A depressed economy is one which suffers a severe, continued, long-standing, recession in economic activities resulting from unforeseen rapid rise in the value of a unit of account. An economic depression is an uncommon and extreme form of recession categorized by duration, unusual rise in rates of unemployment, employees’ resistance to nominal wage cuts, long-lasting credit contracts such as mortgages, decrease in credit availability due to financial crisis and bank failures, price deflation, decreased output as consumers reduce and productions and investments decline, increased rate of bankruptcies including sovereign debt defaults, reductions in international trade and commerce, anxiety and volatile fluctuations in currency value. These reflect the fact that money, which is the root of the economy, essentially has a market like food or cars which has a specific value at any point in time depending on the existing economic conditions. From a purely economic standpoint, economic depression is defined by two factors; decline in real GDP exceeding 10%, or recession lasting 2 or more years.
Similar to medical depression, economic depression has broad and widespread social, economic and psychological effects. It leads to a dramatic reduction in employment, human potential and productivity as well as cripples a country’s output, efficiency and success. As a matter of fact, loss of employment, being one of the major concerns during an economic crisis, has a causal association with mental health problems such as depression. Depression then reduces the chances of re-employment and reintegration into an already stressed economy and ultimately leads to increased debts for the unemployed. Existing data from research show that financial hardship, typically resulting from a depressed economy, can also lead to increased mental health problems and anxiety, rent and mortgage debt, consumer debt and significant deterioration in quality of life and well-being. Following re-employment after economic depression, the labor force may experience reduction in independence, self-direction, locus of control and competence due to loss of skills during depression.
Although some individuals remain employed during an economic depression, they are not exempt from the consequences of the crisis. Constant anxiety due to job insecurity complicates existing depression and affects the productivity of the working force. There is also stress resulting from increased workload since independence and specified job duties are threatened by the contraction of the workforce. Consequently, the ambitions of individuals to pursue opportunities for employment are limited by less choices and more rigorous job requirements in the labor market. All these effects of a depressed economy ultimately affect nations and global health in general.
Humanitarian crisis can be explained as a remarkable and disastrous event or chain of events that threaten the health, safety and well-being of a group of people, community or the public at large. It is an emergency which prevents a population or large group of people from accessing basic needs such as food, water, healthcare, clothing and shelter. A crisis may result from an internal or external factor or differences, and typically occurs over a large area of land. These events often require local, national and international responses as the immediate community may be unprepared to handle such situations. There are different factors that cause or lead to humanitarian crises; consequently, response to each crisis should be targeted towards the particular sectors affected as well as meet the unique needs of the victims involved. Humanitarian crises may result from natural disasters, man-made catastrophes or a combination of complex emergencies, and may cause short, temporal, long-term or permanent damages. Some common examples of events categorized as humanitarian crisis include: armed conflicts, pollution, epidemics, flooding, pandemics, wildfires, famine and natural disasters including hurricanes and earthquakes.
The consequences of humanitarian crises are detrimental to health and leads to increased movement of people which may eventually result in refugee crisis if not addressed or handled properly. For these reasons, national and international agencies such as Ministries of Health, WHO and UNICEF need to assist in the rectification of these tragedies. Till date, the magnitude of the international humanitarian response has remained inadequate and unsatisfactory as up to 2 billion people in over 40 countries worldwide suffer several challenges- especially health-related, from crisis conditions. A recent study published in The Lancet titled “Health in Humanitarian Crisis” revealed that large-scale humanitarian crises are constantly ongoing in many African and Asian countries. Implicated countries include Syria, Afghanistan, Central African Republic, DR Congo, Iraq, Libya, Nigeria, Somalia, South Sudan, and Yemen. After assessing the evidence base for health interventions in humanitarian crises, the study found that there are significant variations in the quantity and quality of evidence available. This reflects the lack of emergency preparedness and limitation of health interventions accessible in times of emergencies and crises.
Noteworthy, many lessons have been learned from past failed responses and lack of recommendations to improve emergency preparedness (EP) and crisis response (CR). Therefore, it is important prioritize EP and CR as well as align humanitarian interventions with development programs, ensure the availability and accessibility of timely and robust health information and to make health interventions more efficient, effective, and sustainable during humanitarian crisis. According to WHO, focused and intensive preparation is fundamental to improved response systems. Identified priorities include health assessments, coordinated response strategies, joint action to tackle suffering and reduce deaths; early identification of response gaps and renovation of local systems that are essential for better health
Universal health coverage (UHC) is based on the fact that all humans have a right to health. It is a movement to make sure that everyone receives the health care and services that they need, at the time which they need it, in the appropriate way or quality and without suffering any financial hardship or going bankrupt while paying for them. To achieve this, it is important that the public sector, which is governments, fulfill their legal obligations to realize this human right to health. In view of UHC, it is therefore important to assess and evaluate the growing engagement and involvement of private parties in the health sector because of their reputation and mission to maximize and prioritize profits and gains. More so, private sectors are not under legal obligations to provide subsidized care or public goods; they may also not have sufficient funds and incentives to accommodate externalities that affect the availability, timeliness, accessibility and quality of health care services.
The engagement of the private sector in the delivery of healthcare includes a broad range of activities carried out by various non-governmental players. These players may include independent multi-national companies, nongovernmental organizations, and nonprofit entities. Undeniably, these private or non-state sectors, including international donors, non-governmental organizations, for-profit providers and traditional healers, play important roles in health care financing and delivery, especially in developing countries. In this way, private sectors have remained useful and their resources have been harnessed in furthering UHC and other public and global health goals through public private engagements or partnerships. Though, this may present some challenges in terms of the ethics, efficiency, safety, effectiveness and cost of health services- given the fact that they’re set-up for profit.
These partnerships are complex and take a variety of forms. It is important for governments in developing countries to strengthen positive private partnerships and take advantage of them to achieve UHC since the lack of resources hinders them to solely deliver and finance healthcare unlike developed countries where the governments mostly fulfill this role. Consequently, the health systems of most developing countries are ‘mixed’- private sectors are integrated with public health systems, with market systems often playing the leading role. Unfortunately, in such systems and countries, insufficient government funding and poor regulation of the private sectors continue to undermine the equity and efficiency of the health system, healthcare and services in general.
In global health, there are many successful partnerships with the private sector that help save and improve lives- according to United States Agency for International Development (USAID). These partnerships facilitate additional funding, contribute unique expertise and help scale impact. USAID emphasizes collaboration, co-design, and co-financing with private sectors, as the drivers of capital markets, to achieve a faster, inclusive growth in global health.
