Two recent reports by the World Health Organisation and the United Nations focus on the poverty, degradation and social squalor confronting millions of people world-wide. Both highlight the fact that despite a tremendous growth in economic activity--due to the penetration of transnational corporations into every corner of the world and the development of productivity, technique and computerisation--the world's poor have not benefited.
The World Health Organisation (WHO) report coincides with the body's fiftieth anniversary. It is a comprehensive review of the health and well being of the world's population throughout this period as well as a prognosis for the next 25 years.
There are many signs access to health care has become an issue in advanced industrial countries as a result of the deepening economic crisis. WHO reports that for the first time in decades, life expectancy in Europe actually declined last year. Rapid and severe impoverishment and outbreaks of infectious disease resulted in a dramatic drop in life expectancy in the former Stalinist-ruled countries. This was a reversal of a steady 20-year rise in life expectancy these countries.
While overall health standards globally have steadily increased over the years, the health gap between the rich and poor is at least as wide as it was half a century ago, and becoming wider. In general non-communicable diseases such as coronary heart disease, cancer, diabetes and mental disorders are more common than infectious diseases in the advanced countries.
The report notes, however, that whilst life expectancy is increasing globally, three out of four people in the poorest nations today are dying before the age of 50--the global life expectancy figure of half a century ago. This year, of 21 million deaths world-wide, 2 out of 5 will be to those under the age of 50, including 10 million children who will never see their first birthday. About 300 million people live in 16 countries where life expectancy actually decreased between 1975 and 1995.
In 1997, of a global total of 52.2 million deaths, 17.3 million were due to infectious and parasitic diseases; 15.3 million were due to circulatory diseases; 6.2 million were due to cancer; 2.9 million were due to respiratory diseases and 3.6 million were due to perinatal conditions. The leading causes of deaths from infectious diseases were acute lower respiratory infections (3.7 million), tuberculosis (2.9 million), HIV/AIDS (2.3 million) and malaria (1.5-2.7 million)
About 50 percent of deaths of children under the age of five are associated with malnutrition. At least 2 million deaths of the children this age could be prevented by existing vaccines. Most of the rest are preventable by other means.
More than 15 million adults aged 20 to 64 are dying every year. Most of these deaths are premature and preventable. Among the premature deaths are those of 585,000 young women who die during pregnancy or childbirth. While the risk in Europe is one in 1,400, in Asia it is one in 65 and in Africa one in 16.
Tomorrow's children face a 'new morbidity' of illnesses and conditions that are linked to social and economic changes, including rapid urbanisation, neglect, abuse and violence; especially amongst the growing numbers of street children. One of the biggest hazards to children in the twenty-first century will be the continuing spread of AIDS/HIV. In 1997, 590,000 children under 15 became infected with HIV. The disease could reverse some of the major gains achieved in child health over the last 50 years.
The transition from childhood to adulthood will be marked for many in the coming years by violence, delinquency, drugs, alcohol, motor vehicle accidents and sexual hazards. For many, especially those growing up in poor urban areas, adolescence will represent the most dangerous years of life.
The number of people aged over 65 will have risen from 390 million in 1997 to 800 million by 2025--from 6.6 percent to 20 percent of the total population. The medical and social facilities needed for the aged to lead healthy lives have been vastly reduced through the destruction of welfare state provision. Even in the advanced countries old people cannot meet more than a small fraction of the costs of the health care they need. In the coming years, few countries will be able to provide specialised care for their large population of aged individuals.
The development of globalisation and the rapid urbanisation associated with it has dramatically altered people's lives. The global population was 2.8 billion in 1955 and is 5.8 billion now. In 1955, 68 percent lived in rural areas and 32 percent in urban. In 1995 the ratio was 55 percent rural and 45 percent urban. By 2025 it will be 41 percent rural and 59 percent urban.
Despite its contents, the WHO report finishes by praising the ability of the profit system to resolve these problems. It predicts that the economic expansion of the 1990s will continue and by 2025 many of the social problems we now face could be overcome--provided of course that there is no 'major economic crisis'.
A second report, the UN's Human Development Report, concentrates on the distribution of the world's resources. It, too, reveals a tremendous polarisation between rich and poor, between the oppressed nations and the advanced capitalist powers.
World consumption has expanded at an unprecedented pace over the twentieth century, with private and public consumption expenditures reaching $24 trillion in 1998, twice the level of 1975 and six times that of 1950.
Consumption per capita has increased steadily in industrialised countries (about 2.3 percent annually over the past 25 years). In contrast, the poorest 20 percent of the world's population have been left out of the consumption explosion. The average African household, for instance, consumes 20 percent less than it did 25 years ago.
Well over 1 billion people are deprived of basic consumption needs. Of the 4.4 billion people in the oppressed countries, nearly three-fifths lack basic sanitation. Almost a third have no access to clean water. One-quarter do not have adequate housing. A fifth have no access to modern health services and do not have enough dietary energy and protein. A fifth of children do not attend school to grade 5. World-wide 2.2 billion people are anemic, including 55 million in industrialised countries. In the oppressed countries, only a privileged minority has access to motorised transport, telecommunications and modern energy.
Globally 20 percent of the world's people in the highest income countries account for 86 percent of total private consumption expenditures--the poorest 20 percent a minuscule 1.3 percent. Specifically, the richest fifth:
- consume 45 percent of all meat and fish, the poorest fifth 5 percent;
- consume 58 percent of total energy, the poorest fifth less than 4 percent;
- have 74 percent of all telephone lines, the poorest fifth 1.5 percent;
- consume 8 percent of all paper, the poorest fifth 1.1 percent;
- own 87 percent of the world's vehicle fleet, the poorest fifth less than 1 percent.
Despite high consumption, poverty and deprivation are found in all industrial countries and in some they are growing. The report shows that between 7 and 17 percent of the population of industrialised countries are poor. These levels of deprivation have little to do with the average income of the country. Sweden has the least poverty (7 percent), though ranked thirteenth in average income. The United States, with the highest average income of the countries ranked, has the highest population share experiencing poverty. The report shows conclusively that underconsumption and human deprivation are not just the lot of the poor people in the 'developing' world. More than 10 million people in advanced nations suffer a similar fate. More than 100 million people are homeless. And at least 37 million people are without jobs, often experiencing a state of social exclusion.
To illustrate the growing divide between rich and poor, the UN notes that the 225 richest people in the world have a combined wealth of more than $1trillion--equal to the annual incomes of the poorest 47 percent of the earth's population, some 2.5 billion people. The three richest people on the planet--Microsoft's Bill Gates, the Walton family of Wal-Mart stores and investor Warren Buffet--have assets exceeding the combined GDP of the 48 least developed countries.
'It is estimated that the additional cost of achieving and maintaining universal access to basic education for all, basic health care for all, reproductive health care for all women, adequate food for all and safe water and sanitation for all is roughly $40 billion a year,' the UN explains. 'This is less than 4 percent of the combined wealth of the richest 225 people.'
The report notes, 'globalisation is integrating not just trade, investment and financial markets. It is also integrating consumer markets. This has two effects--economic and social. Economic integration has accelerated the opening of consumer markets with a constant flow of new products.
'On the social side local and national boundaries are breaking down in the setting of social standards and aspirations in consumption. Market research identifies 'global elites' and 'global middle classes' who follow the consumption styles, showing preferences for 'global brands'. There are the 'global teens'--some 270 million 15-18 year olds in 40 countries--inhabiting a 'global space', a single pop-culture world, soaking up the same videos and music and providing a huge market for designer running shoes, t-shirts and jeans.'
Despite this, 'Not only have consumption levels been too low to meet basic needs for more than a billion people, their growth has often been slow and interrupted by setbacks. In 70 countries with nearly a billion people, consumption today is lower than it was 25 years ago. In cannot be raised without accelerating economic growth--but growth has been failing many poor countries. Despite the spectacular growth of incomes for many people in Asia, only 21 developing countries world-wide achieved growth in GDP per capita of at least 3 percent each year between 1995 and 1997--the rate needed to set a frame for reducing poverty.'
Again, after presenting a devastating indictment of the social impact of the profit system, the UN arrives at conclusions even more bankrupt than the WHO. The report is prefaced by the Keynesian economist J.K. Galbraith, who baldly states that the growth of poverty can be attributed to a mixture of personal greed and disinterest: 'The problem is not economics; it goes back to a far deeper part of human nature. As people become fortunate in their personal well-being, and as countries become similarly fortunate, there is a common tendency to ignore the poor ... it is a habit of mind to which I would now attribute major responsibility.'
With respect to the plight of the poor nations, the problem is that the imperialist powers in their haste to grant their former colonial possessions self-determination, 'left a number of countries without effective self-government,' Galbraith states. The answer? A return to imperialist rule and gunboat diplomacy: 'Nothing is so accepted in our time as respect for sovereignty; nothing, on occasion, so protects disorder, poverty and hardship.... I do believe we need a much stronger role for international action, including the United Nations.'
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