Economics & Development

This report examines how countries across East Asia and the Pacific are responding to the dual challenges of rapid population aging and urbanization. Drawing on case studies from Fiji, Indonesia, Viet Nam, China, Thailand, and the Republic of Korea, it explores strategies to promote healthy longevity, strengthen primary health care, and develop integrated systems of health, social, and long-term care for older adults. The study highlights how rising life expectancy, increasing prevalence of noncommunicable diseases, and changing family structures are placing growing pressure on health and social care systems. While countries are at different stages of demographic transition, they share common challenges, including workforce shortages, fragmented care delivery, financing constraints, and the need for age-friendly urban environments. Through comparative analysis, the report identifies key lessons for advancing healthy aging, including the central role of primary health care, development of long-term care systems, support for caregivers, digital innovation, community-based services, and stronger multisectoral governance. It demonstrates that context-specific, integrated approaches can improve health outcomes, enhance quality of life for older adults, and generate significant social and economic benefits. The report serves as a resource for policymakers seeking to build resilient, inclusive, and sustainable systems that enable older populations to age with dignity and independence.

How does transport infrastructure shape services provision, labor markets, and regional inequality? This paper studies the 2000 opening of the Øresund Bridge between Malmö, Sweden, and Copenhagen, Denmark, which sharply reduced travel time. The setting mirrors infrastructure linking peripheral regions to urban hubs, while the border makes unobserved services measurable in trade statistics. The bridge enabled cross-border commuting for on-site services and lowered business-travel costs for partially remote services like consulting. The paper develops a spatial model with commuting, migration, and services trade to separate these channels and quantify welfare effects. Services trade is distance-sensitive, with elasticities from −1.06 to −0.45, but less so than commuting. Lower commuting costs thus generate uneven gains, while lower services trade costs produce more diffuse benefits. Ignoring services understates welfare gains of infrastructure by 18%, especially for farther regions benefiting through services trade via business travel but not commuting.

Belize’s small market size, limited procurement capacity, and exposure to external shocks create structural procurement challenges that raise unit costs, delay implementation, and increase fiduciary risk. Recent operations consistently point to thin supplier markets, limited experience with complex and life-cycle–based procurement, reliance on specialized international suppliers, and capacity constraints within implementing agencies. These challenges are most acute in foundational sectors - energy, water, sanitation, and climate-resilient infrastructure - where procurement complexity is high and economies of scale are critical.

This paper studies the effectiveness of different policy instruments in accelerating the adoption of low-carbon technologies. Despite substantial declines in the costs of these technologies, diffusion remains uneven, driven by local economic conditions and policy environments. Using a modeling approach grounded in technology diffusion theory, the paper assesses how price-based (for example, carbon taxes and subsidies) and non-price-based (for example, mandates and regulatory requirements) instruments affect technology diffusion and carbon emissions across four East Asian economies. The analysis explicitly accounts for path dependence, learning, and technology uncertainty, factors often overlooked in standard models. The results highlight the importance of timing and policy sequencing: in the early stages of diffusion, price instruments may be less effective while non-price instruments can more successfully address coordination failures and subsequently enhance the impact of carbon pricing. The optimal policy combinations ultimately depend on the stage of technological maturity, initial technology adoption patterns, and local conditions.