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Opinion

International financial coordination to tackle health problems


Published : 18 Jul 2023 09:57 PM

Socio-economic strategists appear to have hit the nail on the head by pointing out that Governments and international financial institutions need to adopt new ways of providing post-pandemic support to avoid hurting vulnerable communities even further during the Post-Pandemic period. This view has surfaced with various countries all over the world facing diverse healthcare issues arising out of dengue, cholera and diarrhea.

The dengue outbreak in Bangladesh as well as in several South Asian countries, in Africa and Latin America is severely testing social economic conditions, including paucity of financial support for required healthcare and also medical facilities.

In fact it has recently been pointed out by the media that dengue fever, caused by Aedes mosquitoes has taken a serious turn in Bangladesh with steep rise in the number of infections, particularly in Dhaka. There has been a worrying turn in the number of cases and fatalities. The total number of deaths in the first few days of July has already reached 14 whereas 9 deaths were recorded in July of last year. The total number of deaths from dengue this year has reached 65. The paradigm surge indicates that the total number of cases crossed 12,000 with over 3000 cases originating around Dhaka. The sad aspect of this unraveling problem as revealed by DGHS has also drawn attention to the fact that about 60% of the deaths from dengue were female. This scenario has led authorities to conduct extensive drives to identify and control the hotspots of Aedes mosquito breeding ground in different parts of Dhaka.

Analyst Holt has drawn attention to the fact that in the first place the level and distribution of support of these funds has been poor, with the most vulnerable in society, such as informal workers and women appearing to have failed to reach the benefit of relief programmes. Such an ineffective approach appears to be only deepening inequalities at a time when relevant institutions within the United Nations have been warning that up to 95 million additional people could soon descend into extreme poverty in comparison with pre-Covid-19 levels.

Kohonen, Director of the Financial Transparency Coalition (FTC) has also underlined through his observation that “The elite have been sheltered from the worst effects of the pandemic. Nearly 40 percent of Covid-19 recovery funds has gone to large corporations, through measures like loans and tax cuts. This means that social protection for, in particular, women and informal workers, has been inadequate.” Research carried out in this context by FTC has found that in 21 countries in the Global South, large corporations received 38 percent of recovery funds while small and medium-sized enterprises (SMEs) got 20 percent. Social protection measures accounted for only 38 percent. Informal workers received only 4 percent or sometimes even less of the funds- in the countries surveyed. Studies have also exposed that especially women were globally hit hardest by the Covid-19 pandemic, and that economic policy measures taken in response have largely been gender-blind, exacerbating existing gender inequality and economic insecurity in the sector.

Other analysts have also referred to findings of the International Labor Organization (ILO) about the 2 billion informal workers worldwide, and noted that over 740 million of them were women. However, there appears to be a higher share of women than men in informal employment in many of the world’s poorest regions: in more than 90 percent of countries in sub-Saharan Africa, 89 percent of southern Asian countries, and almost 75 percent of Latin American countries. In most cases the vulnerability among women workers go down the ladder even further because most often women also are in jobs likely to be associated with poor conditions, limited or non-existent labor rights and social protection, and comparatively low pay. There is also the absence in most areas of adequate healthcare support.

The FTC report has gone on to draw attention to another facet- that while the COVID-19 pandemic has had a huge impact on women’s employment, working hours, and increases in unpaid domestic and care work duties- women in general have received half the funds than men received.

Some other analysts have also mentioned that their scrutiny of the FTC report has revealed that just doing work collecting data on the distribution of recovery funds underlined how little thought had been given to women in Covid-19 response policies. Interestingly, it has also been revealed that only in a handful of the countries surveyed- in Guatemala, Honduras, Bangladesh, Brazil, and Costa Rica- partial gender-disaggregated data on Covid-19 grants were made available to analyze the Covid-19 support structure. It has also been admitted that available data has shown that women in these countries did receive the majority of social protection funds despite some continuing “discriminative aspects”.

In this regard attention has been particularly drawn towards Ecuador where existing difficulties are hampering the access to aid programmes. Apparently, in that country people have to register online and then go at certain times to receive their aid products. This has however been difficult for a lot of women who either had to be in the home at those times or it was hard for them to avail of public transport to get to the places to receive aid. This has led social strategists to suggest that the criteria under which aid is given out should include a gender perspective. One has to agree with such an observation.

Groups like the FTC and its members, including the TJNA, and their findings are important not just in terms of the post-pandemic recovery but in highlighting the need to change how support is given to the most vulnerable communities in developing countries in the long-term future. Such a matrix should clearly also include easier access to monetary support through banking channels. In this age of digitalization that will facilitate faster extension of support to the needy. We in Bangladesh have managed to move forward faster within this dimension because of our banking delivery systems getting faster.

In addition, it must be remembered, as pointed out by economists A. Chowdhury and J.K. Sundaram- “policy fights over inflation have many dimensions, including class. Instead of helping people cope with rising living costs, increasing interest rates only makes things worse, hastening economic slowdowns. Thus, workers not only lose jobs and incomes, but also are forced to pay more for mortgages and other debts. Unemployment, lower incomes, deteriorating health and other pains hurt workers”.

Another significant aspect has emerged through the FTC report. It has also warned that policies pursued by international financial institutions, such as the International Monetary Fund (IMF), of pushing countries to introduce austerity measures and cut funding for basic public services in return for debt restructuring is making things worse. It has cited the example of the cuts in public spending and rises in Value-Added Taxes (VAT) that are being imposed as part of an IMF loan program in African countries. In Zambia it is particularly having the greatest impact on the poor.

Economist Ishmael known for his insistence on social values has also reiterated that “our current financial structures have perpetuated inequality in the way, for instance, financial institutions give loans. Several countries have had to reform their tax systems … and these financial institutions say subsidies and spending should be channeled into some areas and not others, and it ends up that money is targeted towards large corporate, and vulnerable communities are left behind….. sometimes without safety nets”

Such an observation has only underlined that concerned authorities in the government should put people out of poverty and inequality that has resulted from the Covid pandemic scenario and also conflicts taking place in different parts of the world. We need to remember that socio-economic stability is most important within the matrix of sustainable development.

Against this backdrop scenario one needs to carefully assess the recent comments made by the IMF Managing Director who has warned that “People will be on the streets if we do not fight inflation”. This has reiterated need for effective efforts in this regard.

It is true that many countries in the world today are raising interest rates as a blunt weapon to fight inflation. However, sociologists are also countering the undertaking of such measures, because according to them, it worsens living costs and job losses, while tax cuts mainly benefit the rich. Instead, the general view is that the rich should be taxed more to enhance revenue to increase public provisioning of essential services, such as transport, health and education.

This is something which has also received the attention of the IMF MD who has noted that raising taxes on the wealthy will help close the yawning gap between rich and poor without harming growth. Public provision of childcare and labor market programmes (e.g., retraining) will also improve labor supply. Easing worker shortages can thus dampen price pressures.

It is clear that the current situation requires addressing growing inequality. One step forward that might be acceptable to most, particularly in developing countries, would be “redistributive fiscal measures” – taxing high earners to fund expanded social protection and public provisioning. Such procedures have been tried in the past during emergencies and are time-tested means to address disparities. This can be undertaken through loans with cheap interest rates, grants and other forms of inter-active aid.

 

Muhammad Zamir, a former Ambassador, is an analyst specialized in foreign affairs, right to information and good governance