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Month: February 2024

The New Era of Corporate Involvement in Public Health

Posted on by Digital Editor

Corporations are increasingly moving into the public health domain. Companies like Amazon, Google, and Microsoft are being “pulled” by market opportunities for non-traditional actors to “disrupt” healthcare. Others are being “pushed” by the imperative – highlighted by events like the COVID-19 pandemic – to act as responsible community stakeholders, such as by helping to address health inequities.

When such pull and push forces intersect, important opportunities often exist to align economic and social objectives. But if strategic corporate philanthropy is to improve public health, those charged with making decisions and allocating resources must have a deep understanding of the health system. It includes the institutions, organisations, and resources that comprise it and the complex interactions among them.

According to a framework established by the World Health Organization (WHO), health systems have six pillars: service delivery; development and deployment of a health workforce; collection, analysis, and use of critical health information; provision of essential medical products, vaccines, and other health technologies; financing; and effective leadership and governance. To meet a population’s health needs, all six must work harmoniously, in an elaborate process involving inputs, activities, outputs, outcomes, and impact.

Consider COVID-19 vaccination programs, which depended on inputs – including financial resources, workers, equipment, and the vaccines – that are partly output from activities like medical-product development and service delivery, with all the logistics, infrastructure, personnel training, and supervision this entails. Together, all these factors lead to an outcome – getting a large enough share of the population vaccinated – with the impact being a reduction in mortality and morbidity from COVID-19.

As the WHO also explains, an effective health system is fair and equitable, both in the distribution of health goods and services and in how they are financed. It also emphasises efficiency and cost-effectiveness, and responds to the legitimate non-health expectations of those seeking healthcare, such as respect and compassion. Ultimately, an effective system ensures that anyone needing a specific health good or service can access it and derive the relevant benefits.

This framework should guide corporations – and all stakeholders – as they engage in the public health domain. So should the principle that any direct investment in the health system must strengthen one or more of the framework’s six pillars. A clear, data-based strategy for measuring health-system performance is crucial.

Only a comprehensive monitoring and evaluating plan – identifying not only what data need to be measured, but also how, when, and by whom – can ensure that decision-makers have the information they need to plan, organise, and implement effective public health programs. For example, it can help to ascertain high- and low-priority areas, as well as areas where services are being duplicated, thereby improving the allocation of scarce resources.

It can also show which public health interventions are making the biggest difference, and be used to track progress in health outcomes, potentially revealing gaps between population segments.

Organisations seeking to engage in public health can use such data – together with a broader understanding of the health-system framework – to identify where they are best suited to make a difference, based on their competitive or comparative advantages. The better they know the terrain they are entering, the easier it will be to pinpoint unmet needs and anticipate the likely impact of their actions (including possible unintended consequences).

Health actors need to engage effectively with other stakeholders, because public health programs often involve diverse groups with different priorities and objectives that must be harmonised to meet overarching health goals. For such engagement to work, however, trust and credibility are essential. An effective impact-measurement strategy can help here, too, by supporting transparency and accountability.

While basic principles of privacy and confidentiality must be respected, organisations should share the positive or negative results of any public health investment or intervention – including relevant datasets, where feasible – with other stakeholders. Beyond fostering confidence, letting others know what works and what does not would accelerate progress in improving health outcomes. Independent evaluations of programs would also help here.

This requires a set of key performance indicators to be established at different levels of the framework used to measure short-, medium-, and long-term changes resulting from any program. There is no need to reinvent the wheel. On the contrary, public institutions should be aligned with global standards, as established in existing policy documents, so stakeholders use the same language.

The final critical insight for companies entering the healthcare domain is that not only are health systems highly complex, but they also operate within an environment in which they must continually interact with various political, socioeconomic, and sociocultural forces—all of these forces – not just interactions within the health system – shape public-health outcomes. The better newcomers understand these interactions, the more likely they will be to have a positive impact on public health.

Rich Nations’ Hypocrisy of Climate Policies

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Too many rich-world politicians and climate campaigners forget that much of the world remains mired in poverty and hunger. Yet, rich countries are increasingly replacing their development aid with climate spending. The World Bank, whose primary goal is to help people out of poverty, has announced it will divert no less than 45pc of its funding toward climate change, redirecting 40 billion dollars annually away from poverty and hunger.

It is easy to treat climate as the world’s priority for those with a comfortable life. The 16pc of the global population who live in those countries do not typically go hungry or watch loved ones die of easily treatable conditions like malaria or tuberculosis. Most are well-educated, and their average incomes are in the league of what was once reserved for royalty.

Much of the rest of the world, however, still struggles. Across poorer countries, five million children die each year before their fifth birthday, and almost a billion people do not get enough to eat. More than two billion people have to cook and keep warm with polluting fuels such as dung and wood, shortening their lifespans. Although most young kids now attend school, low educational quality means most children in low- and lower-middle-income countries will remain functionally illiterate.

Poor countries desperately need more access to the cheap and plentiful energy that previously allowed rich nations to develop. The lack of access to energy hampers industrialisation, growth, and opportunity. In Africa, electricity is so scarce that the total electricity available per person is much less than what a single refrigerator in the rich world uses.

Raiding development funding for climate spending is an abysmal decision. Climate change is real, but the data does not support using scarce development resources to tackle it ahead of poverty-related ills.

Climate activists argue that poverty and climate change are inextricably linked, and we should do both. But we actually do not. Research repeatedly shows that spending on core development priorities helps much more and much faster per dollar spent than putting funds toward climate. That is because real development investments — whether fighting malaria, boosting the health of women and girls, promoting e-learning, or increasing agricultural productivity — can dramatically change lives for the better and make poorer countries better off in so many ways, including making them more resilient against natural disasters and any additional, climate-related disasters.

By contrast, even drastic carbon emission reductions would not deliver noticeably different outcomes for a generation or more. While spending on adaptation to build resilience in poor countries is slightly more effective than cutting emissions, both are far insufficient compared to investing in the best development policies.

Climate change is not the end of the world. Indeed, a UN panel shows scenarios that the world will dramatically improve over the century and that — despite panicked campaigning — climate change will merely slow that progress slightly. Last year, the world saw its largest cereal production ever. With incomes and yields continuing to climb, hunger will fall dramatically over the coming decades. Climate change is forecast to merely make that hunger decline a smidgen slower.

Likewise, the panel expects global average income to increase 3.5-fold by 2100, absent climate change. Even if we do little against climate, William Nordhaus (Prof.), the only climate economist to win the Nobel Prize, shows that this would merely slow progress slightly — by 2100 incomes would still have risen 3.34 times.

We should tackle climate change smartly through rich country governments making sorely-needed, long-term investments in green energy research and development to innovate low-cost solutions that deliver reliable energy at prices everyone can afford. Much of the poorer world primarily wants to pull people out of poverty and improve their quality of life with cheap and reliable energy. Yet rich countries refused to fund anything remotely fossil fuel-related.

This smacks of hypocrisy, because rich countries themselves get almost four-fifths of their energy from fossil fuels, largely because of the unreliability and storage problems of solar and wind energy. Yet they arrogantly castigate poor countries for aspiring to achieve more energy access and suggest the poor should somehow ‘skip ahead’ to intermittent solar and wind, with unreliability that the rich world does not accept for its own needs.

Climate change ranks far down the priority list of people living in poorer countries. A large survey of leaders in low- and middle-income countries similarly reveals education, employment, peace, and health are at the top of their development priorities, with climate coming 12th out of 16 issues. The poorer half of the world certainly deserves opportunities to better their lives. But as politicians are asking for more money, ostensibly to help the world’s poorest, we should demand it goes to efficient development projects that actually save and transform lives, not to feel-good, inefficient climate programs.

World Economy Shifts Leaving Japan, UK Face Growth Pains as Germany, India Rise

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In recent economic developments that have redrawn the global financial landscape, Germany has overtaken Japan to claim the position of the world’s third-largest economy, while India has surged past the United Kingdom (UK) to secure the fifth spot. This reshuffling of ranks, however, is attributed not to a spurt in economic growth but rather to contractions faced by several leading economies.

Japan, previously the world’s third-largest economy, witnessed two successive quarters of GDP decline last year, with a sharp 3.3pc fall in the third quarter followed by a 0.4pc contraction in the following. The UK, too, is struggling with economic downturns, recording contractions of 1.4pc and 0.3pc in the final two quarters of the year, respectively.

The shifts in global economic standings come at a time when many analysts and conservative economists are projecting a continued period of economic headwinds for the UK and Japan this year. The International Monetary Fund (IMF) projected the economies of these two countries are poised to remain subdued, with anticipated growth rates of 0.9pc (UK) and 0.6pc (Japan).

Contrasting sharply with these figures are the economic performances of the United States (US) and India.

The U.S. economy, defying expectations, maintained a robust growth rate of 3.3pc in the fourth quarter of 2023, a full two percentage points above economists’ forecasts. India, too, emerged as a beacon of growth, with its economy expanding by just over seven percent throughout last year. Germany averted the label of a recession-hit economy despite experiencing a 0.3pc decline in one quarter of 2023.

The backdrop to these developments is the widespread economic upheaval triggered by the COVID-19 pandemic, which saw countries across the globe adopting accommodative economic policies. These measures, while intended to cushion the economic blow, fueled inflation across many economies, particularly those with a heavy reliance on services, such as the UK and the US. However, a retrospective analysis of the economic data from the US and India for last year suggests that these countries not only managed inflation effectively but also leveraged domestic inflation and supply chain disruptions to boost manufacturing opportunities, thereby contributing to GDP growth.

The evolving dynamics of global economics show the crucial role of domestic consumption, capital expenditure, and government spending in shaping a nation’s GDP. With nearly half of GDP contributions stemming from domestic consumption, the interplay between spending and manufacturing becomes a critical driver of demand, supply, job creation, and investment. This cycle, balanced by per capita income and the size of demand, underpins steady economic growth.

The economic models of the United States and India, while both showing signs of growth, illustrate contrasting approaches. The U.S. economy benefits from high-income levels, which translate into greater consumer spending, whereas India’s growth is propelled by its vast population and significant public investment in infrastructure.

In contrast, the United Kingdom has faced economic setbacks following its exit from the European Union (EU), with Brexit leading to a loss of international markets and a dearth of new free trade agreements. Manufacturing and exports have suffered due to diminished demand and reliance on foreign labour, while high energy rates have exacerbated domestic inflation, leaving little room for monetary policy adjustments.

Japan’s economic challenges stem from a different set of issues, including competitive manufacturing and an overreliance on exports, compounded by a declining domestic population and purchasing power. Despite these hurdles, government initiatives in Japan, such as fiscal packages aimed at offsetting inflationary pressures through temporary tax cuts and fuel subsidies, hint at potential paths to economic recovery.

Observers of global economic trends might argue that the contractions observed in developed economies are minor and that a rebound is inevitable. Nonetheless, the implications of these GDP contractions on the global economy, particularly for developing nations, are profound and warrant careful consideration. The experiences of Japan and the United Kingdom offer valuable lessons in economic resilience and adaptability.

For developing countries, particularly those in Africa, the global economic shifts emphasise the importance of embracing population growth as an asset rather than a liability, provided there are strategies in place to build capacities. Sustainable economic growth hinges on the quality and quantity of the population. This insight is exemplified by the relative prosperity of countries like Ethiopia, Nigeria, Senegal, and South Africa, which have leveraged their sizable populations to achieve growth, albeit to varying degrees.

The challenges faced by smaller African countries, often constrained by geographical and demographic factors, highlight the critical role of economic unions and trade agreements in promoting regional stability and growth.

The imperative for African governments to drive economic development through public spending on infrastructure and basic industries, alongside the strategic utilisation of natural resources, cannot be overstated. The constraints imposed by multilateral agencies on public debt and the need for more effective financial intermediation in Africa call for a concerted effort to bolster the continent’s financial services sector and unlock its potential for investment, job creation, and technological advancement.

A Dish Served Cold: Chilling Reality of Eating Disorders

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During a work deployment abroad five years ago, I encountered a woman whose frailty was evident in the prominence of her facial, arm and chest bones. Unable to speak the local language, her fluency in various international languages became my lifeline, easing my stay in unfamiliar surroundings.

We worked for a different company but our shared legal background forged a quick and close connection. As our friendship blossomed, she transitioned from her apartment to reside in the same building as me. Then, I began to notice her aversion to food.

I regularly prepare meals, extending invitations to join me just a floor away. While other colleagues relished the Ethiopian and Eritrean cuisine, she consistently left her plate nearly untouched, offering excuses of an upset stomach or having consumed a large meal earlier. It was not until observant friends pointed out her peculiar behaviour with food that I realised her struggle with an eating disorder. She adamantly denied it despite evident signs of malnutrition.

Determined to help, I began experimenting with international dishes she claimed to be fond of; it did not work. My attempts at humour about the cost of untouched food only underscored the severity of her condition. Her reluctance persisted even in restaurants. Dining with her became uncomfortable as she would meticulously move her food around the plate while I emptied mine.

Repeated efforts to encourage professional help were rebuffed.

Five years later, our paths crossed again when she visited me and my newborn. Her appearance shocked me. My once youthful friend appeared significantly aged and gravely ill. Her frailty had intensified, accompanied by a steadfast denial of any issues with food. A mere sip of a soft drink seemed to sustain her.

I discovered that my friend’s plight was not isolated; eating disorders had become a pervasive issue among local teenagers and concerned parents in Ethiopia.

In a culture that values organic and healthy food, eating disorders are lurking behind, particularly in teenagers. A study done in 2016 put the prevalence of eating disorders among adolescents at 8.6pc while the level of unhealthy weight control behaviours was 30.7pc in Ethiopia. Stories emerged of a 17-year-old boy drastically reducing his food intake due to weight-related teasing, and a 15-old girl hospitalised for similar reasons.

Eating disorders extend beyond unhealthy dietary habits; they are rooted in mental and emotional distress, distorted self-perceptions and critical behaviours surrounding food, weight and body image. They manifest in rigid diets, obsessive calorie counting, secretive binge eating and purging after meals. The consequences are severe; encompassing heart disease, bone loss, stunted growth, infertility and kidney damage.

The recovery journey necessitates identifying the underlying causes driving the disorder. Apart from the genetic and biological causes, certain personality traits and obsessive-compulsive tendencies can contribute to developing the disorder while dysfunctional family dynamics and overemphasis on appearance may increase the risk. Media influence that portrays body ideals leads to body dissatisfaction and the desire to attain an unrealistic body shape or weight.

Emotional and mental issues often fuel an individual’s aversion to food as a means of control, coping with painful emotions, or seeking temporary solace from sadness, anger, or loneliness. Over time, these habits permeate every aspect of their lives, depriving them of self-acceptance.

In the 21st century, societal pressure to conform to accepted weight amplifies concerns about appearance and diet. Distinguishing between a healthy lifestyle and a full-blown eating disorder can be challenging for some, particularly as individuals like my friend go to great lengths to conceal their struggles. Offering help is draining but persistence may eventually lead them to seek the assistance they need.

Triumphs Beyond Profit Margins

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I am greeted by the sight of numerous women lining the streets upon returning home from work each day. Their offerings range from fresh produce to aromatic spices, frankincense and exquisitely crafted handiwork such as hats and tablecloths.

My interaction may be limited to frequent glances with purchase plans usually not coinciding; but my attention is drawn to mothers stationed by the roadside, deftly balancing childcare responsibilities while roasting or boiling corn. They work tirelessly to provide and showcase a remarkable strength, as their husbands engage in hazardous and physically demanding occupations. There are some selling nearly spoiled fruit, with desperate or hungry souls opting to purchase these items for a meagre sum.

One day, I came across a woman selling vegetables. Seated on the ground, she offered me collard greens. Although I recently bought some, her persistence and alluring me to buy one and get one free, I decided to make a purchase. She was grateful. She insisted on gifting me some chillies and kale as a gesture of thanks, but I declined. What she had already given was more than sufficient.

Yeshi, as she introduced herself, opened up about her husband’s illness and subsequent job loss, revealing the difficulties they faced in providing for their family of four. Her determination left me contemplating the strength of women like her who persevere in the face of adversity.

While the corporate world may value success in financial statements, for women like Yeshi, it is measured in their ability to provide for their loved ones. Each sale represents a triumph that transcends mere profit margins, reaching the very heart of their family’s welfare. Their livelihood depends on the unpredictable flow of customers, with each unsold item representing a missed opportunity to put food on the table.

Street vendors play a vital role in informal economies. They are the go-getters, the resourceful entrepreneurs who navigate a reality filled with limited opportunities, constant harassment and uncertain livelihoods.

Unfortunately, the path towards this grim reality is paved with neglect. Restrictive regulations often label them as criminals instead of acknowledging their contributions, pushing them to the fringes of society. Without designated vending zones, they are left with no option but to occupy unsafe and unsanitary spaces, making them susceptible to harassment and extortion. The lack of access to basic infrastructure hinders their ability to maintain hygiene and product quality while the constant burden of unofficial payments to law enforcement depletes their already meagre profits.

The consequences go far beyond affecting individual lives. It not only leads to social issues like begging and crime but also undermines public safety and erodes their trust in authorities. The stagnation of the informal economy, which contributes significantly to GDP and employment, hampers overall economic growth while diminishing the contributions of street vendors.

However, forward-thinking policymakers can change this trajectory by recognising the immense potential of street vendors and implementing supportive measures. By formalising the sector through inclusive policymaking, such as establishing designated vending zones, simplifying licensing procedures and providing accessible training programs, improvements can be made in terms of hygiene, safety, and business management.

Investing in market infrastructure, including sanitation facilities and shared storage units, not only enhances working conditions but also raises the quality of products. Collaborating with microfinance institutions to offer affordable loans empowers vendors to invest in their businesses, ultimately leading to long-term growth and sustainability.

These vendors are unsung heroes who hold their communities together. Their existence is a delicate balance, with each sale breathing life into their businesses and each unsold product posing a threat to their survival.

I realised that choosing to support them is not just purchasing a piece of produce but a contribution to their sustenance. Our decision has the power to create an impact – a meal on a child’s plate.

“A desperate state.”

Posted on by Digital Editor

Sarah Vaughan (PhD), a research consultant and a fellow of the University of Edinburgh’s School of Social & Political Science, spoke before the European Parliament about the alarming development in Tigray. According to Vaughan, the impending humanitarian catastrophe is no less dire than in 1988, when she first visited the area during the height of the civil war.

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The percentage of growth the construction industry registered last year, a significant drop from a historical growth rate of 20pc. The construction industry represents 18pc of Ethiopia’s GDP, estimated to be worth 103 billion dollars in 2023.

LOOKING GLASS

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A public phone around the Gofa Mebrat Hail area evokes memories of a bygone era when access to a global network was not a mere dip into one’s pockets. Telecommunication was introduced in 1894, with network interruptions during Italy’s invasion. Ethiopia re-organised the Telephone, Telegraph and Postal services in 1941 and formed the Imperial Board of Telecommunications (IBTE) in 1952. Ethio telecom which has been divorced from the communications authority since 2010 currently has more than 74 million mobile subscribers.

WHEELING & DEALING

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A row of delivery bicycles around the Haya Hulet area await customers looking for services. The significance of incorporating bike lanes becomes apparent in the capital as delivery services have seen a low-cost alternative recently with bikes offering service with initial prices of 30 Br. Companies facilitating the service in partnership with restaurants have also emerged, offering urbanites the convenience of hot meal delivery.

CHASING PAVEMENTS

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A crew of public servants mounts a new speed bump around the financial district in the Mexico area. According to a three-year study by the Bloomberg Initiative for Global Road Safety, the Haile Garment, Bole Bulbula and Gurd Shola areas were reported as hotspots of traffic accidents. Nearly 78pc of traffic accident fatalities are pedestrians of which nearly half are between the ages of 20-49. Recent advances in artificial intelligence technology applied in self-driving cars have been indicated as holding the potential to significantly decrease the frequency and severity of traffic accidents globally.

Addis Chamber Embarks on Leadership Forum

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A leadership forum where prominent executives will share their experiences in the business environment is organised by the Addis Abeba Chamber of Commerce & Sectoral Association (Addis Chamber) and SAK Training & Consultancy Firm.

Headlining Arega Yirdaw (PhD), president of Unity University, who is expected to address the fortunes and adversities of the leadership ecosystem and share insights into his cascade of experiences, the first round is expected to set off at the Inter-luxury Hotel on Tito Street this week.

According to Zekarias Assefa, deputy secretary general at Addis Chamber, the plan is to prepare the forum every month with different panellists. A 3,500 Br fee is required to participate, with the Chamber expecting about 80 attendees.

Wegagen Bank Launches its Mobile App

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Embracing the digital realm, Wegagen Bank officially launched its mobile banking application last week. The App was inaugurated in Dire Dewa City, with Yehwalashet Zewdu, vice president of the Bank Enterprise Services, showcasing its service that provides secure and seamless financial services.

According to Yehwalashet, Wegagen Mobile meets the evolving needs of its clientele in Amharic, English, Afan Oromo, Tigrigna and Somali languages. Incorporated in 1997, Wegagen Bank has grown to become a prominent financial institution with a paid-up capital of 4.5 billion Br and total assets reaching 58 billion Br. Operating through an extensive network of over 424 branches across the country, it continues to play a significant role in the banking sector expanding its digital reach.