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Analytical Papers
Economic crisis and the role of the health protection in the national security system

Exclusively for AOSS: – N.O.Ryngach - Candidate of Medical Sciences (PhD), Doctorial theses applicant at the Department of the public health of the National Academy of Public Administration under the Office of the President of Ukraine: It is important to assess existing and potential risks to the public health caused by the economic crisis and their possible impact on national security to identify the priorities for the adequate response.

The world economy is experiencing today the worst since the Great Depression financial crisis. Financial problems in 2007 which seemed to be a temporary problem in the housing market in the United States, turned into a global ones in 2008-2009 and led to the collapse of major financial institutions, the rapid fall in world stock markets and a freezing in credit system that became a reason of full-scale economic crisis with the production decline in developed countries and the prospect of rapid worsening of the situation in developing countries. The slow economic growth and more stringent conditions of access to credit would inevitably lead to a reduction in government revenues and the government's ability to provide the necessary investments to achieve the objectives related to all aspects of human development including health.

It is expected that the crisis will negatively affect the possibilities and goals of development envisaged in the UN Millennium Declaration. Among the targets chosen by Ukraine as key ones, two directly related to health (against HIV/AIDS and TB and to reduce maternal and infant mortality).
The existing world crisis is continuing at the backdrop of profound demographic shifts and global environmental and energy problems and therefore is a serious threat both for public health and for health care and social protection systems.

So important is the evaluation of existing and potential risks to human health and the health system in Ukraine caused by the economic crisis and their possible impact on national security in order to identify priorities in health response (as part of national security) to reduce their negative effect.

The basic principle for the government control over the health system should be as follows: to evaluate existing and potential risks and identify those which actually affect industry and to consistently lobby interests, aimed at the survival of the Ukrainian people and the health system at the level of formulation and implementation of anti-crisis policy.

Existing deficit of budget limits both a possible governmental funding for social programs, and the possibilities to get loans from international organizations.

Even in the case of full implementation of budget commitments at the level of last year, the number of purchased medicines, equipment, services, etc. is progressively diminished at the backdrop of increasing prices. Thus, in Ukraine the price of some drugs has increased two or three times, often without any economic reasons. And more expensive became not only imported drugs, prices on which are dependent on currency rate, but domestic as well, most of which are made from imported raw materials.

During the crisis the rich become richer, the poor – more poor, and those who associated themselves with a middle class will shift to the less prosperous. Reducing the availability of social budget health care will inevitably lead to the activation of healers and illegal treatment outside the medical establishments. The number of cases of unskilled care will increase.

Growth failure of governance is the biggest risk to the health system, which could have catastrophic consequences.

The main areas to reduce the negative impact of economic crisis on public health in Ukraine are: ensuring effective crisis management of industry by bringing the subject of health legislation in line with actual economic situation in the country, saving human resources and infrastructure to ensure effective public health surveillance, priority access to primary health care with the smooth functioning of emergency.

Basing on the experience of previous financial crises it is important to underline the need to protect investments in infrastructure and social development (both public and from other sources) in order to avoid a step backwards in human development and to enable resumption of high-quality economic growth in the medium term.

In future it seems perspective to continue the operational monitoring of the situation, further investigating of the impact of global crisis on health, including changes in social standards and lifestyle, to prepare well-grounded administrative measures to prevent the deepening of the threat to the national security-related factor in public health.

Full text of this Analytical Paper you can read in Ukrainian here or in Russian here.

© 2009 AOSS (Academy of Open Society Security)