ASIA & OCEANIA

A High-level Workshop Convenes Experts to Discuss Early Assessment Findings on One Health Approach for Central Asia Program

Government officials representing health, environment, agriculture and finance sectors from countries across Central Asia participated in the One Health Regional Technical Workshop, entitled Developing the Central Asia One Health Framework for Action, which took place in Samarkand, Uzbekistan.

The discussion focused on the early assessment findings of the Central Asia One Health Framework for Action, which aims at providing direction and coordination mechanisms for regional cooperation to address needs in the areas of zoonotic diseases, antimicrobial resistance and food safety. Participants also got acquainted with the findings of a new comprehensive report prepared by the World Bank, “Protecting Food Systems, Preventing Future Pandemics: The Case for a Central Asia One

Health Program”. The workshop reviewed the recommendations from five regional assessments and provided a valuable platform for participants to collaboratively generate practical strategies for implementing the One Health approach at both national and regional levels.

The report shows that the One Health approach is cost-effective for countries and the region. According to World Bank analysis, annual investments of $1.9 to $3.4 billion in One Health systems (based on disease prevalence) by the international community can generate a 44–71% annual expected rate of return and prevent mild pandemics by half or entirely.

Central Asia is particularly vulnerable to emerging infectious disease outbreaks, as it is located at an intersection of global value chains with countries that rely heavily on labour migration. Across the region, animal diseases have a detrimental impact on productivity, regional food supply and agricultural competitiveness. The region also has a unique advantage to prevent and tackle future disease outbreaks due to the shared epidemiological past of the countries. The region already has a foundation for implementing One Health – a collaborative approach that brings agriculture, environment and public health sectors together to prevent, detect, respond to and recover from infectious diseases. Implementing a Framework for Action will require building on this foundation to further strengthen regional cooperation and complement this with investments and capacity building.

“A comprehensive response to implementing a One Health approach will only be possible through regional high-level commitment and coordinated action, in collaboration with international and local partners,” noted Jane Ebinger, World Bank Sustainable Development Sector Leader. “While Central Asian governments would ensure national ownership and technical and financial sustainability of a One Health regional initiative, international partner organisations may be asked to consider providing coordinated support.”

Priority Reforms Key for Sustaining Growth and Achieving China’s Longterm Goals

China’s economic activity bounced back in the first quarter of 2023 with the removal of mobility restrictions and a surge in spending on services. However, growth momentum has slowed since April, indicating that China’s recovery remains fragile and dependent on policy support, according to “Sustaining Growth through the Recovery and Beyond”, a recent China Economic Update released by the World Bank.

China’s GDP growth is projected to rise to 5.6% in 2023, led by a rebound in consumer demand. Capital spending in infrastructure and manufacturing is expected to stay resilient. Meanwhile, external demand is expected to remain soft, with weak global growth impacting exports.

“Implementation of key structural reforms remains crucial to solidify the recovery and achieve China’s longerterm goals of environmentally sustainable, resilient and inclusive growth,” noted Mara Warwick, World Bank Country Director for China, Mongolia and Korea. “The economic recovery provides opportunities for further reducing financial risks, strengthening the social safety net and implementing market reforms to encourage private investment while putting the economy on a more efficient decarbonisation path.”

Risks to China’s growth outlook are tilted to the downside. Sluggish income growth, lingering uncertainty about the recovery in the labour market as well as high household precautionary saving could hold back consumer spending. Although the property sector is showing signs of stabilisation, excessive leverage among developers remains largely unaddressed, and persistent weakness in the sector could weigh on the economic recovery. Externally, risks emanate from weak global growth prospects, sharper-than-expected tightening in financial conditions as well as heightened geopolitical tensions. On the upside, a faster jobs recovery could boost sentiment and contribute to higher consumption growth.

The report also examines opportunities to deploy fiscal policies to reduce inequality, a key development policy objective. “As in the past, robust economic growth that creates jobs and boosts household incomes will remain important for shared prosperity,” commented Elitza Mileva, World Bank Lead Economist for China. “In addition, fiscal policy – both revenue and spending measures – can be effective in promoting more equitable income distribution among China’s population.”

Increased Revenue Required to Meet Thailand’s Public Spending Needs

After a significant fiscal response to COVID-19, Thailand now needs to address growing spending needs while keeping public debt under control, according to a recent World Bank report.

“Thailand Public Revenue and Spending Assessment – Promoting an Inclusive and Sustainable Future” details the reforms needed to mitigate rising fiscal pressures. These include challenges associated with the ageing population, which will increase the costs of public pensions and healthcare while constraining economic growth.

“Thailand can achieve a more equitable and resilient economy by improving the efficiency of public spending, raising revenues and implementing policies to support the most vulnerable and respond to climate-related challenges,” noted Fabrizio Zarcone, World Bank Country Manager for Thailand. “The World Bank stands ready to assist Thailand with its fiscal reforms to achieve these goals.”

The report highlights the need for increased public spending on social protection, education and climate adaptation. Thailand’s Old Age Allowance, among other social assistance payments, is low compared to global standards. Per-student education spending at the pre-primary and secondary levels lags behind international benchmarks. Increased spending in these areas has the potential to improve equity and boost human capital. Significant investments in climate change adaptation are also required – to mitigate the costs associated with increasingly frequent and severe flooding, storms and coastal erosion.

While public debt rose due to the pandemic response, overall fiscal risks remain manageable. The report suggests that in the near term, the government can afford to increase spending on public infrastructure and other priority areas, while consolidating spending elsewhere.

Over the longer term, meeting these spending needs while maintaining a sustainable public debt position will require an increase in public revenues. The report recommends a series of progressive tax reforms that could collectively increase revenues by 3.5 percentage points of GDP. These include raising the VAT rate and removing exemptions, broadening the personal income tax base and streamlining allowances and deductions, as well as expanding property tax collection. If implemented gradually over the rest of this decade, these reforms would promote equity while providing the revenue needed to fund increased spending. Negative impacts on the poor could be offset by social assistance reforms, while still achieving substantial net revenue gains.

“Raising revenue collection will be necessary, and there is also room to improve the efficiency of public spending on social assistance, education and health,” said Kim Alan Edwards, Senior Economist and Program Leader at the World Bank. “For instance, better targeting of social assistance benefits would reduce the overall fiscal cost of raising benefit amounts while ensuring gains in poverty reduction.”

The report suggests that in education, consolidation and better resourcing of primary schools could lead to improvements in learning outcomes. In health, better screening of non-communicable diseases and more focus on preventative measures would reduce the need for more expensive treatments later. The design of public health insurance purchasing arrangements could also be improved to reduce costs.