Maria Sophia Aguirre, Ph. D

Download 222.43 Kb.
Date conversion14.05.2016
Size222.43 Kb.
1   2   3   4   5   6

Sources: Human Development Report, 2003 and Millennium Development Goal Indicators, 2003.

Paved Roads as well as access to water and electricity are an important part of rural and market development. Developing countries a access is very low in paved road access but it fairs better in access to electricity. However, this level of access is mainly in urban and not in rural areas. When telephone and cellular accesses are considered, we find that about 8% of the population has access to these means of communication. However, when looking at these statistics over the past ten years, one can see a trend towards the expansion of cellular phones over telephone landlines.34 Developing countries are moving directly into wireless services, which, in turn allows them to access the Internet without the need of a large infrastructure. In China, for example, it is estimated that about 480 million youth will have access to the Internet before 2005. This implies access to a wealth of information that before was banded or nor available for a large part of the population in this country. Yet, while these means provide access to information, education, and potential markets and, in doing so, open new opportunities for economic growth, for it to be sustainable infrastructure is required. Developing countries have still significant portions of population without access to it.

The family faces serious health problems, especially in the developing world due to infectious diseases and poor quality health programs and sanitation access.35 The main health risks and causes of death for man and woman are:36

  • Cardiovascular diseases (kills 16.7 million per year)

  • Malignant neoplasms (cancer) (kills 7.1 million per year)

  • Injuries (kills 5.2 million per year)

  • Respiratory diseases (kills 3.7 million per year)

  • Perinatal conditions (kills 2.5 million per year)

  • Respiratory infections (kills 3.9 million per year)

  • HIV/AIDS (5 million new cases and kills 2.8 million per year)

  • Diarrhoeal Diseases (kills 1.8 million per year)

  • Tuberculosis (TB) (8 million new cases and kills 1.8 million people per year.)

  • Malaria ( 300-500 million new cases and kills 1.2 million per year)

  • Maternal condition (kills 540,000 per year)

With the exception of the first three and HIV/AIDS, these diseases are rare and treatment is accessible in developed countries at a remarkably low cost. (Table 3). WHO (1999a) reports that the majority of deaths from infectious diseases can be prevented with existing cost-effective strategies. Bednets can prevent 50% of all malaria deaths; Directly Observed Treatment (a short course) can prevent 60% of all TB deaths; and oral rehydrations therapy can prevent up to 95% of deaths from diarrhoeal diseases. Most of those who died due to diarrhoeal diseases are children. Furthermore, the cost of treatment per capita of malaria is $5 cents, for TB is $60 cents and for diarrheas is $1.60.

Table 3

Low Cost Effective Interventions

Cost of Treatment and (Annual Cost per Capita)

U.S. dollars




Chemotherapy for TB (6 months )




Contraceptives (HIV)





Hydration salts for Diarrhea




Pneumonia Antibiotics (5 days antibiotics)



Measles (1 douses of vaccination)








Sources: CDS, WHO

1. Although WHO reports an effectiveness of 99%, the literature reports lower results.

Gallup and Sachs (2000) have estimated that malaria alone has wiped $74 billion from the economies of 31 African countries between 1980 and 1995. The productivity of a worker with malaria is reduced by 60% and to this must be added indirect costs associated with the disease such as hospitalization. This same study argues that if the rich countries were to provide $1 billion a year for an indefinite period, they could help pay not just for drugs, insecticides, and bed-nets, but also for a fund that could be drawn upon once any malaria vaccine were developed. The economic gains of such investment for sub-Saharan Africa’s combined gross domestic product (GDP) would be between $3 and $12 billion a year. It is also known that 75% of TB infections and deaths occur in the 15-54 year age group, which economically is the most productive group in the population. A treatment course costs only $20; successful treatment returns productive people to jobs and to normal life in the community.37

AIDS, which places seventh among the leading causes of death, has captured the attention and the funds of almost the entire world. Although the number of cases is high, it is significantly lower than the reported new cases of malaria and tuberculosis every year. According to the 2003 UNAIDS report, the main modes of the transmission of this disease vary across regions and are mainly three: homosexual activity, injected-drug-use, and heterosexual activity.38 This means that, in most cases, transmission of AIDS is a matter of behavior and, high-risk behaviors should be discouraged and replaced by healthier lifestyles. Furthermore, it means that without addressing that behavior, the response to prevention strategies will always be limited, as proven by Uganda.39 It was not until the ABC program was implemented that Uganda began to make significant strides in reducing the spread of AIDS.40 Clearly, the $1.60 per capita cost of condoms was put to more effective use. In fact, the statistics indicate what few officials are willing to admit, that the AIDS epidemic is a crisis of shattered mores, where sexuality is no longer guided by traditional norms but promiscuity. The message is clear: the only way to avoid acquiring HIV through sexual contact is abstinence from sexual involvement or restricting sexual activity to a mutually faithful, monogamous, life-long relationship with a similarly uninfected heterosexual partner. In most cultures and for all recorded history, this relationship is known as marriage.

A worker with AIDS costs business in sub-Saharan Africa around $200 a year in lost productivity, treatment, benefits and replacement training, i.e., about a year’s salary, and the cost for treatment is approximately 10% of the GDP.41 A number of economic studies also conclude that the AIDS epidemic is slowing the pace of economic growth and depleting the wherewithal to deal with the leading causes of death such as diarrhea, malaria and tuberculosis.42

Majority of deaths due to maternal conditions are caused by poor access to health care. Most of these maternal deaths occurred in developing countries (mainly Africa and South East Asia) and account only for 1.9% of female’s deaths.43 For the most part, they could have been avoided with a simple delivery kit package or medical attention (the cost per package is $1.60).

V. Solutions Often Proposed

The positive correlation between human capital and economic growth, infrastructure and economic growth, healthy institutions and economic development, as well as health and income per capita, are well-known relations in international economic development. These correlations are commonly thought to reflect a causal link running from human capital and infrastructure to economic growth, from healthy institutions to economic development, and from income to health. Recent economic analyses, however, indicate that human capital is essential to both, the development of healthy institutions (social capital) and for infrastructure and technology to allow economic development.44 Furthermore, these economic analyses also indicate that health status (as measured by life expectancy) is a significant predictor of subsequent economic growth as it contributes to human capital growth.45

The approach that international organizations have taken towards dealing with the problems of poverty and lack of economic development that families face in developing countries have been outlined, among other places, in the eight UN Millennium Development Goals defined in the UN Millennium Declaration.46 These include:

  1. Eradicate extreme poverty and hunger

  • Reduce by half the proportion of people living on less than a dollar a day

  • Reduce by half the proportion of people who suffer from hunger

  1. Achieve universal primary education

  • Ensure that all boys and girls complete a full course of primary schooling

  1. Promote Gender Equality and Empower Women

  • Eliminate gender disparity in primary and secondary education preferably by 2005, and at all levels by 2015

  1. Reduce child mortality

  1. Improve maternal health

  • Halt and begin to reverse the spread of HIV/AIDS

  • Halt and begin to reverse the incidence of malaria and other major diseases

  • Reduce by three quarters the maternal mortality ratio

  1. Combat HIV/AIDS, malaria and other diseases

  • Halt and begin to reverse the spread of HIV/AIDS

  • Halt and begin to reverse the incidence of malaria and other major diseases

  1. Ensure environmental sustainability: land and air

  • Integrate the principles of sustainable development into country policies and programs; reverse loss of environmental resources

  • Reduce by half the proportion of people without sustainable access to safe drinking water

  • Achieve significant improvement in lives of at least 100 million slum dwellers, by 2020

  1. Develop a global partnership for development: development assistance and market

  • Develop further an open trading and financial system that is rule-based, predictable and non-discriminatory. Includes a commitment to good governance, development and poverty reduction—nationally and internationally

  • Address the least developed countries’ special needs. This includes tariff- and quota-free access for their exports; enhanced debt relief for heavily indebted poor countries; cancellation of official bilateral debt; and more generous official development assistance for countries committed to poverty reduction

  • Address the special needs of landlocked and small island developing States

  • Deal comprehensively with developing countries’ debt problems through national and international measures to make debt sustainable in the long term

  • In cooperation with the developing countries, develop decent and productive work for youth

  • In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries

  • In cooperation with the private sector, make available the benefits of new technologies—especially information and communications technologies

Two of the main means promoted to achieve these goals have been population control and the support to popularize the use of condoms as a means of managing the crisis of AIDS and poverty. Proponents of these means contend that this leads to "safe sex."47

Population control has been mainly promoted, as previously mentioned, on two main premises: the existence of an inverse relationship between population growth and development derived from the law of diminishing returns as proposed by Malthus (1798), and the Neo-Malthusians view which see people as destroyers of resources and violators of environmental limits. The basic argument of these positions can be reduced to four main points. First, rapid growth in population means the spread of poverty and rapid growth aggravates conditions such as poor health, malnutrition, illiteracy, and unemployment.48 Second, population threatens government stability in developing countries and encourages confrontation between developed and developing countries.49 Third, population pushes future generations to scarcity, and an unsustainable environment carrying capacity.50 Fourth, population growth is a symptomatic of the larger problem of women's oppression—the more children a woman has, the less opportunity she has for her own self-actualization and development.51

In summary, assuming a fixed level of resources, this position predicts a decrease in per capita income in two ways: 1) more consumers divide any given amount of goods, and 2) each worker produces less because there is less capital, private and public, per worker. In addition, the growing number of young children poses an additional burden in the reduction of consumption because they consume but they do not produce. Finally, population growth hinders economic growth because, by reducing savings and education, it reduces investment. A key assumption of this theory is the ceteris paribus condition where resources are given and therefore constant.52 The problem, of course is that the scientific evidence points in the other direction,53 suggesting that economic theories used to support population control polices are unfounded and do not do much for the development of less developed countries.54 On the contrary, empirical results suggest that it hampers their most important resource: population, and sets countries on a path towards a population trap.

A growing proportion of the retired population compared with the active working population characterizes an aging society. The reversal of the age pyramid affects several countries today, developed countries mainly although developing countries are beginning to be affected as well. The causes of the present aging population are complex. Some sources have been found in the living conditions and socio-cultural changes. Among these are included:

  • Decreased infant mortality.

  • Sharply increased mean age at which women first give birth.

  • Labor codes that do not facilitate women’s desire to harmoniously integrate their family life and professional activity.

  • In developed countries, a widespread attitude that keeping a certain quality of life is more important than having children posing a paradox that Wattenberg describes in The Birth Dearth: “In the wealthier age of history many youth say that they can not afford to have more than two children.”

  • A divergence between pessimism and hope experienced by the population.

Implosion and the consequent aging in population bring with them serious problems for developed and even more so for less-developed and developing countries. Some of these problems include:

  • A smaller population needs to support an aging population that is less active and has a greater need of healthcare and medical services. If one adds to this the fact that most social security systems are predominantly of the pay-as-you-go type, the absence of younger generations endangers the possibility of supporting the elder population.55

  • Saving rates are affected by a society's age structure, mirroring the change in an individual's saving rate over the life cycle. This, in turn affects investment.

  • Solutions proposed to alleviate the situation include resorting to euthanasia. In fact, some EU countries have already legalized it.

  • Within the active population there is a tension between the young and the somewhat older people, as the latter try to protect their jobs while younger generations enter into reduced job markets.

  • An impact on education: in order to provide for the economic burden of the elderly, there is a great temptation to cut down on the money allocated for the training of new generations. Consequently, the transmission of cultural, scientific, technical, artistic, moral and religious common goods is thereby endangered.

  • Danger of ‘moroseness’, or a lack of intellectual, economic, scientific, and social dynamism and reduced creativity, resulting in systemic stagnation.

  • The problem of increasing illegal immigration into population imploding countries accompanied with a significant impact on the countries receiving this large immigrations.56

  • Increasing loneliness among the population because of small families and reduction of extended family (Eberstadt, 1995).

It is clear that the promotion of population control to obtained sustainable economic development will not help solve any of the above problems but rather worsen them.

The cost of malaria to African countries is 1-5% of GDP.57 Direct and indirect costs of malaria in sub-Saharan Africa exceed $2 billion. The World Bank lending at the end of 2003 amounted to $300 million for malaria and $560 million for tuberculosis. The WHO funds allocated for these diseases totaled $369 million in 2002- 2003. At the same time, the World Bank allocated $1.5 billion in grants, loans and credits to fight HIV/AIDS over the past five years. The cost of antiretroviral regimens has decreased significantly ($12,000 per year to $500) in the past five years thank to the efforts of many institutions providing affordable medicines to those who suffer of HIV/AIDS in developing countries. Although malaria and tuberculosis constitute a much larger problem for the economies in many developing countries, these diseases are systematically left at the margin when comes to actual funding. None of the amounts allocated for malaria or tuberculosis compare to the annual population assistance levels of $2 billion a year. Yet, scientific data reports that access to family planning increases both adults and sexual promiscuity and use of condoms increases the risk of contracting AIDS.58

This misuse of funds does not only affect health but also other fundamental elements of economic growth. Figure 5 depicts the expenditures on grant-financed development activities of the UN system between 1990 and 2001. While population assistance has significantly increased, expenditures on grant-financing allocated towards transportation, science and technology, energy, employment, industry, and trade and development expenditures initiatives have decreased significantly.

Figure 5

Expenditure on Grant-Financed Development Activities

of the United Nations System by Sector

(Percentage of total)

Source: Compiled from Comprehensive Statistical Data on Operational Activities for Development,

years 1990-2003.

The contrast is even more striking when the use of grant-financed development activities on education versus population are examined. (Figure 6). As previously mentioned, such a misallocation of funds directly hampers human capital and, in doing so, it hampers economic development. This simple change in allocation of funds would save billions of dollars in countries across the world that could be allocated, instead, towards the increase of human capital (education), basic infrastructure and health services, among others.

Table 6

Expenditure on Grant-Financed Development Activities

of the United Nations System by Sector

(Percentage of total)

Source: Compiled from Comprehensive Statistical Data on Operational Activities for Development years 1990-2003.

Developed countries seem to be realizing the consequences that the breakdown of the family has had in their society. Therefore, they are seeking out policies that will help reverse this trend. They seem to know that redistribution of income towards the victims of such disruption is not enough, thus they have begun to develop and implement legislation that supports families vis a vis other types of arrangements. Great Britain for example, in the 1999 released a report entitled Supporting Families, advancing a proposal to create an Institute for Family and Parenthood to advise parents in matters regarding the education of children. It also proposed the elimination of the 24 hour-notice of civil marriage and the introduction of preparatory classes, so as to encourage couples to become aware of their right and duties in marriage. Similarly, the U.S. has supported a marriage initiative, which aims at strengthening marriages by preparing couples to marry and by assisting those who are in need.

France has also shown a significant shift in family policies, which are directed to reinforcing family supports. For example as of 1999, all families with at least two children receive family subsidies independent of their income level. It also extends child-support to parents to 19 years of age, or 20 if the dependent is a student. It also expands credits and subsidies for family housing. Holland and the U.S. have both introduced, as a labor right, parental leave for family needs, thus giving rise to ‘family days’ benefits. The goal is to facilitate parents balancing their family as well as their work obligations.59 In summary, we can say that industrialized economies as a whole have been supporting new efforts to reverse the negative effects of the weakening of the family and reinforce this basic unit of society.60

At the private sector level, businesses are also responding to the need of strengthening the economy. They feel first hand the consequence of its disruption. Some of these initiatives include systems of flexible working hours for men and women, work sharing, the provision of facilities so to allow women to work from their home some days of the week, in house child care, and the extension of maternity leave with an option to work on a part-time basis for some additional time.

1   2   3   4   5   6

The database is protected by copyright © 2016
send message

    Main page