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Covid-19 requires policy makers to consider evidence on both population health and economic welfare. Over the last two decades, the field of health economics has developed a range of analytical approaches and contributed to the institutionalisation of processes to employ economic evidence in health policy. We present a discussion outlining how these approaches and processes need to be applied more widely to inform Covid-19 policy; highlighting where they may need to be adapted conceptually and methodologically, and providing examples of work to date. We focus on the evidential and policy needs of low- and middle-income countries; where there is an urgent need for evidence to navigate the policy trade-offs between health and economic well-being posed by the Covid-19 pandemic.

Despite major public finance reform efforts over the last decade, Myanmarese public finances continue to be characterized by relative weakness in revenue collection, budget execution, and long-term sustainability. Myanmar is therefore in need of comprehensive public finance reform. Two top priorities of the Myanmar Sustainable Development Plan are to establish a fair and efficient tax system to increase government revenues, and to ensure effective public financial management. In this paper, we analyse the scope for fiscal tax reform to finance future Myanmar Union budget deficits and lower the need for central bank financing. Specifically, we employ a newly developed dynamically recursive computable general equilibrium model for Myanmar to analyse the economic efficiency and household income distribution impacts of employing four tax instruments, including the expansion of existing commercial taxes, customs duties, and corporate taxes, and the introduction of new secondary and tertiary education payroll taxes, to finance 2022– 40 government budget deficits. Our results demonstrate that eliminating Myanmarese government budget deficits could release savings for future capital accumulation and lead to net present value GDP gains, regardless of tax instrument, but also that real household welfare losses will be substantial and potentially persist throughout our 20-year horizon. While the payroll and enterprise tax instruments are identified as efficient and progressive, they are likely to suffer from weak tax bases, implying that commodity-focused tax instruments, including sales taxes and progressive but less efficient import tariffs, will need to continue to form the core of any comprehensive tax reform in Myanmar.

Myanmar has, in recent years, strengthened its focus on human capital as a development pillar, and introduced legislation and adopted conventions on child labour. But child exploitation continues, including use of forced labour by the military and children performing hazardous work. Moreover, Myanmar faces a rapidly closing window of opportunity within which to train its workforce to meet the future challenges of declining population growth and an ageing society. To address the twin challenges of child exploitation and future labour market needs, we study a comprehensive stylized education reform package for child workers aged 10–14. We employ a newly developed dynamically recursive 2021–40 computable general equilibrium model for Myanmar to analyse the economic and household income distribution impacts of a combined child work elimination and education programme allowing current child workers to achieve the same distribution of educational attainment as wider society over a 15-year transition period. While child work elimination would be costly for disadvantaged rural households, the combined programme may leave them better off, though only after a long transition period. At the societal level, the opportunity costs of child work elimination outweigh the long-term economic benefits of education over our 20-year horizon. In spite of the lack of societal economic benefits, our proposed reforms do seem to be advantageous, dealing with the unethical and appalling continuation of child labour practices while improving income distribution in favour of disadvantaged rural households. This would allow Myanmar to move towards the goal of SDG8, ‘Decent Work and (Inclusive) Economic Growth’, while training current generations to support an ageing Myanmarese society.

Myanmar is facing climate change (CC) induced changes to the productivity of their critically important rice sector over the coming century. Moreover, the recent five-year Myanmarese Agriculture Development Strategy (ADS) sets out a vision of achieving an ‘…inclusive, competitive, food and nutrition secure, climate change resilient, and sustainable agricultural system…’ by 2030. In this paper, we investigate the productivity pillar of the ADS strategy. Specifically, we employ a newly developed dynamically recursive 2021–40 computable general equilibrium model for Myanmar to analyse seven current and future CC scenarios for state and region-specific paddy yield changes during the 2020s, 2050s, and 2080s, derived from IIASA and FAO’s Global Agro‐Ecological Zones GAEZ V.3 model scenarios, allowing us to analyse the relative importance of both rainfed and irrigation farming practices and of high input-use and low input-use technologies, and how these important agricultural technology farming decisions interact with CC-induced paddy yield changes. Our results suggest that, while Myanmarese smallholders, using low input-use farming technologies, may face small or even negative economic impacts from CC-induced rice paddy yield changes, high input-use farmers, across all states and regions, will benefit from CC-induced paddy yield changes towards the end of the century, highlighting the importance of expanding access to high input-use technologies, e.g. via expanded use of extension services and by providing better access to credit for smallholder farmers. We also find, counterintuitively, that farming households using irrigation farming practices will benefit less from CC-induced paddy yield changes compared to households using rainfed farming practices. Finally, our results point to strong differences in CC impacts between states and regions, indicating that mitigating action should be focussed on exposed regions such as the critically important Ayeyarwady region.

We estimate the potential impact of COVID-19 on the United Kingdom economy, including direct disease effects, preventive public actions and associated policies. A sectoral, whole-economy macroeconomic model was linked to a population-wide epidemiological demographic model to assess the potential macroeconomic impact of COVID-19, together with policies to mitigate or suppress the pandemic by means of home quarantine, school closures, social distancing and accompanying business closures. Our simulations indicate that, assuming a clinical attack rate of 48% and a case fatality ratio of 1.5%, COVID-19 alone would impose a direct health-related economic burden of £39.6bn (1.73% of GDP) on the UK economy. Mitigation strategies imposed for 12 weeks reduce case fatalities by 29%, but the total cost to the economy is £308bn (13.5% of GDP); £66bn (2.9% of GDP) of which is attributable to labour lost from working parents during school closures, and £201bn (8.8% of GDP) of which is attributable to business closures. Suppressing the pandemic over a longer period of time may reduce deaths by 95%, but the total cost to the UK economy also increases to £668bn (29.2% of GDP), where £166bn (7.3% of GDP) is attributable to school closures and 502bn (21.9% of GDP) to business closures. Our analyses suggest Covid-19 has the potential to impose unprecedented economic costs on the UK economy, and whilst public actions are necessary to minimise mortality, the duration of school and business closures are key to determining the economic cost. The initial economic support package promised by the UK government may be proportionate to the costs of mitigating Covid-19, but without alternative measures to reduce the scale and duration of school and business closures, the economic support may be insufficient to compensate for longer term suppression of the pandemic which could generate an even greater health impact through major recession.

Historic levels of funding have reduced the global burden of malaria in recent years. Questions remain, however, as to whether scaling up interventions, in parallel with economic growth, has made malaria elimination more likely today than previously. The consequences of "trying but failing" to eliminate malaria are also uncertain. Reduced malaria exposure decreases the acquisition of semi-immunity during childhood, a necessary phase of the immunological transition that occurs on the pathway to malaria elimination. During this transitional period, the risk of malaria resurgence increases as proportionately more individuals across all age-groups are less able to manage infections by immune response alone. We developed a robust model that integrates the effects of malaria transmission, demography, and macroeconomics in the context of Plasmodium falciparum malaria within a hyperendemic environment. We analyzed the potential for existing interventions, alongside economic development, to achieve malaria elimination. Simulation results indicate that a 2% increase in future economic growth will increase the US$5.1 billion cumulative economic burden of malaria in Ghana to US$7.2 billion, although increasing regional insecticide-treated net coverage rates by 25% will lower malaria reproduction numbers by just 9%, reduce population-wide morbidity by -0.1%, and reduce prevalence from54% to 46% by 2034. As scaling up current malaria control tools, combined with economic growth, will be insufficient to interrupt malaria transmission in Ghana, high levels of malaria control should be maintained and investment in research and development should be increased to maintain the gains of the past decade and to minimize the risk of resurgence, as transmission drops.

BACKGROUND: Recent increases in life expectancy may greatly expand future Alzheimer's Disease (AD) burdens. China's demographic profile, aging workforce and predicted increasing burden of AD-related care make its economy vulnerable to AD impacts. Previous economic estimates of AD predominantly focus on health system burdens and omit wider whole-economy effects, potentially underestimating the full economic benefit of effective treatment. METHODS: AD-related prevalence, morbidity and mortality for 2011-2050 were simulated and were, together with associated caregiver time and costs, imposed on a dynamic Computable General Equilibrium model of the Chinese economy. Both economic and non-economic outcomes were analyzed. FINDINGS: Simulated Chinese AD prevalence quadrupled during 2011-50 from 6-28 million. The cumulative discounted value of eliminating AD equates to China's 2012 GDP (US$8 trillion), and the annual predicted real value approaches US AD cost-of-illness (COI) estimates, exceeding US$1 trillion by 2050 (2011-prices). Lost labor contributes 62% of macroeconomic impacts. Only 10% derives from informal care, challenging previous COI-estimates of 56%. INTERPRETATION: Health and macroeconomic models predict an unfolding 2011-2050 Chinese AD epidemic with serious macroeconomic consequences. Significant investment in research and development (medical and non-medical) is warranted and international researchers and national authorities should therefore target development of effective AD treatment and prevention strategies., BACKGROUND: Recent increases in life expectancy may greatly expand future Alzheimer's Disease (AD) burdens. China's demographic profile, aging workforce and predicted increasing burden of AD-related care make its economy vulnerable to AD impacts. Previous economic estimates of AD predominantly focus on health system burdens and omit wider whole-economy effects, potentially underestimating the full economic benefit of effective treatment.METHODS: AD-related prevalence, morbidity and mortality for 2011-2050 were simulated and were, together with associated caregiver time and costs, imposed on a dynamic Computable General Equilibrium model of the Chinese economy. Both economic and non-economic outcomes were analyzed.FINDINGS: Simulated Chinese AD prevalence quadrupled during 2011-50 from 6-28 million. The cumulative discounted value of eliminating AD equates to China's 2012 GDP (US$8 trillion), and the annual predicted real value approaches US AD cost-of-illness (COI) estimates, exceeding US$1 trillion by 2050 (2011-prices). Lost labor contributes 62% of macroeconomic impacts. Only 10% derives from informal care, challenging previous COI-estimates of 56%.INTERPRETATION: Health and macroeconomic models predict an unfolding 2011-2050 Chinese AD epidemic with serious macroeconomic consequences. Significant investment in research and development (medical and non-medical) is warranted and international researchers and national authorities should therefore target development of effective AD treatment and prevention strategies.