Rising Asia, Growing Inequalities

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The Asian Trends Monitoring Bulletin is a project sponsored by the Rockefeller Foundation, New York, the Centre for Strategic Futures, Singapore and the Lee Kuan Yew School of Public Policy, National University of Singapore. The Lee Kuan Yew School of Public Policy gratefully acknowledges the financial assistance of the Rockefeller Foundation and the Centre for Strategic Futures, Singapore.

The Asian Trends Monitoring Bulletin focuses on three areas of strategic concern to Asia’s well-being and future development: trade and investment facilitation; health systems; and energy security.

The Asian Trends Monitoring Bulletins are designed to encourage dialogue and debate about critical issues that affect Asia’s ability to reduce poverty and increase awareness of the implications for pro-poor policy and policy development.

Disclaimer The opinions expressed in the Asian Trends Monitoring Bulletin are those of the analysts and do not necessarily reflect those of the sponsor organisations.

Frequency The Asian Trends Monitoring Bulletin will be produced ten times a year. All issues are available for free at www.asiantrendsmonitoring.com/download.

Production Manager, Production & Research Dissemination Chris Koh

Editorial Trade & Investment Facilitation Darryl S.L Jarvis Johannes Loh

Health Systems Phua Kai Hong Nicola Pocock

Energy Security T S Gopi Rethinaraj Taufik Indrakesuma

Contact details of the editorial team are available on the last page of this publication.

Permission is granted to use portions of this work copyrighted by the Lee Kuan Yew School of Public Policy. Please acknowledge the source and email a copy of the book, periodical or electronic document in which the material appears to chris.k@nus.edu.sg or send to

Chris Koh Lee Kuan Yew School of Public Policy 469C Bukit Timah Toad Singapore 259772



CONTENTS 1

RISING ASIA, GROWING INEQUALITIES

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ACCESS TO INFRASTRUCTURE: NOT KEEPING PACE WITH ECONOMIC GROWTH

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MATERNAL AND CHILD HEALTH AND CHRONIC DISEASE IN ASEAN: THE NEGLECTED AND UNFINISHED AGENDA

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UNBANKED AND UNCONNECTED: IS THE GAP TOO WIDE TO CLOSE?

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UNCOVERING CROSS-CUTTING LINKAGES

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REFERENCES

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EDITORIAL TEAM



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RISING ASIA, GROWING INEQUALITIES Asia is rising! Asia’s growth is now celebrated the world over, much of this focused on China and the phenomenal economic growth that over the last 30 years has lifted hundreds of millions of people out of abject poverty. As the Economist reported in 2007, "in China each person now produces four times as much as in the early 1970s with as many as 400 million people being lifted from poverty into the ranks of an urban dwelling middle class in the space of a single generation." Not before has the world witnessed such a rapid transformation and one that has affected the lives of so many. But Asia is not China, and this remarkable transformation is not a ubiquitous story for all of Asia, let alone all of China. While Southeast Asia has similarly experienced its own economic miracles, the problems of endemic poverty, increasing divides between rural and urban communities, and absolute growth in economic inequalities, represent the dark shadow of Asia’s success that is too easily overlooked. Asia is rising but not all Asians are enjoying this growth; many have realised only marginal improvements to their economic resilience, others have gone backwards, and still others now suffer an ever more precarious existence, shut out of any hope of accessing even the most basic of infrastructures. A deeper examination of the "rise of Asia" reveals growing gaps in access to basic financial, health, education, and social services, both across countries and within national borders. Despite Southeast Asia’s economic success, millions of its poor continue to exist in a parallel economy: a mass underclass of invisible urban and rural populations who are marginalised from the changing economic landscapes that so often make the media headlines each of us are familiar with. In this issue of the Asian Trends Monitoring (ATM) Bulletin we focus on this contradictory narrative: “Rising Asia: Growing Inequalities,” and highlight how growth often manifests in ways that reduce the economic resilience of marginal communities.

"The development gap among ASEAN is critical to our own integration, our own achievement, our own aspiration as one strong marketed." – Dr. Surin Pitsuwan, Secretary-General of ASEAN, at the 3rd Initiative for ASEAN Integration Development Cooperation Forum, 2010.

We have enclosed three posters which reveal shocking inequalities in the following areas: • Access to infrastructure: not keeping pace with economic growth; • Maternal and child health and chronic disease in ASEAN: the neglected and unfinished agenda; and • Unbanked and unconnected: is the gap too wide to close? We disaggregate the data to show gaps between countries, income groups and urban and rural areas. We also present time series data to highlight the evolution of these trends. In this issue, we hope not only to open eyes, but also to spark discussion and action. We invite you to share the ATM Bulletin with colleagues or friends who are interested in poverty alleviation in Southeast Asia. The ATM Bulletin is available for download online at www.asiantrendsmonitoring.com/downloads, where you can also subscribe to future issues. Additional content and videos are hosted on the website, where you can share your thoughts with us on this issue. Thank you again for supporting the ATM Bulletin, and as always, your comments and feedback are welcome. Johannes Loh Nicola Pocock Taufik Indrakesuma


It is indisputable that the pace of infrastructural development in ASEAN has accelerated in the last two decades because of its rapid economic growth. Access to basic physical infrastructure such as paved roads, clean drinking water, sanitation facilities and electricity in ASEAN has improved greatly since the 1990s. For example, the region is quickly catching up to the world average in access to water, while it continues to exceed the world average in access to sanitation. However, a closer look at the numbers suggests that the rise of ASEAN has been accompanied by growing inequalities. While many people in the region are beginning to take basic services such as potable water, proper sanitation, and electricity access for granted, others (especially the poor and rural inhabitants) are still deprived of such necessities. It is clear that the benefits of the Asian growth miracle have not permeated all parts of ASEAN, because access to basic services in poor countries lags behind those available in richer countries. Cross-country gaps still persist There is still a huge gap between countries in Cambodia, Laos, Myanmar and Vietnam (CLMV) and the rest of ASEAN. Even within the ASEAN-6 group, Singapore and Malaysia are often miles ahead of the other four in their provision of basic services. • Access to non-solid cooking fuel remains a rarity in the CLMV, with almost all of the people in Cambodia, Laos, and Myanmar still relying on solid fuels such as charcoal and wood; • Despite a high regional average for improved water sources, with nearly 84% access, Laos, Cambodia, and

Myanmar only have the infrastructure to provide clean drinking water for 57%, 61% and 71% of their populations, respectively. Thus, millions of people in those countries are exposed to severe health risks as they are forced to use water from dirty, contaminated sources; and • Access to electricity in the CLMV region also remains low, with a regional average of below 50%. Out of the ASEAN-6, Indonesia is by far the worst performer with over 70 million of its people still deprived of electricity access. Rural growth not always on par with urban growth Within countries, the disparities between urban and rural areas are still wide, but have slowly shrunk over the past decade. Most ASEAN countries have narrowed the gaps in access to sanitation and water, with particularly large improvements in access to water. This has allowed rural-urban inequalities in ASEAN to remain very low compared to the world average. Much progress can be seen in Myanmar, which, reportedly, closed their urban-rural gaps for water and sanitation to almost one-fourth of the previous decade’s levels. On the other hand, some countries, specifically Cambodia and Laos, have not followed the example of their neighbours, instead witnessing widening rural-urban gaps in water and sanitation access. Urban areas are faced with ever-growing slums The 2011 Millennium Development Goals (MDG) Report states that the share of urban populations living in slums decreased between 1990 and 2010, due to improvements in housing conditions and provision of basic infrastructure. However, the report notes that due to population growth and urbanisation, the absolute number of people in slums have increased over that period of time.


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A look at slum conditions in ASEAN reveals findings that are consistent with the MDG Report. In the Philippines, Vietnam and Indonesia, slums have shrunk quite significantly in terms of percentage of the urban population, but have continued to grow in absolute numbers. However, in Cambodia, Laos, Myanmar and even Thailand, the numbers indicate not only an increase in absolute numbers of slum dwellers, but an increase in proportions as well. This implies that the urban poor have not benefited from the rising national income levels. Gaps across income groups are still wide When the data is disaggregated by income groups, it becomes clear that most of the infrastructural improvements in ASEAN have mainly benefited the wealthier parts of society. Across ASEAN, basic infrastructure is now accessible for over 90% of its richest population quintile. Most of the cross-country differences found in the region can be attributed to differences in access for the lower income groups. For example, despite the previously mentioned improvements in sanitation systems found in Laos, only 6% of the poorest quintile has access to proper sanitation. Food for thought • Although the gaps in access to basic infrastructure in regions such as Sub-Saharan Africa have received much media coverage and international attention, it seems that the same is not true for Asia and ASEAN especially. However, the trends certainly point to a need for policymakers in the region to step up their game in addressing these problems; • Compared to the rate of progress in the development of information and communications technology in ASEAN, it is clear that basic infrastructure and services such as electricity, water and sanitation are lagging behind. Governments in ASEAN need to go back to basics and provide these fundamental services to their people; • Given the dilemma between a rapidly growing urban population and a rural population that is falling further behind, governments in ASEAN must be careful in assigning priorities to development projects. Accelerating rural development is necessary to reach 100% coverage in those areas, but urban development projects are equally vital because they are affecting an increasingly larger share of the population; and • There are a number of successful projects that have been carried out by non-government actors. However, most

actors are faced with resource constraints, which limit possible expansions of projects. Thus, governments should consider best practices from success stories for replication on a larger scale.

“…as the overall ASEAN poverty rate decreases, we are witnessing an increase in the endogenous development gap between urban and rural areas within member countries…” – Mek Phanlack, Acting President of the Lao National Leading Committee for Rural Development and Poverty Reduction, 2010


Maternal mortality rates: not on track for 2015 Some ASEAN countries are lagging behind on their maternal health commitments and are unlikely to reach the Millennium Development Goal (MDG) 5: improve maternal health, by 2015. Whilst Laos has seen a notable downward trend in maternal mortality rates (MMR) since 1990, the country currently has the highest death rate of mothers in the region, where one mother dies in every 172 child births. It is unlikely that Laos will reach the target to reduce MMR by ¾ between 1990 and 2015.i Neither is Cambodia, despite a recent focus on training and an incentive scheme that rewards midwives with cash payments for each delivery.ii It is no coincidence that both countries (along with the Philippines) observe the highest rural-urban skilled birth attendance gaps. Skilled birth attendance in rural areas is only 11% in rural Laos, despite 68% of the population being located in rural areas. Child health: where you are born matters Child mortality in the poorest ASEAN countries shows a disturbing trend – children from the poorest families are three times more likely (at least) to die than those from the wealthiest families. This is partly because the MDG 4: reduce child mortality, is equity blind. Recent evidence shows that resources are being allocated to achieve the average reduction in child mortality, with policymakers myopic to intra-country inequities.iii Initiatives like Countdown to 2015’s Equity profiles spotlight equity adjusted rates but data are scarce for most countries. Child stunting rates are at 30% or higher according to latest available estimates in Cambodia, Laos, Myanmar and Vietnam – an indication that children are deprived of adequate nutrition in the womb or in the first five years of their lives, and/or they experience debilitating cycles of illness. Many stunted children experience long-term deficits in cognitive ability along with losses in stature.iv

Unequal measles immunisation coverage Immunisation coverage is taken as a primary indicator of a health system’s effectiveness by health experts. There are marked differences in immunisation coverage by location (urban versus rural) and wealth (highest versus lowest quintile), but the biggest discrepancy by far is the mother’s educational level (highest versus lowest). In the Philippines, mothers with the lowest levels of education are almost three times less likely than those with the highest levels of education to have immunised their 1-year old child against measles. Recent evidence shows that small non-financial incentives may increase the take-up rate of immunisation. Results from a randomised controlled trial in India by the JPAL Poverty Action Lab showed that in resource-poor settings, a non-financial incentive (small bag of lentils) combined with education and reliable services was an effective predictor of immunisation take-up by families.v Chronic diseases: killing more in poor countries than in rich ones Chronic diseases are responsible for 80% of deaths in developing countries globally and 60% in Southeast Asia. Chronic diseases kill more people than infectious diseases and injuries combined, with cardiovascular disease and diabetes emerging as the predominant threat, especially in low income countries like Cambodia, Laos and Myanmar. As chronic disease experts recently decried in the Lancet, absolute deaths from chronic diseases in the poorest countries dwarf those in high-income countries like Singapore – despite chronic disease being the main cause of death in the city-state.vi The reasons behind escalating chronic disease rates are numerous – extensive tobacco use, unhealthy diets, insufficient physical activity and escalating obesity, and poor access to healthcare.


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These trends are particularly evident in Malaysia and China. Average daily calorie consumption was 2,880kcal in Malaysia and 2,930kcal in China, with obesity rates at 44.6% and 25% respectively. In addition, these two countries see the highest levels of physical inactivity at a whopping 61.4% in Malaysia and 31% in China.vii Smoking prevalence remains high at 40% or more in all countries. Unfortunately, donor funding for health does not reflect the chronic disease burden. Infectious diseases like malaria and HIV/AIDs receive disproportionate development assistance for health funding relative to the deaths they cause.viii This is partly because combating chronic disease was not explicitly included in the MDGs. Time-bound, outcome-based targets for chronic diseases have not been set in most countries, in contrast to the MDGs. Promisingly, Thailand has included the reduction of heart disease as an MDG plus goal.viv Other countries should consider setting time-bound, outcomebased targets regarding chronic disease risk factors, such as to reduce obesity or smoking prevalence by a certain percentage by 2015. Worryingly, the majority of chronic disease deaths are actually afflicting people of productive age – killing 66.9% of those under 70-years old in Cambodia, 61.3% in the Philippines and 56.7% in Laos.x The development implications are clear: not only is the working age population shrinking in relation to the growing numbers of the elderly, but those who can work may face lessened labour productivity, prolonged periods of morbidity and early death. Food for thought • Although three ASEAN countries, Vietnam, Cambodia and Laos, are ranked as “high performers” across the MDGs as a whole by the Centre for Global Development,xi the unlikelihood of Laos and Cambodia in achieving MMR targets by 2015 prompts a rethink of why this particular goal is lagging behind. Women, children and the elderly, particularly the poor, are least likely to complain and assert their rights to health services. How does this affect the priorities of health ministries? • Rural-urban gaps in health service coverage and richpoor intra-country gaps persist. Providing services that reach the most vulnerable groups (least educated women, children from the poorest families, rural inhabitants) will require sustained political commitments to fund and provide health services as a public good. This will be

particularly salient as private health providers catering to the needs of rich urbanites spring up across ASEAN and within China. • Tackling the chronic disease burden requires multi-sectoral efforts beyond the health system alone – education, sanitation and water access, road infrastructure and food supply are implicated. Whether powerful corporations that contribute to the chronic disease burden can engage meaningfully in the fight to reduce its prevalence remains to be seen, but experience with the tobacco industry suggests otherwise.

“…the rise of chronic diseases calls for some serious thinking about what the world really means by progress. What is the net gain if the benefits of economic growth are cancelled out by the costs, like medical bills, lost productivity, and premature death, of a preventable disease?” – Dr Margaret Chan, Director General of the World Health Organisation


The rapid penetration of mobile phones into markets in developing countries is a success story that the world is familiar with today. According to a World Bank study, the impact of

There is also another story here of a digital divide that is definitely not associated with success. The World Bank study also found that the increase in growth was even more pronounced

telecommunications penetration on economic growth rates is highly significant. For every ten percentage point increase in the penetration of mobile phones, there is an increase in 0.81 percentage points in economic growth.xii The average number of mobile subscribers in ASEAN rose from 7.7 per 100 people in 1999 to 83.1 in 2009.

for every ten percent penetration of internet and broadband users, translating to a 1.12% and 1.38% increase in economic growth, respectively. Reliable access to the internet, let alone broadband internet access, remains either unavailable or unaffordable, particularly for the poor in ASEAN. Thus closing this divide is not only a challenge to achieve greater equality, but also an opportunity to accelerate growth.

Developing countries have progressed considerably in the last decade in terms of mobile connectivity. The question of the hour is then whether the opportunities for growth afforded by this phenomenon are being capitalised fully. One of the sectors that could truly benefit in developing countries from mobile phone penetration is the financial services sector. However, it has been observed that one billion people have access to mobile phones but remain unbanked, indicating that there exist unexploited opportunities for growth.

What it means to be “unbanked” People who have no access to financial services through any type of financial sector organization such as banks, non-bank financial institutions, financial cooperatives and credit unions, finance companies, and NGOs are considered “unbanked’. – Definition by UN Capital Development Fund: International Year of Microcredit 2005.

Unconnected: broadband internet remains a distant dream for most of ASEAN inhabitants Across countries, there is a clear digital divide: the poorer ASEAN states (Cambodia, Laos, and Myanmar) lag behind in mobile, internet and broadband penetration. However, even in Vietnam, Indonesia, the Philippines and Thailand, 30% of people at most have access to the internet, while not even 3% of the population enjoy the benefits of broadband internet connections. In the absence of reliable data on the rural-urban breakdowns for information and communications technology indicators, it can only be speculated how pronounced intra-country differences are. It comes as no surprise that high costs represent one of the main barriers to faster internet connections. As the International Telecommunications Union reports, an entry-level fixed broadband connection costs on average 190 PPP$ (purchasing power parity in US$) per month in developing countries, compared to only 28 PPP$ in developed countries. Without massive investments in connectivity, it seems unlikely that prices will drop to anywhere near affordable levels for the poor. The limitations of mobile internet, as well as relatively high prices for more sophisticated


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smartphones, present further barriers to connecting the poor to the world. More than one billion people own a mobile phone but have no access to financial services Estimates put the number of unbanked people around the globe who have access to a mobile phone at about one billion.xiii While mobile phone subscriptions in the region are growing at a rapid pace and could reach close to 100% penetration within a few years, the majority of the population in ASEAN remains unbanked.xiv The numbers for Southeast Asia (see poster) convey a clear message. There is a huge unmet demand for easy-to-use financial services, in particular among the poor and those in remote areas.

pushed more aggressively to convince private operators to replicate successful business models such as the MPESA, a mobile banking service by Safaricom in Kenya? • With the breathtaking speed of mobile phone penetration even in low-income countries, the idea of complementing wired internet connectivity becomes increasingly relevant. The potential of mobile e-services, from mobile banking, to e-health, to e-government services for the poor remains largely untapped in ASEAN. The ambition of the ASEAN Economic Community 2015 and beyond will only be meaningful if the millions of people still living in poverty obtain access to finance and become part of Asia’s growth story.

Is branchless banking the solution for pervasive financial exclusion? There is enormous market potential for providing financial services to the unbanked. For example, 98% of unbanked Filipinos receive their income in cash and a large proportion of them use informal saving instruments (hiding the money, giving it to family or using a savings club). In recent years some commercial branchless banking initiatives have been launched successfully in Cambodia (Wing) and the Philippines (Smart and Globe). Growing income inequality in ASEAN: a future powder keg? A trend of growing concern is the increase in income inequality. The poorest quintile of the population in ASEAN member states has fewer opportunities in education and later in employment and weak social safety nets in case of unemployment or sickness. Growing income inequality presents an imminent danger for equitable societal development and could lead to future social tensions between the ruling elites and the poor. Food for thought • Digital exclusion often traps the poorest communities in their current state of development while richer strata of society pull away through information advantages, better access to capital and subsequent productivity gains. While information and communications technology are by no means a “silver bullet” for poverty alleviation, policymakers should integrate the aim of closing the digital divide in their development agendas and identify unexploited opportunities. • Given that successful branchless banking initiatives have been around for a few years, why have policymakers not

"With broadened [financial] access, our population, including those living in poverty, can unlock financial and small business opportunities. These opportunities will, in turn, improve their well-being. Ultimately, this will reduce poverty and inequality.” – Dr. H. Susilo Bambang Yudhoyono, President of the Republic of Indonesia, at the 15th ASEAN Finance Ministers’ Meeting


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UNCOVERING CROSS-CUTTING LINKAGES Improving access to financial services alone will not reduce disparities in access to public services emerging between the rich and the poor in the countries we spotlight. Similarly, policies to reduce obesity will be limited without ensuring access to a public transportation system, a smart network of roads and pavements and sustainable supply of healthy foods. When discussing future priorities for governments and development actors in the region, connecting the dots between the three sectors is not optional but necessary to address the growing gaps we present in the three posters. Above all in this issue, we seek to highlight that an equitable growth strategy will entail policy innovations across these three sectors in order to address inequities that cut across them. Furthermore, cooperation with other sectors that we do not highlight (such as agriculture, education) will be required for policies to be cross-sectoral in some cases. Crosscutting policy issues are less explicit to the naked eye and below we provide a few examples of such linkages. Further elaboration of cross-cutting policy innovations can be found in the upcoming Asian Trends Monitoring Bulletin 13: Innovations against Inequality. Tackling chronic disease: health, education and city planning Health systems in ASEAN and China alone cannot tackle the rising chronic disease burden. Rapid, often knee-jerk, urbanisation and city planning is leading to a mushrooming of non-pedestrian friendly cities across Asia, with implications for physical activity levels and obesity, with its consequent biological risk factors for chronic disease. A recent study in India found that rural to urban migrants experienced higher prevalence of obesity than rural non-migrants, because they adopted modes of life that put them at similar risk to the urban population.xv Working with city planning agencies can reap dividends for health ministries and ultimately avoid expensive curative costs, as can focusing on prevention and health lifestyles in conjunction with education policymakers. In the upcoming Asian Trends Monitoring Bulletin, we explore intervention mechanisms that traverse sectors to reduce chronic disease risk. The disease burden of solid fuels The use of solid fuels for cooking food and heating homes is a massive problem for the poor, not only because of problems

associated with gathering firewood and charcoal (such as the opportunity cost of time), but also because of nefarious health impacts. World Health Organisation reports show that children under 5-years old are up to 2.3 times more likely to contract acute infections of the lower respiratory tract if they are regularly exposed to indoor air pollution from solid fuel use.xvi The health impacts of solid fuel use extend beyond child mortality, making adults (especially women) more prone to chronic obstructive pulmonary disease and even lung cancer.xvii Thus, addressing the problem of inequality in energy access may also have indirect impacts on solving problems of chronic disease. The potential of information and communications technology Better access to information and communications technology can contribute to greater equality of opportunity for the poor through a variety of innovative applications that cut across the themes presented in this bulletin. It has the potential to reduce costs for taking advantage of financial services, it can help to link remote places to more advanced health services (such as e-health initiatives) and it generally lowers transaction costs for both the population and governments. Using the data posters If you have not unfolded the enclosed data posters yet, we would like to invite you now to spread them out and study the information across the three themes. We hope that our selection of indicators will inform exciting and important debates among friends, colleagues and experts alike. In addition, we encourage you to share your thoughts on this issue with us via our website at www.asiantrendsmonitoring.com.


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References i.  President urges Laos to achieve MDG last lap, 2010 – 2015. Laos Voices, 21 Sept 2010. http://laovoices.com/2010/09/21/president-urges-laos-to-achievemillenium-development-goals-last-lap-2010-2015/ ii.  Loy, Irwin. Cambodia struggles to reduce maternal deaths. Inter Press Service, 19 June 2011. http://www.ips.org/mdg3/ development-cambodia-struggles-to-reduce-maternal-deaths/ iii.  Reidpath D, Morel C, Mecaskey JW, Allotey P: The Millenium Development Goals fail poor children: the case for equity – adjusted measures.PLOS medicine 2009, 6 (4), e1000062. iv.  UNICEF (2000): Stunting in children under 5. http://www.unicef.org/pon00/ leaguetos1.htm v.  Banerjee A, Duflo E, Glennerster R, Kothari D: Improving immunisation coverage in rural India: clustered randomised controlled evaluation of immunisation campaigns with and without incentives. BMJ 2010, 340:c2220 vi.  Dans, A, Ng, N, Varghese, C, Tai, E.S, Firestone, R, Bonita, R: The rise of chronic non-communicable diseases in Southeast Asia: time for action. Lancet 2011; 377 (9766):680 – 689. vii.  Insufficient physical activity defined as less than five times of 30 minutes of moderate activity per week, or less than three times of 20 minutes of vigorous activity per week, or equivalent in population aged 15+ (age-standardised estimates). WHO Global Health Observatory, 2008 data. http://apps.who.int/ ghodata/ viii.  Institute for Health Metrics and Evaluation (IHME): Financing global health 2010: development assistance and country spending in economic uncertainty. Seattle, WA: IHME, 2010.

1.  United Nations Statistics Division. 2010. Millennium Development Goals Indicators. 2.  World Health Organisation. 2003. World Health Survey.

viv.  UNDP Thailand (2010) MDG plus in Thailand.http://www.undp.or.th/ focusareas/mdgplus.html

3.  World Bank. 2010. World Development Indicators and Global Development Finance Database.

x.  WHO Global Health Observatory, 2008 data. http://apps.who.int/ghodata/ xi.  Centre for Global Development (CGDEV): Who are the MDG trailblazers? A new MDG progress index.Working paper 222, August 2010.

4.  World Bank. 2010. World Development Indicators and Global Development Finance Database. 5.  United Nations Statistics Division. 2010. Millennium Development Goals

xii.  Qiang, C. Z. W. (2009). Telecommunications and Economic Growth, World Bank. Unpublished Paper. xiii.  CGAP (2009). Mobile Banking: From Concept to Reality. http://www.cgap. org/p/site/c/template.rc/1.26.10806/ xiv.  For a detailed discussion of the methodology refer to Kendall, J., Mylenko, N., & Ponce, A. (2010). Measuring financial access around the world. Washington, D.C: World Bank. xv.  Ebrahim S, Kinra S, Bowen L, Andersen E, Shlomo YB, Lyngdoh T, Ramakrishnan L, Ahuja RC, Joshi P, Das SM, Mohan M, Davey Smith G, Prabhakaran D, Reddy KS: The effect of rural-to-urban migration on obesity and diabetes in India: a cross-sectional study. PLOS medicine 2010 (7) 4: e1000268. xvi.  WHO. 2006. “Fuel for Life: Household Energy and Health” xvii.  See reference 16.

Indicators. 6.  International Energy Agency. 2009. World Energy Outlook Electricity Access Database. 7.  World Bank. 2010. World Development Indicators and Global Development Finance Database. 8.  World Bank. 2010. World Development Indicators and Global Development Finance Database. 9.  See reference 6. 10.  See reference 7. 11.  See reference 8.


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1.  Countdown to 2015 (2010). Equity Country Profiles. Retrieved 20 August 2011. http://www.countdown2015mnch.org/ reports-publications/2010-country-profiles 2.  World Health Organisation, Global Health Observatory (2008). Healthrelated Millennium Development Goals > MDG 1 Poverty & Hunger > Children < five years stunted. Retrieved 20 August 2011. http://apps.who.int/ghodata/ 3.  World Health Organisation, Global Health Observatory (2008). Equity > Women and health > Maternal mortality ratio (per 100,000 live births). Retrieved 20 August 2011. http://apps.who.int/gho/indicatorregistry/App_Main/ view_indicator.aspx?iid=26 4.  World Health Organisation, Global Health Observatory (latest year). World Health Statistics > Health Inequities > Measles (MCV) immunisation coverage among 1-year-olds (%) by wealth quintile, location, mother’s education. Retrieved August 20 2011. http://apps.who.int/ghodata/. Data for Cambodia (2005), Indonesia (2007), Philippines (2008), Vietnam (2002). 5.  World Health Organisation, Global Health Observatory (latest year). World Health Statistics > Health Inequities > Births attended by skilled health personnel, place of residence. Retrieved 20 August 2011. http://apps.who.int/ ghodata/. Data for Laos (2006), Cambodia (2005), Philippines (2003) and Indonesia (2007). 6.  World Bank (2004). Gross National Income, PPP per capita. World Development Indicators Database. Retrieved August 20 2011. http://data. worldbank.org/indicator. World Health Organisation, Global Infobase (2004). Non-communicable disease death rate per 100,000 population (age-standardised

estimate). Non-communicable diseases as a proportion of total deaths. Retrieved August 20 2011. https://apps.who.int/infobase/Mortality.aspx 7.  World Health Organisation, Global Health Observatory (2008). Non-communicable diseases > Mortality > NCD deaths per 100,000 (agestandardised estimate) by cause, both sexes. Retrieved August 20 2011. http:// apps.who.int/ghodata/ 8.  World Health Organisation, Global Health Observatory (latest year). Retrieved 20 August 2011. http://apps.who.int/ghodata/ 9.  United Nations Human Development Report (2010). Retrieved 20 August 2011. http://hdr.undp.org/en/ 10.  See reference 8. 11.  See reference 8, data for 2006. 12.  Asian Development Bank Statistical Database System (2003). https://sdbs. adb.org/sdbs/index.jsp. Singapore data from Health Promotion Board National Nutrition Survey (1998). Retrieved 20 August 2011. 13.  See reference 8.


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1.  International Telecommunication Union (2010). Internet users (per 100 people). World Development Indicators Database. Retrieved August 19, 2011 from http://data.worldbank.org/indicator/IT.NET.USER.P2 2.  International Telecommunication Union (2010). Fixed broadband Internet subscribers (per 100 people). World Development Indicators Database. Retrieved August 19, 2011 from http://data.worldbank.org/indicator/IT.NET. BBND.P2/ 3.  International Telecommunication Union (2010). Mobile cellular subscriptions (per 100 people). World Development Indicators Database. Retrieved August 19, 2011 from http://data.worldbank.org/indicator/IT.CEL.SETS.P2/ 4.  See reference 3. 5.  Demirgüç-Kunt, A., Beck, T., Honohan, P., & World Bank. (2008). Table A1: Composite measure of access to financial services. In: Finance for all?: Policies and pitfalls in expanding access. Washington, D.C: World Bank, pp.190-191.

Development Indicators Database. Retrieved August 5, 2011 from http://data. worldbank.org/indicator/SI.DST.05TH.20/. 9.  Bertelsmann Stiftung (2011). Social safety nets & Equal Opportunity. Bertelsmann Transformation Index 2010. Retrieved August 19, 2011 from http://www.bertelsmann-transformation-index.de/fileadmin/pdf/Anlagen_ BTI_2010/Detailed_Scores_BTI_2010.xls 10.  International Monetary Fund (2011). Gross domestic product per capita, current prices. World Economic Outlook Database, April 2011. Retrieved August 17, 2011 from http://www.imf.org/external/pubs/ft/weo/2011/01/weodata/ index.aspx. 11.  World Bank (2009). Income share held by lowest 20%. World Development Indicators Database. Retrieved August 5, 2011 from http://data.worldbank. org/indicator/SI.DST.FRST.20 12.  See reference 7.

6.  Consultative Group to Assist the Poor (CGAP) (2010). ATMs and POSs. Financial Access 2010 – Financial Indicators. Retrieved August 15, 2011 from http://www.cgap.org/p/site/c/template.rc/1.11.142554/1.11.142572/

13.  See reference 5.

7.  Consultative Group to Assist the Poor (CGAP) (2010). Branches per hundred thousand adults: commercial banks. Financial Access 2010 – Financial Indicators. Retrieved August 15, 2011 from http://www.cgap.org/p/site/c/ template.rc/1.11.142554/1.11.142572/

15.  See reference 2.

8.  World Bank (latest available year). Income share held by highest 20%. World

14.  See reference 3.


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TRADE & INVESTMENT FACILITATION Darryl Jarvis is an Associate Professor at the LKY School of Public Policy. He specialises in risk analysis and the study of political and economic risk in Asia, including investment, regulatory and institutional risk analysis. He is an author and editor of several books and has contributed articles to leading international journals. He has been a consultant to various government bodies and business organisations and for two years was a member of the investigating team and then chief researcher on the Building Institutional Capacity in Asia project commissioned by the Ministry of Finance, Japan. His current research is a large cross-national study of risk causality in four of Asia’s most dynamic industry sectors. He teaches courses on risk analysis, markets and international governance and international political economy. His email is darryl.jarvis@nus.edu.sg

Johannes Loh is working as a Research Associate at the Lee Kuan Yew School of Public Policy. He holds a Master’s degree in Public Policy from the Hertie School of Governance in Berlin. His previous research experience includes international student mobility, visual political communication, aid governance and public sector reform in developing countries. Recently, he completed a research project on Success Factors for Police Reform in Post-conflict Situations with the German Technical Cooperation. Prior to joining the Lee Kuan Yew School of Public Policy he has also worked for the United Nations Environment Programme in Geneva, Transparency International Nepal and the Centre on Asia and Globalisation in Singapore. His email is johannes.loh@nus.edu.sg and you can follow his updates on trade & investment facilitation on Twitter, @seasiatrade.

HEALTH SYSTEMS Phua Kai Hong is a tenured professor at the LKY School of Public Policy and formerly held a joint appointment as Associate Professor and Head, Health Services Research Unit in the Faculty of Medicine. He is frequently consulted by governments within the region and international organisations, including the Red Cross, UNESCAP, WHO and World Bank. He has lectured and published widely on policy issues of population aging, healthcare management and comparative health systems in the emerging economies of Asia. He is the current Chair of the Asia-Pacific Health Economics Network (APHEN), founder member of the Asian Health Systems Reform Network (DRAGONET), Editorial Advisory Board Member of Research in Healthcare Financial Management and an Associate Editor of the Singapore Economic Review. His email address is spppkh@nus.edu.sg

Nicola Pocock is a research associate at the LKY School of Public Policy. She is also the research manager at aidha, a non profit financial education and entrepreneurship training school for migrant women, especially domestic workers, in Singapore. She holds a BA from Warwick University and an MSc from Kings College London. Prior to joining the LKY School of Public Policy, she interned as a Fast stream trainee in the UK civil service at the Home Office and as a research volunteer at Amnesty International. Nicola has also carried out social work in Marseille, France as a European Union sponsored youth volunteer. Her research interests span health and social policy, health systems financing, social impact assessment, gender, migration and financial behaviours. Her email is sppnp@nus.edu.sg and you can follow her work on health systems on Twitter @healthSEAsia.

ENERGY SECURITY T S Gopi Rethinaraj joined the Lee Kuan Yew School of Public Policy as Assistant Professor in July 2005. He received his PhD in nuclear engineering from the University of Illinois at Urbana-Champaign. Before coming to Singapore, he was involved in research and teaching activities at the Programme in Arms Control, Disarmament and International Security, a multi-disciplinary teaching and research programme at Illinois devoted to military and non-military security policy issues. His doctoral dissertation, “Modeling Global and Regional Energy Futures,” explored the intersection between energy econometrics, climate policy and nuclear energy futures. He also worked as a science reporter for the Mumbai edition of The Indian Express from 1995 to 1999, and has written on science, technology, and security issues for various Indian and British publications. In 1999, he received a visiting fellowship from the Bulletin of the Atomic Scientists, Chicago, for the investigative reporting on South Asian nuclear security. His current teaching and research interests include energy security, climate policy, energy technology assessment, nuclear fuel cycle policies and international security. He is completing a major research monograph "Historical Energy Statistics: Global, Regional, and National Trends since Industrialisation" to be published in Summer 2012. His email address is spptsgr@nus.edu.sg

Taufik Indrakesuma is a research associate at the Lee Kuan Yew School of Public Policy. He is a recent graduate of the Master in Public Policy programme at the Lee Kuan Yew School of Public Policy. He also holds a Bachelor in Economics degree from the University of Indonesia, specialising in environmental economics. Taufik has previously worked as a Programme Manager at the Association for Critical Thinking, an NGO dedicated to proliferating critical thinking and human rights awareness in the Indonesian education system. His research interests include behavioral economics, energy policy, climate change mitigation and adaptation as well as urban development policy. His email is spptri@nus.edu.sg and you can follow his work on energy security on Twitter @SEAsiaEnergy.



The Lee Kuan Yew School of Public Policy is an autonomous, professional graduate school of the National University of Singapore. Its mission is to help educate and train the next generation of Asian policymakers and leaders, with the objective of raising the standards of governance throughout the region, improving the lives of its people and, in so doing, contribute to the transformation of Asia. For more details on the LKY School, please visit www.lkyspp.nus.edu.sg


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