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Latin America and the Caribbean countries need to spend more and better on health

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Health spending in Latin America & the Caribbean (LAC) was about USD 1,000 per person in 2017, only ¼ of what was spent in OECD countries (adjusted for purchasing power). At the same time, health systems’ capacity is also considerably lower, including the ability to provide access to services of good quality to the most vulnerable groups. In addition, much is left to to be done to improve efficiency, effectiveness and targeting of health spending. While the LAC region is struggling to respond to the major challenges of the COVID-19 pandemic, a serious reflection is needed not only on how to secure more funding but also on how to spend resources better, according to a new joint OECD – World Bank report, the first Health at a Glance publication entirely dedicated to the LAC region.


Health at a Glance: Latin America & the Caribbean 2020 says that total health expenditure across LAC countries is 6.6% of GDP, lower than the 8.8% in OECD countries. Spending varied from 1.1% in Venezuela to up to 11.7% in Cuba and 9.2% in Uruguay in 2017.


Government spending and compulsory health insurance represent an average of 54.3% of total health spending in LAC, significantly lower than the 73.6% in the OECD. This  shows that health systems in the LAC region are heavily dependent on out-of-pocket expenditures or supplemental private insurance from households. Honduras, Haiti and Guatemala have the highest proportions of private spending, while Cuba and Costa Rica have the lowest.


Health systems in LAC have fewer resources and less capacity than OECD countries to confront the COVID-19 pandemic. The LAC region has an average of two doctors per 1,000 population, and most countries stand well below the OECD average of 3.5, with only Cuba, Argentina and Uruguay having more. The average number of hospital beds in LAC is 2.1 per 1,000 population, that is less than half of the OECD average of 4.7. Barbados, Cuba and Argentina have more hospital beds than the OECD average, whereas the stock is below one hospital bed per 1,000 population in Guatemala, Honduras, Haiti, Venezuela and Nicaragua. Moreover, according to data gathered just before the COVID-19 pandemic started, there were just 9.1 Intensive Care Unit (ICU) average beds per 100,000 population in 13 LAC countries, which is much lower than the 12 ICU average beds per 100,000 population found in OECD countries. Brazil, Uruguay and Argentina are above the LAC average, while the lowest ratios are observed in Costa Rica and El Salvador.


Health at a Glance: LAC 2020
highlights that poor allocation of health spending is slowing down, if not halting, progress towards universal health coverage in LAC. For example, weak health information systems are a major impediment. Across 22 LAC countries, an average of 10% of all deaths are never reported in public mortality databases. This means a reliable picture of population health is often missing. According to the Global Corruption Barometer, 42% of respondents across 12 LAC countries considered that there were corruption problems in the health sector. Most LAC countries have parallel health sub-systems with multiple and overlapping mechanisms of governance, financing and service provision, making it hard to steer resources to where they are most needed in an efficient way.


The report also highlights how quality of care in LAC is often poor. Twelve out of the 33 LAC countries fall short of attaining the minimum immunisation levels recommended by the WHO to prevent the spread of diphteria, tetanus and pertussis (90% of the target population) and 21 out of 33 fail to meet this target for measles (95% of the target population). This indicates the difficulties that countries are likely to have in making a future COVID-19 vaccine available for the whole population. Among six LAC countries with available data, women with early diagnosis for breast cancer had a 78% probability of surviving at least five years, while in adults with colon cancer it was 52% and for rectal cancer it was 46%, which are all much lower than the 85%, 62% and 61% survival rates observed in OECD countries.


Finally, the publication identifies key critical risk factors for poor health in LAC. Eight percent of children under the age of 5 and 28% of adolescents are overweight. This figure increases to over 53% among adult men and to more than 61% among adult women. Obesity increases the risk of chronic disease, and can also lead to complications and death in patients infected by COVID-19. Moreover, nearly one in four men and close to one in ten women aged 15 and above smoke daily. Smoking rates among children aged between 13 and 15 years old are 15% for boys and 12% for girls. Although average alcohol consumption in LAC is lower than in the OECD, it has increased by 3% between 2010 and 2016. Almost 35% and 22% of road traffic accidents among men and women, respectively, can be attributed to alcohol consumption.

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The Netherlands is well prepared to reduce CO2 emissions

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The Netherlands is taking a well-balanced approach to its plans for a rapid transition to a carbon-neutral economy that will support strong growth and energy security, according to a new energy policy review by the International Energy Agency.

To drive this ambitious shift, the Netherlands has focused its energy and climate policy on cutting greenhouse emissions, with targets to reduce emissions by 49% by 2030 and by 95% by 2050 from 1990 levels. In June 2019, it adopted a national Climate Agreement that was developed through a process involving diverse groups from across Dutch society that worked together to define policies and measures aimed at achieving these targets.

“The Netherlands’ Climate Agreement shows broad social and political commitment to its energy transition and serves as an excellent example of how collaborative policy-making can lay the framework for ambitious targets,” said Dr Fatih Birol, the IEA’s Executive Director. “The IEA looks forward to supporting the government as it implements its plans.”

The Netherlands faces notable challenges, the IEA policy review highlights, since its economy remains heavily reliant on fossil fuels and has a concentration of energy- and emission-intensive industries. The IEA report welcomes the steps the government is taking to address these challenges. These include the introduction of carbon pricing for industrial emissions and a competitive subsidy programme that supports a wide variety of emission reduction technologies. It also applauds the government’s leadership in supporting electric vehicles through incentives to purchase them and significant investments in charging infrastructure.

“I congratulate the Netherlands for developing a broad policy framework with robust measures to drive emission reductions in all sectors,” Dr Birol said. “The balance of ambitious targets and competitive support measures will help drive a cost-effective energy transition.”

The IEA report highlights new energy security challenges the Netherlands is facing. In line with its climate targets and in response to safety concerns over earthquakes caused by natural gas production, the government plans to end production from the Groningen gas field by mid-2022. Gas from Groningen covers a large share of the Netherlands’ heating and industrial energy demand and is a key source of regional gas supply.

The government is taking firm measures to reduce natural gas demand, both domestically and in cooperation with neighbouring countries. At the same time, it is taking a leading role in developing a market for low-carbon hydrogen to partly replace natural gas and drive emission reductions in hard-to-decarbonise sectors like industry and heavy transportation. This is complemented by support for carbon capture and storage, which is also aimed at lowering industrial emissions.

“The Netherlands has a clear vision for reducing its dependence on natural gas while protecting energy security,” Dr Birol said. “In addition, its commendable leadership on low-carbon hydrogen will help drive cost reductions that are needed for this important technology to play a key role in accelerating clean energy transitions around the world.”

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Day-to-Day Items That Can Now Be Made Using Organic Materials Only

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According to Pew Research, three-quarters of Americans are concerned about helping improve the environment.

Unfortunately, only one in every five Americans is willing to make an effort to change the negative impacts on the environment. A key reason why this happens is that many people have no idea where to start when it comes to saving mother earth.

But did you know that you can be a hero just by substituting some of the essential items you use every day with eco-friendly products?

If you’re in doubt, here are a few everyday items that you can substitute with their readily available eco-friendly alternatives.

1.     Reusable Grocery Bags

Every year, an estimated one trillion plastic bags are used globally. Most of these bags end up in landfills, where they take forever to degrade.

The use of recyclable shopping bags can reduce plastic waste without any inconvenience on your part.

Unlike bags made of plastics, recyclable shopping bags decay faster due to their natural materials. Being reusable also means that they last longer, which allows you to save money while saving the planet.

2.     Eco-friendly Blankets

A comfortable blanket that also eases your ecological footprint worries will definitely give you a restful sleep. Blankets made from recyclable materials are environmentally friendly as they leave less synthetic fillings on the environment.

A eucalyptus blanket is an excellent example of an eco-friendly blanket. These blankets are soft and subtle as they are made from a poly microfiber eucalyptus fabric. Unlike traditional beddings, these eco-friendly blankets keep 50 plastic bottles away from landfills, which is much better for our environment.

3.     Recyclable Straws

Americans use around 500 million plastic straws daily, which could fill over 125 million school buses.

Plastic straws are made from polypropylene, a dangerous chemical that affects our estrogen levels. The disposal of these plastic straws also introduces a lot of plastic waste into the environment.

But you can now substitute your plastic straws with reusable stainless steel straws. We also have biodegradable straws in the market made from bamboo sticks, coconut leaves, cane stems, or paper.

4.     Organic Sanitary Towels

Organic sanitary pads are gaining popularity as they have fewer dyes and additives. They are also safer for the environment.

Most of the modern sanitary pads are manufactured from plastics or their derivatives. Many women complain that the perfumes and dyes often used on these pads irritate their sensitive skin. This has seen many ladies turn to organic pads.

Most organic sanitary towels are made of cotton cloth or other biodegradable materials. Others have a plant-based top material made of wood, bamboo, jute palp, or banana. This makes them free from plastics, chemical dyes, and additives. The organic sanitary towels are also more comfortable, sustainable, and eco-friendly. Since they are also compostable, their use reduces the accumulation of plastic waste on our planet.

The above four products are just a few examples of eco-friendly alternatives that you can use in place of everyday products. If you haven’t started saving our planet, now would be a good time to start!

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COVID-19 leads to massive labour income losses worldwide

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The devastating losses in working hours caused by the COVID-19 pandemic  have brought a “massive” drop in labour income for workers around the world, says the International Labour Organization (ILO) in its latest assessment of the effects of the pandemic on the world of work.

Global labour income is estimated to have declined by 10.7 per cent, or US$ 3.5 trillion, in the first three quarters of 2020, compared with the same period in 2019. This figure excludes income support provided through government measures.

The biggest drop was in lower-middle income countries, where the labour income losses reached 15.1 per cent, with the Americas the hardest hit region at 12.1 per cent.

The ILO Monitor: COVID-19 and the world of work. Sixth edition , says that the global working hour losses in the first nine months of 2020 have been “considerably larger” than estimated in the previous edition of the Monitor (issued on 30 June).

For example, the revised estimate of global working time lost in the second quarter (Q2) of this year (when compared to Q4 2019) is for 17.3 per cent, equivalent to 495 million full time equivalent (FTE) jobs (based on a 48-hour working week), whereas the earlier estimate was for 14 per cent, or 400 million FTE jobs. In Q3 of 2020, global working hour losses of 12.1 per cent (345 million FTE jobs) are expected.

The outlook for Q4 has worsened significantly since the last ILO Monitor  was issued. Under the ILO’s baseline scenario, global working-hour losses are now projected to amount to 8.6 per cent in the fourth quarter of 2020 (compared to Q4 2019), which corresponds to 245 million FTE jobs. This is an increase from the ILO’s previous estimate of 4.9 per cent or 140 million FTE jobs.

One reason for the estimated increases in working-hour losses is that workers in developing and emerging economies, especially those in informal employment, have been much more affected than by past crises, the Monitor says.

It also notes that the drop in employment is more attributable to inactivity than to unemployment, with important policy implications.

While many stringent workplace closures have been relaxed, there are significant variations between regions. 94 per cent of workers are still in countries with some sort of workplace restrictions, and 32 per cent are in countries with closures for all but essential workplaces.

The “fiscal stimulus gap”

The 6th edition of the Monitor also looks at the effectiveness of fiscal stimulus in alleviating labour market impacts.

In countries where sufficient data is available for Q2 2020, a clear correlation exists, showing that the larger the fiscal stimulus (as a percentage of GDP), the lower the working-hour losses. In that period, globally an additional fiscal stimulus of 1 per cent of annual GDP would have reduced working hour losses by a further 0.8 per cent.

However, while fiscal stimulus packages have played a significant role in supporting economic activity and reducing the fall in working hours, they have been concentrated in high-income countries, as emerging and developing economies have limited capacity to finance such measures.

In order for developing countries to reach the same ratio of stimulus to working hours lost as in high-income countries, they would need to inject a further US$982 billion (US$45 billion in low-income countries and US$937 billion in lower-middle income countries). The stimulus gap for low income countries amounts to less than 1 per cent of the total value of the fiscal stimulus packages announced by high-income countries.

This huge “fiscal stimulus gap” is even more worrying in the light of the social protection deficits in many developing countries. Moreover, some of these countries have also had to redirect public spending from other objectives in order to mitigate the labour market impact of the crisis.

“Just as we need to redouble our efforts to beat the virus, so we need to act urgently and at scale to overcome its economic, social and employment impacts. That includes sustaining support for jobs, businesses and incomes,” said ILO Director-General Guy Ryder.

“As the United Nations General Assembly gathers in New York, there is pressing need for the international community to set out a global strategy for recovery through dialogue, cooperation and solidarity. No group, country or region can beat this crisis alone,” he concluded.

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