For many years, it wasn’t the economy that determined voting behaviour in Turkey. The country’s president, Recep Tayyip Erdoğan, won almost every election he contested despite a deteriorating economic outlook.

This is commonly explained by the importance of identity politics in a country that has been polarised by the policies of Erdoğan’s ruling Justice and Development (AK) Party over its 22 years in power.

However, Erdoğan’s streak came to a screeching halt on Sunday March 31 following Turkey’s local elections. His AK Party lost the popular vote for the first time since 2002 and the main opposition group claimed victory in key cities including Istanbul and Ankara.

The reason why this time was different lies in the huge accumulated costs from years of policy mistakes that are now beginning to bite in a serious way.

So, what was the economic outlook as the country went to the polls?

On March 21, Turkey’s central bank raised interest rates unexpectedly to 50%. The move was the latest in a succession of rate rises that have followed Erdoğan’s re-election as president in May 2023. It was viewed as evidence of the central bank’s determination to fight runaway inflation that is hovering close to 70%.

The rising interest rates have been widely applauded as a much-needed reversal from the unorthodox monetary policy that had gone on far too long. Erdoğan’s unconventional policy stance arose from his deep-held conviction that raising interest rates would increase inflation rather than reduce it.

The pandemic and Russia’s invasion of Ukraine caused inflation to soar worldwide. While almost every central bank raised interest rates in response, Turkey went on an interest rate cutting spree. Keeping rates artificially low contributed to the rise in domestic inflation, and has made Turkey an inflation champion on a par with Argentina and Venezuela.

Decoupling from other emerging economies

Emerging markets have been surprisingly resilient in the face of the global financial squeeze. Unlike in the past, many emerging economies have avoided huge fluctuations in their exchange rates, have not been subject to debt distress and have managed to keep inflation under control.

One reason for this is the success of emerging economies in improving their policy frameworks, particularly by enhancing the independence of their central banks. More specifically, central banks in these countries have significantly improved their communication and transparency, and have become much better at forecasting inflation. As such, countries including Chile, Czech Republic and South Africa have outperformed their counterparts in advanced economies.

Sadly, Turkey was an outlier in this sphere. The country has completely ditched the independence of its monetary policy to such an extent that its central bank has had six different governors in the last five years.

Politics has also played a disproportionate role in the making of economic policy. Changes to the Turkish constitution, which were put in place in 2018, gave Erdoğan significant executive powers to push for very generous spending ahead of the 2023 presidential elections.

Minimum wage rose substantially and costly pension schemes and subsidised housing projects were put in place. This expansion in public spending naturally contributed to the inflationary pressures that were already brewing.

Turkey’s outlier position in loose monetary policy, cutting rates between 2021 and 2023 while everyone else had been tightening, is the very reason why its central bank is now having to push rates up while others are just starting the easing cycle.

Why does this matter?

Getting monetary policy wrong matters for most countries. But it matters particularly for countries like Turkey that are highly open to trade and financial flows, and for whom exchange rate movements are a crucial source of fluctuation in the domestic economy.

One of the biggest losers of Erdoğan’s unorthodox monetary policy has been the Turkish lira. Over the past six years, the value of the lira has fallen dramatically against the US dollar. In January 2018, you would have needed to part with 3.76 liras to purchase one US dollar. Today, this figure stands at 31.9 liras.

Large fluctuations in the value of the lira matter for the Turkish economy for several reasons.

First, a significant part of Turkey’s imports are inputs used in the production process, particularly of vehicles, machinery and mechanical appliances that make up nearly half of the country’s exports. Any fall in the value of the lira will push up input costs and hence prices, reducing the competitiveness of the country’s exports.

Second, Turkey imports a substantial part of its energy from abroad. In much the same way, any depreciation of the lira will make it more expensive to import energy.

Third, Turkey is sitting on substantial external liabilities in foreign currency terms. This makes the depreciation of the lira even more costly. Any loss in its value magnifies the amount of resources required to repay a given level of foreign currency liabilities.

Moving forward

Turkey’s return to more orthodox economic policy is good news. But it is so overdue that even the sharp reversals in policy have not been sufficient to turn the tide on its economy, especially in the fight against inflation. Persistent inflationary pressures have forced citizens to increase their holdings of foreign currency, which has put further pressure on the lira.

Facing a slowdown in foreign capital inflows, the authorities have had to burn significant amounts of foreign currency reserves to prevent the lira from depreciating further. The sharp rise in interest rates on March 21 should be seen in a similar vein and as the price the country is having to pay for its past policy mistakes.

More importantly, it has been nearly a year since Turkey returned to more conventional economic policy and there is no plan for a restructuring of the economy with proper institutional reform at its core. If proof is needed as to whether robust and independent policy institutions benefit economic performance, you need look no further than the recent resilience of other emerging economies.

Brazil, for example, hasn’t only rebounded strongly from the pandemic. It has managed to control inflation and boasts one of the best performing currencies in the world.

Gulcin Ozkan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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There has been a sharp increase in the number of people in Japan suffering with the rare but dangerous bacterial condition, streptococcal toxic shock syndrome (STSS). According to reports, cases of this potentially fatal strep A illness have more than tripled in Tokyo compared with this time last year.

While experts aren’t entirely certain why cases have risen so sharply to record levels, many believe it could be due to people being less vigilant about protecting themselves from infection after COVID measures were dropped.

Many countries, including the UK, have seen a similar increase in illnesses caused by strep A bacteria in the post-lockdown period – highlighting the continued burden that these bacteria have on public health.

Group A strep

STSS is caused by group A streptococcal bacteria, whch are quite common. Between 5% and 20% of healthy adults have these bacteria living inside them without any symptoms. But even when they don’t cause illness, group A streptococcal bacteria can still be spread to other people unknowingly through touch, coughs and sneezes.

Strep A bacteria are commonly spread through close contact with an infected person. This means that people who spend time in crowded places – such as schools or dormitories – may be at greater risk of catching these bacteria. Even people who aren’t ill can be colonised by them, as they are well adapted to grow in healthy human hosts.

But strep A bacteria can shift gears from being symptom-free and harmless into the source of numerous diseases. Infection may be triggered by larger numbers of the bacteria, mutation to a more aggressive strain, or perhaps some reduction in host defences. Most often, this will cause localised, short-lived infections – such as strep throat, tonsillitis or impetigo on the skin.

However, strep A bacteria can also ambush patients a few weeks after these milder infections, causing severe, lifelong complications – including rheumatic heart fever or inflammation of the kidneys. These complications are more common in certain populations, such as those who are homeless or living in poverty, or people with drug and alcohol use problems.

Strep A bacteria can also cause more severe illnesses, including scarlet fever, sinusitis, pneumonia, cellulitis, bone and blood infections.

In rare cases, strep A bacteria can spread from cuts and wounds deep into soft tissues and muscle, leading to necrotising fasciitis or “flesh-eating disease”. And streptococci can in some situations release immune-activating toxins that activate the immune cells in tissues, triggering STSS.

Toxic shock

STSS patients often complain initially of fevers, muscle aches and nausea, before becoming confused or drowsy. Low blood pressure follows, leading to cold hands and feet, a rapid heart rate and breathing too. Without the blood pressure they need to function, organs then begin to fail, usually 24 to 48 hours after the symptoms emerged.

STSS has a high mortality rate – ranging from 5% in younger patients who have been admitted quickly to intensive care, to up to 70% in the elderly.

Treatment for suspected STSS should be delivered as rapidly as possible. Patients will require oxygen, intravenous fluids and even cardiac support, alongside antibiotics and intravenous immune antibodies to deactivate strep A toxins. Even if referral and treatment is given quickly, it may still take patients many weeks to recover from the physical effects.

STSS is more common in people who have a poor immune system– including the elderly, people taking steroid medications, people recovering from a recent illness (particularly chickenpox), those with type 2 diabetes, and people with drug and alcohol problems. The elderly are a large and growing component of Japan’s population, which may explain why cases of STSS are particularly high there.

The rise in STSS cases is probably also a consequence of fewer COVID restrictions in this post-lockdown period. Public health measures such as mask wearing, washing and disinfecting hands and social distancing all helped to reduce the spread of strep A bacteria. People were exposed to larger numbers of bacteria when these controls were lifted.

Fortunately, strep A bacteria remain responsive to penicillin, although resistance has been identified in some strains. This means that strep A – and STSS – remain treatable.

Researchers are also working on developing a protective vaccine against strep A bacteria. If successful, this would not only protect against milder illnesses caused by streptococci, but also against rheumatic fever and perhaps the more acute severe illnesses such as STSS.

Strep A bacteria are estimated to contribute to more than half a million deaths globally each year. While relatively few of these are the consequence of STSS, this number highlights a need to better monitor group A streptococci, their evolution and the diseases they cause.

Protecting yourself against strep A bacteria remains relatively simple. Many of the practices we followed during the height of the pandemic – such as wearing masks, washing hands and avoiding crowds – can help us avoid strep A too.

Colin Michie does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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A fungus devastating frogs and toads on nearly every continent may have an Achilles heel. Scientists have discovered a virus that infects the fungus, and that could be engineered to save the amphibians.

Credit: Brian Gratwicke/U.S. Fish & Wildlife Service

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