How New Zealand, Singapore, South Korea and Kerala stand out

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Societies do not differ very much in their ability to predict disasters, but their willingness to cope with them varies widely. New Zealand, Singapore, South Korea and the state of Kerala in India, which stand out in their Covid-19 response, are characterized by innovative actions and results on the ground. A common denominator of disaster preparedness is the priority of investment in health and education, which is also associated with a high level of trust and citizen participation in institutions.

For decades, Kerala has focused on basic education, public health and welfare systems with the involvement of local civic organizations – and these investments have paid off as India grapples with a devastating second wave of Covid-19. Despite high registered infection rates and peaks due to periodic mismanagement, Kerala’s Covid-19 record remains a cheap outlier. The state showed strong resistance during the Nipah virus outbreak in 2019 and the massive floods of 2018 and 2019. The state has a nationwide low death rate of 0.4% from Covid-19 infections.

Singapore is ranked best country by Bloomberg for building resilience to Covid-19, with an infection death rate of 0.05%. Answers to digital and technological applications were at the top of the republic’s agenda. Singapore’s new generation of apps and technologies such as TraceTogether, a digital check-in system, SafeEntry, to track and contain epidemics, ePlanner to locate the vulnerable and their travel patterns. Digital technologies are of great relevance for countries of all income levels. For example, responses from Kerala included using E-Sanjeevani, a telemedical portal that provides psychosocial support for the sick.

Number two on the Bloomberg Index, New Zealand makes extensive use of scientific expertise in public health, infectious diseases, genomics, modeling and immunology. Like Singapore, New Zealand has learned its lessons from SARS. As part of its actions during the Covid pandemic, a vaccine task force was made responsible for ensuring access to safe and effective vaccines as a strategy to overcome the crisis. New Zealand has canceled all international flights, strictly adhering to public health guidelines.

In the face of a massive outbreak of the virus, South Korea installed drive-through tests, body sterilizers in public places, and heat scanners. Health administration authorities have developed mobile apps to track and monitor people in quarantine, overseas visitors, and use drones to disinfect large public areas. South Korea’s high teledensity enabled information to be disseminated to the target population through informational alerts sent to their cell phones.

South Korea is known for its trust in institutions and has benefited from citizen participation as the reach of ICT has been linked to protecting people’s privacy.

Investing in early warning and evacuation has proven to be one of the greatest cost benefits across the spectrum of disasters. Note the dramatic decline in death rates related to these investments across South Asia. Japan shows how better warnings can be given by locating the vulnerable and allowing them to escape to shelter. Following the 2018 and 2019 bushfires, the Australian Natural Disaster Resilience Index assesses the risk profiles of communities affected by bush fires. After the 2005 tsunami, the Indonesian region of Aceh built multi-purpose evacuation centers.

Since no country or state can have enough human and financial resources in precisely the locations most severely affected by a disaster, better coordination is needed to get resources to the right places at the right time. After the great earthquake in eastern Japan and the 2011 tsunami, Japan improved relations between the national government, which oversees the policy, and the local government, which is responsible for its implementation. It is paying off for Indian states to build an interstate pool of technology, supplies, and manpower to address shortfalls.

Crisis preparedness is based on high investments in health and education, which also include trust and community participation in political action. Singapore and South Korea have historically seen impressive economic growth rates, but it is their high proportions of investments in health and education, including the private sector, that appear to be making lasting contributions to building resilience.

Kerala did not enjoy high economic growth like other states. Gujarat and Uttar Pradesh rank higher than Kerala for doing business. But the 2020 Public Affairs Index ranked Kerala as the best-governed major state in 2019 based on 50 indicators reflecting equity, growth and sustainability. In the health sector, infant mortality in Kerala is one-third that of Gujarat and life expectancy is 10 years longer than that of Uttar Pradesh.

The per capita expenditure on health by the state governments (which account for the larger share than the central government in India) varies widely (Table 1). Kerala’s per capita spending is more than double that of Madhya Pradesh, Uttar Pradesh and Bihar.

Investing in health and education, which on the one hand strengthens human capacities, and on the other hand, decentralized decisions that strengthen these capacities through innovation, make a decisive contribution to resilience and well-being during disasters. Given the significant increase in extreme events, it is imperative that countries and states increase their resilience to disasters.


The authors are each visiting professor and alumnus of the Lee Kuan Yew School of Public Policy, Singapore.

Table 1 Public health spending in India’s 20 most populous states, 2016

(Per capita, Indian rupees, index with country average = 100)

Status

Health expenditure per capita

Himachal Pradesh

233

Tripura

188

Kerala

125

Chhattisgarh

116

Assam

112

Uttarakhand

108

Rajasthan

106

Haryana

106

Gujarat

94

Andhra Pradesh

89

Tamil Nadu

88

Punjab

85

Odisha

83

Karnataka

82

Maharashtra

80

West Bengal

66

Jharkhand

64

Madhya Pradesh

62

Uttar Pradesh

61

Bihar

54

Source: https://main.mohfw.gov.in/sites/default/files/HEALTH%20SECTOR%20FINANCING%20BY%20CENTRE%20AND%20STATEs.pdf; http://mospi.nic.in/statistical-year-book-india/2016/171


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