Note by the Secretariat (Request by the United Kingdom of the Netherlands for admission of Curaçao as an associate member of ECLAC)

Spanish version available

An assessment of the economic impact of climate change on the health sector In Jamaica

Climate change is a naturally occurring phenomenon in which the earth‘s climate goes through cycles of warming and cooling; these changes usually take place incrementally over millennia. Over the past century, there has been an anomalous increase in global temperature, giving rise to accelerated climate change. It is widely accepted that greenhouse gas emissions from human activities such as industries have contributed significantly to the increase in global temperatures. The existence and survival of all living organisms is predicated on the ability of the environment in which they live not only to provide conditions for their basic needs but also conditions suitable for growth and reproduction. Unabated climate change threatens the existence of biophysical and ecological systems on a planetary scale. The present study aims to examine the economic impact of climate change on health in Jamaica over the period 2011-2050. To this end, three disease conditions with known climate sensitivity and importance to Jamaican public health were modelled. These were: dengue fever, leptospirosis and gastroenteritis in children under age 5. Historical prevalence data on these diseases were obtained from the Ministry of Health Jamaica, the Caribbean Epidemiology Centre, the Climate Studies Group Mona, University of the West Indies Mona campus, and the Meteorological Service of Jamaica. Data obtained spanned a twelve-year period of 1995-2007. Monthly data were obtained for dengue and gastroenteritis, while for leptospirosis, the annual number of cases for 1995-2005 was utilized. The two SRES emission scenarios chosen were A2 and B2 using the European Centre Hamburg Model (ECHAM) global climate model to predict climate variables for these scenarios. A business as usual (BAU) scenario was developed using historical disease data for the period 2000-2009 (dengue fever and gastroenteritis) and 1995-2005 (leptospirosis) as the reference decades for the respective diseases. The BAU scenario examined the occurrence of the diseases in the absence of climate change. It assumed that the disease trend would remain unchanged over the projected period and the number of cases of disease for each decade would be the same as the reference decade. The model used in the present study utilized predictive empirical statistical modelling to extrapolate the climate/disease relationship in time, to estimate the number of climate change-related cases under future climate change scenarios. The study used a Poisson regression model that considered seasonality and lag effects to determine the best-fit model in relation to the diseases under consideration. Zhang and others (2008), in their review of climate change and the transmission of vector-borne diseases, found that: ―Besides climatic variables, few of them have included other factors that can affect the transmission of vector-borne disease….‖ (Zhang 2008) Water, sanitation and health expenditure are key determinants of health. In the draft of the second communication to IPCC, Jamaica noted the vulnerability of public health to climate change, including sanitation and access to water (MSJ/UNDP, 2009). Sanitation, which in its broadest context includes the removal of waste (excreta, solid, or other hazardous waste), is a predictor of vector-borne diseases (e.g. dengue fever), diarrhoeal diseases (such as gastroenteritis) and zoonoses (such as leptospirosis). In conceptualizing the model, an attempt was made to include non-climate predictors of these climate-sensitive diseases. The importance of sanitation and water access to the control of dengue, gastroenteritis and leptospirosis were included in the Poisson regression model. The Poisson regression model obtained was then used to predict the number of disease cases into the future (2011-2050) for each emission scenario. After projecting the number of cases, the cost associated with each scenario was calculated using four cost components. 1. Treatment cost morbidity estimate. The treatment cost for the number of cases was calculated using reference values found in the literature for each condition. The figures were derived from studies of the cost of treatment and represent ambulatory and non-fatal hospitalized care for dengue fever and gastroenteritis. Due to the paucity of published literature on the health care cost associated with leptospirosis, only the cost of diagnosis and antibiotic therapy were included in the calculation. 2. Mortality estimates. Mortality estimates are recorded as case fatality rates. Where local data were available, these were utilized. Where these were unavailable, appropriate reference values from the literature were used. 3. Productivity loss. Productivity loss was calculated using a human capital approach, by multiplying the expected number of productive days lost by the caregiver and/or the infected person, by GDP per capita per day (US$ 14) at 2008 GDP using 2008 US$ exchange rates. 4. No-option cost. The no-option cost refers to adaptation strategies for the control of dengue fever which are ongoing and already a part of the core functions of the Vector Control Division of the Ministry of Health, Jamaica. An estimated US$ 2.1 million is utilized each year in conducting activities to prevent the post-hurricane spread of vector borne diseases and diarrhoea. The cost includes public education, fogging, laboratory support, larvicidal activities and surveillance. This no-option cost was converted to per capita estimates, using population estimates for Jamaica up to 2050 obtained from the Statistical Institute of Jamaica (STATIN, 2006) and the assumption of one expected major hurricane per decade. During the decade 2000-2009, Jamaica had an average inflation of 10.4% (CIA Fact book, last updated May 2011). This average decadal inflation rate was applied to the no-option cost, which was inflated by 10% for each successive decade to adjust for changes in inflation over time.

Preliminary Overview of the Economies of Latin America and the Caribbean 2003

Includes bibliography

Preliminary Overview of the Economies of Latin America and the Caribbean 2004

Includes bibliography

Economic relations of Brazil and the United States and the Enterprise for the Americas Initiative

Includes bibliography

The global context and the renewal of the United Nations = El contexto global y la renovación de Naciones Unidas

Introducción En esta época posterior a la guerra fría y de creciente globalización, el rol de las Naciones Unidas experimenta constantes redefiniciones y desafíos. El señor Kofi Annan, Secretario General, afirmó que las Naciones Unidas se encuentran hoy en una encrucijada, y que el momento es tan trascendente como lo fue el de su fundación, hace sesenta años. Aunque los principios fundamentales de la democracia, los derechos humanos y el estado de derecho siguen siendo universalmente aceptados y se consideran piedra angular del orden mundial, el Secretario General considera, como otros muchos, que ha llegado el momento de rediseñar su estructura básica para combinar el imperativo de la acción con la necesidad de legitimidad". En este contexto, durante la visita oficial del Secretario General a Chile en noviembre del 2003, la Comisión Económica para América Latina y el Caribe (CEPAL) fue anfitriona de la mesa redonda "El contexto global y la renovación de las Naciones Unidas", en la que participaron la señora Tarja Halonen, Presidenta de la República de Finlandia, el señor Ricardo Lagos, Presidente de la República de Chile, y el señor Annan. Entre los invitados a este acto se encontraban miembros del cuerpo diplomático en Santiago de Chile, destacados intelectuales, representantes de la sociedad civil y académicos que enriquecieron el debate con preguntas y comentarios. Los tres líderes analizaron la situación política, económica y social del mundo de hoy en el contexto del actual proceso de reforma de las Naciones Unidas. Disertaron sobre los desafíos del desarrollo, el multilateralismo, la interdependencia de los países y su necesidad de contar con una participación ciudadana creciente y coherente en los planos local, regional y mundial. Uno de los temas centrales fue el poder, y el modo en que las Naciones Unidas pueden canalizarlo y redistribuirlo con el fin de que su ejercicio sea colectivo y civilizado. Aunque es imposible resolver en una mañana o en una sola reunión estos complejos asuntos, que en ocasiones resultan abrumadores, tenemos la esperanza de que este libro proporcione inspiración, conceptos e ideas que permitan alcanzar soluciones eficaces e innovadoras en el futuro. José Luis Machinea Secretario Ejecutivo CEPAL"

Towards a new international financial architecture: report of the Task Force of the Executive Committee on Economic and Social Affairs of the United Nations, 21 January 1999 = Hacia una nueva arquitectura financiera internacional: informe del Grupo de Trabajo del Comité Ejecutivo de Asuntos Económicos y Sociales de las Naciones Unidas, 21 de enero de 1999

Publicación bilingüe

Some considerations on the possible effects of the failure of the United States Congress to renew the ATPDEA

Includes bibliography

Trade in services negotiations: a review of the experience of the United States and the European Union in Latin America

Includes bibliography

Finding solutions to the debt problems of developing countries: report of the Executive Committee on Economic and Social Affairs of the United Nations (New York, 20 May 1999)

Includes bibliography

Social dimensions of macroeconomic policy: report of the Executive Committee on Economic and Social Affairs of the United Nations

Introduction The social agenda is long-term in nature, in the sense that poverty alleviation along with a better distribution of income, wealth and opportunities are long-term goals. A sound macroeconomic policy, on the other hand, has to do largely with the consistent management of short-term policy instruments pursuing a sustainable and predictable pace for aggregate economic variables and major prices (wages, inflation, interest rates and exchange rates). In spite of the different arena and rationale in which they play, there are strong links between the two. First and most obvious, macroeconomic adjustment and structural reform are more likely to be sustainable when they are equitable. Second, social intervention —i.e., policies, programmes and reforms aimed at improving social performance in the long run—, needs stable funding which is not always available in view of macroeconomic constraints. Third, macroeconomic instability —especially episodes of recession or hyperinflation— increases poverty and inequality, while restoring macroeconomic equilibrium does not restore previous social balances. Finally, there is no unique macroeconomic policy mix to tackle a given situation, and the policy options may not be neutral from a social standpoint. Monetary, fiscal and exchange rate policies, together with structural reform, have major consequences for the social wellbeing of societies, not only in terms of protection against shocks and crises but also in terms of equity. Many, if not all, of the necessary social policies are of a domestic nature. This report thus concentrates on domestic strategies aimed at maximizing the linkages between consistent macroeconomic policies and social progress. Pursuing them, however, depends to a considerable extent on the international enabling environment in which the global financial system, the unsettled debt crisis and increasing ODA flows play a significant role. Countries operate in a world economy where market players everywhere immediately scrutinize domestic monetary, financial or fiscal policy decisions and the performance of exchange rate regimes of individual countries. Under these conditions, the room for manoeuvre of policymakers has become considerably constrained. Consequently, it is becoming increasingly complex to incorporate the social dimensions into such policy decisions, to the extent that external analysts consider that authorities are sacrificing sound macroeconomic policies. The main message of the report is that the expediency of short-term economic efficiency as embedded in much of the advice on macroeconomic stability needs to be tempered by long-term development objectives. The report starts with a short historical background which describes the ascendancy of macroeconomic policies over social development policies (chapter I). It continues with an evaluation of the relation between macroeconomic consistency and social effort (chapter II), and the importance of sustainable and stable growth for social progress (chapter III). The report then turns to the need for an equity-enhancing growth strategy (chapter IV) and an analysis of the priorities of social policies in an integrated approach to growth (chapter V). The final chapter adds some final institutional remarks.

The United Nations and ECLAC at the half-century mark of the Organization

Includes bibliography

The creation of the United Nations and ECLAC

Includes bibliography