficiaries.

Lessons are still being sought on making the financing of these and other welfare schemes sustainable.

Another major issue is the effect of the current recessionary situation on social security. The ILO report devotes a section to this, raising concerns that austerity measures are affecting social security and creating new poverty, not just in Europe but also in developing countries.

The report finds that most people are without adequate social protection at a time when it is most needed. Only 27% of the world population enjoy access to comprehensive social security.

Social security and healthcare for children, working-age people who face unemployment or injury and older persons is a universal human right, but the promise of universal social protection remains unfulfilled for the large majority, says the ILO.

In the first phase of the global financial crisis (2008-09), at least 48 high and middle-income countries put in place stimulus packages totalling US$2.4 trillion (RM7.7 trillion) that devoted roughly a quarter to social protection measures.

This helped the economies to regain balance as well as protect the unemployed and vulnerable from any economic disaster in these countries.

But in the second phase from 2010 onwards, many governments reversed course and embarked prematurely on fiscal consolidation.

As many as 122 governments are contracting public expenditures in 2014, of which 82 are developing countries, said Isabel Ortiz of the ILO.

The austerity measures include reforms to the pension, health and welfare systems that often reduce their coverage or funding, eliminate subsidies and cuts the number of health and social workers.

High-income countries are contracting their social protection. In Europe, this has contributed to increases in poverty, now affecting 123 million people or 24% of the population.

In contrast, many middle-income countries are expanding their social protection systems, supporting household incomes.

China has sharply increased minimum wages and is close to achieving universal pension coverage, while Brazil has further increased the rate of social protection coverage and minimum wages since 2009.

Due to their low income, the poorer countries have lower social security levels. However, some countries, for example Mozambique, have also extended social protection, yet often through temporary safety nets with very low benefit levels.

At the global level, governments allocate only 0.4% of GDP to child and family benefits. This should be scaled up since many of the 18,000 child deaths a day could be averted through social protection.

Expenditures for social protection for working-age people vary widely worldwide. Only 12% of unemployed workers receive unemployment benefits, ranging from 64% in Western Europe to less than 3% in the Middle East and Africa.

On pensions, 49% of all people over pensionable age worldwide do not receive a pension, while the pension levels are too low for many recipients to avoid poverty.

The good news is that social protection is a mandate of the ILO and other UN agencies. It is expected to be included in the Sustainable Development Goals, which are now being negotiated by the UN in New York. If the principle of social protection is increasingly adopted, the discussion will focus more on how to implement this, with all the problems and options to be considered.

Read the full article at: http://www.thestar.com.my/Opinion/Columnists/Global-Trends/Profile/Articles/2014/06/09/Lending-a-hand-to-the-helpless/

Best regards,

Martin Khor
Executive Director
The South Centre
www.southcentre.int

Dear friends,

Let me reinforce Christina Behrendt’s (ILO) message. On a day like this, the World Day Against Child Labour, we should also recognizes that nearly 60 percent of all child labour is found in agriculture, be it in crop production, livestock farming, forestry or fisheries. Working on the farm is not necessarily bad for children. In fact, it can be good for their development. However, when we talk about child labour it is because, children are exposed to conditions that are harmful to their health and education, thus violating their rights and undermining their future chances of finding decent employment as an adult. Poverty is at the root of persistent child labour, but for the reasons explained it in fact perpetuates poverty and undermines food security.

I also agree with Christina that improved social protection measures for children and their families can help prevent child labour in rural areas. Investments in education, health and nutrition in rural areas are essential to improving productive employment opportunities for youth and adults, in turn reducing poverty and the demand for child labour. But, of course, it is but one piece of the puzzle. Broader rural development and poverty reduction efforts are needed to prevent child labour at its root causes.

In order to raise awareness about the importance of addressing child labour in agriculture, FAO and ILO are working together to develop the E-learning course “End child labour in agriculture”. To access a preview of the first unit and for more information on the upcoming units, please visit: http://www.fao.org/2/childlabouragriculture

Also, to learn more about FAO’s work preventing and reducing child labour in agriculture, visit: http://www.fao.org/childlabouragriculture

Warm regards,
Rob

Rob Vos
Coordinator Strategic Programme on Rural Poverty Reduction (SO3) and
Director Social Protection Division (ESP)
Food and Agriculture Organization (FAO)
Room C-328
Viale delle Terme di Caracalla -- 00153 Rome, Italy
email:  rob.vos@fao.org
Website: http://www.fao.org/economic/esw/esw-home/en

Dear friends,

Today is the World Day Against Child Labour – an imperative, still 168 million children are in child labour, more than half of them in hazardous jobs.

This World Day Against Child Labour draws attention to the essential role of social protection in keeping children out of child labour. The World Day 2014 calls for:

·         Action to introduce and extend social protection floors and build social protection systems

·         National social protection systems that are sensitive to children’s needs and help fighting child labour

The role of family and child benefits in keeping children out of child labour is now well established, particularly where cash benefits are combined with measures to ensure effective access to education and health care. Less well researched, yet nonetheless important, is the role of other elements of national social protection systems in preventing child labour, including universal health coverage, maternity protection, unemployment protection, disability benefits and old age pensions.

Social protection is an essential element of an integrated policy response to child labour, and is part of a broader policy agenda, as Aung San Suu Kyi highlighted in her video message for the World Day: "The best way to get rid of child labour is to make it unnecessary for the security of families. That is to say we have to provide families with the economic, social and political security that would make it unnecessary for them to use their children to secure their future. If we want to secure the future of our globe, we have to secure the future of our children and let us start by doing that to putting an end to child labour".

Read more on child labour and social protection

Best regards.

Christina Behrendt
Senior Social Protection Policy Specialist
Social Protection Department
International Labour Office
4 Route des Morillons
1211 Geneva, Switzerland
Phone: +41 22 799 6455
e-mail: behrendt@ilo.org
Visit www.social-protection.org
Follow us on Twitter and Facebook

Dear friends,

​“The essence of a satisfactory health service,” wrote Aneurin Bevan, the founder of Britain’s National Health Service, “is that the rich and the poor are treated alike, that poverty is not a disability, and wealth is not advantaged.” That vision underpins the idea of universal health coverage (UHC) – a theme that is back with a vengeance on the international development agenda.

Governments are issuing stirring declarations of intent to provide health coverage for all citizens. Aid donors are promising to back their efforts. UHC has even made it on to the short list for adoption as a post-2015 goal.

All of which should be good news for the world’s poor. Ultimately, UHC is about ensuring that all citizens have access to accessible, affordable, quality health provision, regardless of their wealth, gender or other circumstances. We are a long way from that destination. Each year, around 100 million people are driven into poverty by health costs. Some 46 million women give birth without skilled attendance and 26 million children are left unvaccinated against killer diseases. And health inequality remains a life-and-death issue: being born into a poor household in sub-Saharan Africa typically raises the risk of child mortality by a factor of three.

Finance is at the heart of the problem. Governments in low income countries spend too little of their limited resources on health. The upshot is limited and poor quality services that people have to pay for when they fall ill. Around two-thirds of health spending takes the form of out-of-pocket payments – and no money means no treatment.

So progress towards UHC must be a prescription for better health and reduced inequality, right?

Well, yes and no. In health provision as in wealth creation the benefits of national progress often trickle down to the poor very slowly. Unfortunately, progress towards UHC is often governed by the rule of ‘inverse equity’, with those most in need benefiting last and least.

An excellent new paper by Adam Wagstaffe and colleagues at the World Bank demonstrates the point. The authors use survey data to examine national progress towards health-related Millennium Development Goal targets across 64 countries. They then disaggregate performance between the richest 60 per cent and the poorest 40 per cent – an application to health of the World Bank’s ‘shared prosperity’ goal.

The results are instructive. Most countries are making overall progress and relative inequality is falling – on average the poorest 40 per cent are registering faster rates of progress. However, the average obscures as much as it reveals. In almost half of the countries covered inequalities in child survival and malnutrition are growing. Inequality in immunisation was also increasing in around 25 countries. The report builds on a growing body of research evidence on the persistence of health disparities.

Allowing the poor to fall behind in the midst of progress towards UHC is not compatible with basic principles of fairness, equity and social justice. That is why UHC reforms should be guided by the principle of progressive universalism – a commitment to ensure that the poor benefit as least as much as the non-poor from increased coverage.

How should this principle be applied to the post-2015 framework? A thoughtful recent World Bank/WHO paper addresses this question. It argues that policy makers should monitor progress among the poorest 40 per cent – an approach implicitly endorsed in the new World Bank paper.

This is where I part company. Why the ‘bottom 40’? One potential pitfall of this metric is that it potentially diverts attention from the most marginalised. My own preference would be to set explicit equity targets for closing gaps in outcomes and coverage. These could include halving gaps in infant mortality between the richest and poorest 20 per cent, between urban and rural areas, and between ethnic groups

Of course, no amount of quibbling over targets will deliver UHC. One of my frustrations with much of the current debate is the triumph of technical detail over politics. Ultimately, progressive universalism required a mix of public finance, compulsory pooled insurance and equitable public spending. What are the political coalitions and alliances needed to drive change?

There are no blueprints – but experience points to some useful guidelines. Countries such as Thailand, Brazil and Mexico have introduced highly progressive universal health insurance coverage. They did so initially by focussing resources on the poor before expanding the insurance pool to cover the middle class. The reforms survived sometimes turbulent political transitions, in part because they delivered benefits to a broad constituency; and in part because reformers were able to generate a political consensus.

Other ODI research provides insights on how not to pursue progressive universalism. India has invested heavily in health insurance programmes ostensible aimed at the poor. But as a (must read) report by our social protection team documents, these programmes have done little to reduce out-of-pocket payments or reduce health disparities. Poor design and chronic under-financing of primary health care help to explain why.

One parting thought. Aneurin Bevan saw health disparities as a source and symptom of deeper social inequalities. His NHS remains a model for progressive universalism. Yet Britain has some of Europe’s deepest health disparities, as captured in this slide from the King’s Fund. So how about some post-2015 health equity targets for the UK?

Read the full article here: http://www.odi.org.uk/opinion/8458-universal-health-coverage-but-mind-equity-gaps.

Best regards.

Kevin Watkins

Executive Director

Overseas Development Institute ODI

Keep up-to-date with the latest news and views from ODI: http://www.odi.org.uk/services

Dear colleagues,

The premier international conference on public health policy is the World Health Assembly, organised by the World Health Organisation, which attracts Ministers of Health and other top health officials as well as non-governmental organisations to Geneva every year.

This is where the latest trends in public health problems are presented and debated, and action plans for solutions are adopted. This year’s Assembly, which closed on May 24, had 3,500 participants and saw a record number of issues debated and resolutions adopted.

One of the key buzzwords during the Assembly was “universal health coverage” (UHC). This is being promoted by the WHO and several governments as one of the goals for the United Nations’ post-2015 Development Agenda.

There is no precise definition for the term, but it is widely taken to mean that everyone should have access to medical treatment and other health services.

Inability to pay should not prevent someone from being “covered” by the health system, and people should not become financially burdened in order to receive treatment.

The UHC concept is a great one, similar to the “health for all by the year 2000” slogan that the WHO adopted in the 1980s. The “right to health” is one of the human rights recognised by the United Nations.

UHC was the centre of discussion at the panel session on the post-2015 Development Agenda, halfway through the WHA. WHO Director General Margaret Chan stated that there are various ways to finance and achieve UHC and it is for each country to choose its own model.

If UHC is adopted, it will be a big step forward towards equity in the health system.

In a resolution on health in the post-2015 development agenda, the Assembly proposed priority for the health of the newborn, non-communicable diseases, mental health, neglected tropical diseases and completion of existing health Millennium Development Goals.

It also stressed the importance of universal health coverage and the need to strengthen health systems.

The Assembly also adopted a resolution on antibiotic resistance after many delegates expressed their concerns that the bacteria’s growing resistance to medicines was making it difficult to treat many diseases.

The WHO had recently issued a report showing increasing prevalence of resistance in many diseases including tuberculosis (TB), pneumonia, diarrhoea, malaria, skin diseases, and gonorrhoea. It warned of a post-antibiotic era, where drugs will no longer be able to cure infectious diseases.

The resolution urges governments to strengthen the proper use and management of drugs, support research to extend the life span of existing drugs, and to develop antibiotics and diagnostic technologies.

The WHO was asked to develop a draft global action plan within a year to combat antimicrobial resistance, that includes rational drug use, better surveillance, access to medicines and discovery of new drugs.

The Assembly adopted the first-ever global plan to end preventable deaths of newly born babies and stillbirths by 2035, and called for all countries to aim for fewer than 10 newborn deaths per 1000 live births and less than 10 stillbirths per 1000 total births by 2035.

Every year almost three million babies die in the first month of life and 2.6 million babies are stillborn (they die in the last three months of pregnancy or during childbirth).

The Plan’s goals will require every country to invest in high-quality care before, during and after childbirth for every pregnant woman and newborn.

The Assembly also approved the WHO’s strategy to help countries improve access to essential medicines. Key principles include selecting a limited range of medicines using best evidence, efficient procurement, affordable prices, effective distribution systems, and rational use.

Another new global strategy was adopted for TB, aimed at ending the global TB epidemic, with targets to reduce TB deaths by 95% and to cut new cases by 90% by 2035.

Non-communicable diseases, including those caused by diet, were also discussed. At her opening speech, Dr Chan highlighted the increase in childhood obesity, especially in developing countries, and announced a Commission on Ending Childhood Obesity.

The health plight of the poor in middle-income countries was also a theme at the Assembly. Dr. Chan highlighted that 70% of the world’s poor live in middle-income countries. She called for policies to ensure benefits are fairly shared.

A side-event by health NGOs focused on how the middle-income countries were being left out of schemes such as supply of free medicines or the relaxation of patent rules to help the poor, as these are often reserved for low-income countries.

Some developing countries voiced frustration on how they are being picked upon by the United States for having patent laws that prioritise making medicines affordable to the public.

Dr. Chan, in another speech, also criticised free trade agreements that enable tobacco companies to challenge measures taken by governments to curb cigarette sales.

Other issues the WHA discussed include autism, psoriasis, an action plan for disabilities, palliative care, financing for research and development for diseases that affect developing countries, strengthening of medicines regulations, and assessment of health technologies.

Read the full article here

Best regards
Martin Khor
Executive Director
The South Centre
www.southcentre.int

Dear colleagues,

During the recent World Health Assembly (WHA), some policy developments regarding Universal Health Coverage (UHC) became apparent: DG Margaret Chan’s opening address referred to UHC as “one of the most powerful social equalizers among all policy options. The World Bank is a welcome partner in helping countries make their health systems more inclusive”.   The DG considers this “to be a strong signal that UHC is financially feasible and makes good economic sense”. (http://www.who.int/dg/speeches/2014/wha-19052014/en/).

In other words: Countries do not need to wait for economic development any more before investing in health protection for all and such investments contribute significantly to equity. This move has long been awaited: Already in 2001, the International Labour Conference (ILC) reached a consensus that countries should give high priority to extending health protection to all and in its 2008 health protection strategy ILO made the point that such investments are possible for countries at all income levels (http://www.ilo.org/gimi/gess/ShowRessource.action?ressource.ressourceId=5956). This has been recently reaffirmed in the ILO Social Protection Floors Recommendation, 2012 (N°. 202) (http://www.ilo.org/gimi/gess/RessourcePDF.action?ressource.ressourceId=31088) on national floors of social protection.

But how can UHC be achieved? The DG of WHO stated that “universal coverage cannot be achieved through private market-based systems of user fees and private insurance, or through voluntary community-based schemes.” (http://www.who.int/dg/speeches/2014/uhc/en/). This is confirmed in many developing countries: The market or charities were not able to abolish impoverishment from high health care costs and achieve access to health care for all. This requires the overall and primary responsibility of the State, as stated in the Recommendation.

Worrying is a statement from the joint WHO/WB monitoring framework for UHC for post 2015. (http://www.who.int/healthinfo/universal_health_coverage/en/): This framework suggests measuring UHC in terms of some "tracer interventions" rather than focusing on all treatments and preventive measures that constitute essential health care. And what is worse, the measurement is limited to the poorest 40 % of the population. How can we talk about  universality if only some limited treatments for 40 % of the poorest are meant? Universality is defined as 100 % of at least essential health care and not less! How can equity, inclusiveness and the right to health be achieved in countries such as  Burundi, where  more than 80 per cent of the population is living on less than 2 US$/day?  What about the equalizing effects and the economic sense of UHC?

Xenia Scheil-Adlung
Health Policy Coordinator
Social Protection Department
International Labour Organization 

Dear colleagues,

Today, the World Social Protection Report 2014-15 was launched.  The report is a comprehensive source of information on social protection systems, policy trends and social protection statistics.

The report: (i) provides a global overview of the organization of social protection systems, their coverage, benefits, and public expenditures; (ii) following a life-cycle approach, presents social protection for children, women and men in working age, and older persons, including progress towards universal health coverage; (iii) analyses recent policy trends, eg. negative impacts of fiscal consolidation and adjustment measures; (iv) calls to expand social protection for crisis recovery, inclusive development and social justice. 

I hope that this report will be a useful tool for practitioners, and provide the basis for better informed policy-making. 

Please disseminate through your networks.

The report:  http://www.ilo.org/gimi/gess/ShowTheme.do?tid=3985

Isabel Ortiz
Director Social Protection
International Labour Organization (ILO)
4 Route des Morillons
CH-1211 Geneva 22 Switzerland
Tel. +41.22.799.6226; ortizi@ilo.org
Visit www.social-protection.org