A regional approach to disaster risk reduction strategies, which integrates the health sector, would help countries mitigate the effects of natural disasters by improving resilience and emergency response.
Two weeks ago, Typhoon Haiyan tore across the Philippines archipelago leaving in its wake the increasingly familiar scenes of decimated communities and fields of debris that follow such catastrophic events.
With Typhoon Haiyan, the goodwill generated by the services of Overseas Filipino Workers (OFWs) in high-income OECD and oil-rich Gulf Arab states has no doubt contributed to the generous public donations now flowing in from around the globe. OFWs make significant service contributions particularly in the health, social and domestic care sectors and their remittances account for the largest proportion of foreign exchange income for the Philippines, with the biggest sources coming from OFWs resident in the US, Saudi Arabia, Canada, the UK, the United Arab Emirates, Singapore, and Japan. These countries have been among the largest contributors to the current emergency aid effort.
Future disasters of a similar scale in other countries, however, may not be able to tap into this unique source of global goodwill. It is thus of increasing importance to develop systems for emergency response and resilience that are less dependent on charitable contributions from high income countries.
Moving from charity to self-sufficiency
According to the latest SREX report of the Intergovernmental Panel on Climate Change, natural disasters of this scale will continue to occur globally, and a more recent report from the Institution of Mechanical Engineers concludes that the rapid urbanization being witnessed around the world will amplify individual countries’ susceptibility to them.
These disasters will disproportionately affect the most vulnerable, and in a few fleeting moments can roll back years of hard fought progress on human health and development goals; it is imperative then that sufficient investment is made into disaster risk reduction (DRR) strategies at all levels.
Multi-billion dollar natural disasters are now more common, and five of the ten costliest disasters have occurred in the last four years. In 2012 alone, such disasters were estimated to have cost $378 billion. Aid spending on disaster prevention and preparedness programmes in recent decades has however not reflected the needs within the sector. The Global Facility for Disaster Reduction and Recovery (GFDRR) estimates that in the 20 year period from 1991-2010, of the $3.03 trillion spent globally on international aid, only $13.5 billion (0.45%) were spent on disaster prevention and preparedness.
For the Philippines and the surrounding typhoon, tsunami and earthquake-prone region as a whole, a multinational, collaborative approach to preparing for and responding to such disasters is in the interests of all neighbours. This spirit of cooperation should extend to cover preparedness and mitigation strategies, as well as early warning systems and emergency response and recovery.
Sufficient attention must also be paid by governments and multilateral agencies to the integration of the health sector, a key component of an effective regional DRR strategy. There are already some successful schemes where this has been achieved.
For example, Latin American countries have developed, in collaboration with the Pan American Health Organization (PAHO), a regional Hospital Safety Index. With over half of the 16,000 hospitals in Latin America and the Caribbean located in areas at high risk for disasters, this index helps health facilities assess their safety by predicting the likelihood a hospital or health facility will continue to function in emergency situations, based on structural and functional factors (including the environment and health services network to which it belongs).
PAHO played a crucial role in bringing together individual countries to collaborate on the initiative, and demonstrated the value of a regional approach incorporating local expertise and needs. Recent disasters have spurred similar activity in a variety of countries, including Pakistan, Nepal and some Caribbean island states, now committed to building safer, more resilient hospitals as part of a national DRR strategy.
Within this broad remit of cooperation around health and DRR should lie a joint financing mechanism for disaster preparedness and response. In the past few years a number of innovative financing tools have been developed that allow countries to pool monetary assets and risk in a common disaster fund which can be rapidly accessed when required for funding health and other related interventions in a disaster situation. The World Bank for instance, already offers catastrophe (CAT) bonds that transfer the risk of a natural disaster to investors by allowing the issuer not to repay the bond principal if a major natural disaster occurs.
Countries and regions could similarly develop their own financial products after careful consideration of their own disaster risk and insurance needs. There should also be an agreed framework for sharing logistical assets between participating countries in the event of a disaster. These should include assets such as aircraft, military and civilian ships and floating mobile hospital units.
Since the inception of the United Nations International Strategy for Disaster Reduction (UNISDR) and the adoption of the ten-year Hyogo Framework for Action (2005-2015), a wealth of evidence, expertise and experience has been generated in how countries can best prepare for and mitigate the effects of natural disasters. For its part, the World Health Organization has worked closely with UNISDR to develop the Humanitarian Health Action programme specifically focusing on integrating and sustaining the importance of health in DRR strategies.
The essential tools for a regionally tailored and evidence-based DRR strategy are therefore already present in southeast and east Asia. In the spirit of self-sufficiency and mutual goodwill it is high time the countries of this repeatedly affected region now come together and cooperate on a DRR strategy that pools their resources and expertise.
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