Macroeconomics and Health (CMH)

MacroHealth Newsletter

No. 4 May 2003


Just as SARS is transmitted from person to person and place to place, the disease is spreading economic havoc. Health sector expenditure is soaring as costly measures are adopted nationwide: a new SARS hospital, fever clinics, and rings of monitoring and defense stations in Beijing and other provinces. Meanwhile, the virus is slowly spreading into the impoverished rural hinterlands, where public awareness of the risks of SARS is limited and the long-neglected health care system may be unable to cope with an outbreak. China has not been sufficiently investing in health for the past two decades and the health system is badly prepared to tackle diseases such as SARS.

In the four months since SARS first emerged in China, WHO has helped the Government to appreciate the threat of SARS, supporting the authorities with direct technical expertise and immediate advice on the identification, prevention and control of the outbreak. Moreover, WHO has provided the Government with longer-term solutions for strengthening health systems and increasing financing in health to improve responses to existing and emerging health risks. One such solution is a strategy for achieving sustained economic growth through investment in health, based on the recommendations of the CMH Report.

In December 2002, Chinese authorities were presented with evidence that investing in health not only results in healthier populations, but also contributes to equitable development and economic growth. This has led authorities to seriously consider extending coverage of crucial health services, including essential health interventions, particularly for the poor. These would improve responses to public health threats, save millions of lives each year, and contribute to the country's economic development. Research on key issues is critical and includes: identifying China's health priorities through systematic analysis of disease burdens and health risks in different parts of the country; identifying interventions to address those diseases and health risks; costs and financing of interventions and services; and strengthening health systems to deliver essential services to the people.

China's situation presents both a formidable challenge and a great opportunity. Increased investment in health coupled with a stronger public health system would improve responses to deadly outbreaks such as SARS, address China's disease priorities and future health challenges, and eventually yield unprecedented dividends to the country.

Dr Henk Bekedam
WHO Representative, China


Investing in health discussed during World Health Assembly briefing

A briefing on "Scaling up Investment in Health: Country Responses to the Commission on Macroeconomics and Health" took place during this year's fifty-sixth World Health Assembly on 21 May. A WHO team from Regional and Country Offices and from HQ jointly delivered the presentation. Participants included representatives from Member States and the civil society who were invited to debate the issue of scaling up health investment for the world's poor in order to save millions of lives, generate economic gains and reduce poverty. Participants heard how regions and countries have progressed with fostering the linkage between macroeconomics, development and health efforts, and with plans for incorporating the promotion of better health outcomes in national development strategies.

Another technical briefing "Pro-poor health policies towards the Millennium Development Goals: country evidence and tools" also took place on the 21 May. This briefing presented initial WHO evidence on the effectiveness of various policies and interventions in improving health outcomes of the poorest and in reducing the poor/non-poor health gaps in developing countries.

Global consultation on CMH

The Second Consultation on Global and National Responses to the CMH Report will take place from 28-30 October 2003 in Geneva. Convened by WHO HQ with the active support of Regional and Country Offices, the meeting will offer an important opportunity to debate on the most effective approaches for increasing investment in health. Senior country representatives will update participants on country achievements linking health to poverty reduction processes and economic development, share innovative experiences and discuss common issues.

New WHO publication

WHO has recently published a new booklet Investing in Health: A Summary of the Findings of the Commission on Macroeconomics and Health. The new publication describes the main findings and recommendations of the CMH Report and outlines how some countries are moving forward by examining health priorities and the investments required to achieve better and sustained health outcomes. First copies of the publication were distributed at the World Health Assembly. The booklet can be downloaded from:

WHO Macroeconomics and Health web site launched in May 2003

The new WHO Macroeconomics and Health website has been launched in May 2003. The website will provide detailed information on WHO macro-economics and health work, the latest action in countries, news and links with related sites, and links to the CMH Report and its Working Group Reports. Published documents and reports can be downloaded from the site. To ensure that the website becomes a forum for sharing ideas, information and news, readers are encouraged to submit their views and work on macroeconomic and health issues. For more information, visit:

Poverty and health guidelines

The Organization for Economic Co-operation and Development (OECD) and WHO have recently jointly published Poverty and Health in the DAC Guidelines and Reference Series. This DAC Reference Document dedicated to health and poverty in developing countries expands on the DAC Guidelines on Poverty Reduction and provides a set of policy recommendations to a broad range of development agency staff working on policy and operations. It provides a framework for action within the health system, and beyond it, through policies in other sectors and through global initiatives. This document outlines a pro-poor health approach that:

  • Gives priority to promoting, protecting and improving the health of the poor
  • Includes the development of pro-poor health systems, with equitable financing mechanisms
  • Encompasses policies in areas that have a crucial impact on the health of poor people (education, nutrition, water and sanitation)
  • Is integrated in country-led poverty reduction strategies and health sector programmes
  • Takes into account global public goods and policy coherence concerns, including health surveillance, R&D in poverty-related diseases, trade policy issues regarding drugs and vaccines, and migration.

For more information on the Development Assistance Committee (DAC) please visit:,,EN-about-notheme-2-no-no-no-0,00.html The Guidelines can be ordered from:,,EN-document-notheme-2-no-15-40344-0,00.html