Economic and health care restructuring— the need for better governance

In recent years, public health in developing countries has been affected by the restructuring in both the health and non-health sectors (e.g. education, employment, transport), and international politics. Economic and health care restructuring have had an impact on health. We aim to highlight some key events in South-East Asia and their effect on public health during the past 15 years and to propose measures to deal with the phenomena. Globalization has brought about restructuring that impacts on health and health care. The economic boom in most developing countries has seen a restructuring around cheap labour, foreign investment and oil discovery.1 Unfortunately, restructuring has not put in place adequate governance—the systems of management, monitoring and evaluation—to ensure transparency and accountability.2 Thus, in South-East Asia, the boom was followed, in 1997, by a crisis sparked by the devaluation of the Thai and Malaysian currencies. The crisis threatened to become a global economic recession. Many put the blame on blunders by Ministries of Finance in defending their currencies. However, it can be argued that the root cause of the crisis was due to inadequate governance of the economic sector for many years, spearheaded by corruption (nepotism, cronyism, and favouritism) as well as mismanagement including non-productive investment, wasteful practices, inefficiency and procrastination. People borrowed money for speculative activities with a high return, such as for golf courses, rather than investing in potentially productive sectors.3