Fifty years ago, health outcomes in the countries of Eastern Europe and Central Asia were not far behind those in Western Europe and well ahead of most other regions of the world. But progress since then has been slow. While life expectancy in the ECA region today is close to the global average, the gap with its western neighbors has doubled, and other middle-income regions have all surpassed ECA. Some countries in the region are doing better, but full convergence with the world’s most advanced health systems is still a long way off. At the same time, survey evidence suggests that the health sector is the top priority for additional investment among populations across the region. The experience of high-income countries also suggests that popular demand for strong and accessible health systems will only grow over time. Yet these aspirations must be reconciled with current fiscal realities. In brief, health sector issues are a challenge here to stay for policy-makers across the ECA region. This report draws on new evidence to explore the development challenge facing health sectors in ECA, and highlights three key agendas to help policy-makers seeking to achieve more rapid convergence with the world’s best performing health systems. The first is the health agenda, where the task is to strengthen public health and primary care interventions to help launch the “cardiovascular revolution” that has taken place in the West in recent decades. The second is the financing agenda, in which growing demand for medical care must be satisfied without imposing undue burden on households or government budgets. The third agenda relates to broader institutional arrangements. Here there are some key reform ingredients common to most advanced health systems that are still missing in many ECA countries. A common theme in each of these three agendas is the emphasis on improving outcomes, or “Getting Better”.

This study explores the appropriateness of health-related Millennium Development Goals (MDGs) for the countries of the Europe and Central Asia region, and the implications for policy choices at the regional, subregional and country levels. Findings include that, for the region as a whole, proportionately more gains in life expectancy would accrue from the control of non-communicable diseases (NCDs) than from achieving the targets in the classic MDGs. Other issues highlighted include the importance of reducing morbidity and premature mortality from NCDs and external causes across the entire region; and the need to focus on the classic MDG indicators (infant mortality rates, under-five mortality rates and maternal mortality ratios) in the countries of Central Asia and the Caucasus.

Annotation Provides information on progress and trends, including poornonpoor disparities; health systems reform as a means of laying building blocks for the efficient and equitable delivery of effective interventions; the financing of health spending through domestic resources and aid; and improving the effectiveness of development assistance in health. Linking the health Millennium Development Goals? agenda with the broader poverty-reduction agenda, this book is a valuable resource for policymakers in developing countries and development practitioners working in the health, nutrition, and population sector as well as students and scholars of public health.

The report presents the yearly assessment of global progress towards the MDGs, determining the areas where progress has been made, and those that are lagging behind. It pinpoints the areas where accelerated efforts are needed to meet the MDGs by 2015. The report is based on a master set of data compiled by the Inter-Agency and Expert Group on MDG indicators led by the Statistics Division of the Department of Economic and Social Affairs.

Compared to other regions, Europe and Central Asia are by far the oldest. Moreover, population aging is set to accelerate further over the coming decades as large segments turn old. Additionally, some countries such as Russia and certain Eastern European countries are facing a shrinkage of their population. Against this backdrop, this report investigates what stands in the way of societies reaping the full benefits of increased longevity--that is, longer lives and potentially prolonged payoffs from human capital--and what can help to mitigate the possible negative impacts of a smaller and older workforce. Beginning with a focus on demographic trends, the report puts the rapid decline in fertility and contrasting migration trends in the region in a historical perspective and looks forward to the varying paths that population change may follow in the region. Next, it examines the evidence on the likely impact of demographic change on growth and savings, the labor force, firm and economy-wide innovation, poverty and inequality, and intergenerational solidarity. Finally, the report goes beyond diagnostics and puts an emphasis on what we know regarding successful policy interventions, presenting evidence on what has and has not worked in the past.--Publisher description.

The COVID-19 pandemic hit countries’ development agendas hard. The ensuing recession has pushed millions into extreme poverty and has shrunk government resources available for spending on achieving the United Nations Sustainable Development Goals (SDGs). This Staff Discussion Note assesses the current state of play on funding SDGs in five key development areas: education, health, roads, electricity, and water and sanitation, using a newly developed dynamic macroeconomic framework.