Copyright 2002 Toronto Star Newspapers, Ltd.
Toronto
Star
January 4, 2002 Friday Ontario Edition
SECTION: EDITORIAL; Pg. A22
World's poor need more money for health
On
the list of factors keeping poor countries poor bad governance, war, natural
disasters a prominent place must go to disease. By the most conservative
estimates, malaria robs sub-Saharan Africa of 6 per cent of its economic
strength, and the actual figure could be even higher than 50 per cent. As AIDS
spreads, the situation will be even more devastating. Disease cuts the lifespan
of workers and reduces productivity. High infant mortality compels families to
have many children; the families are thus able to spend less on the health and
education of each child, and mothers are kept from joining the work force. The
health of the world's poorest nations is normally and properly measured in
lives. Now, a new study commissioned by the World Health Organization puts a
dollar figure on the rewards of improving health among the globe's poor. It
makes a compelling argument that a dramatic increase in health spending by both
rich and poor nations would produce huge economic and human benefits.
The Commission On Macroeconomics And Health, led by professor Jeffrey
Sachs of Harvard, asks rich countries to spend an extra one-tenth of 1 per cent
of their economies on the health of the poor. In Washington's case, this would
mean doubling current health aid, an extra $10 billion a year.
If all wealthy countries co-operated, it would add $38 billion
a year to health spending by 2015. The commission argues that if that money went
to poor nations that also spent more and improved their health-care systems,
these countries would see at least $360 billion a year in
economic gains, lifting millions of people out of poverty.
The study has
been well-received in Europe, where several prominent leaders have called for a
sharp increase in health spending. In Washington, the response has been
skeptical. Sachs and his co-authors say that one of the biggest obstacles to
reaching the study's goals is changing the U.S. view of foreign aid. Here, help
for the Third World is dismissed as waste.
It is hard to imagine
anything less wasteful than the health spending recommended, in terms of the
good it does and its cost-effectiveness. While foreign aid has often failed to
produce results, health improvements are actually the easiest to deliver. We
know how to cure a case of tuberculosis for $15, but many poor
countries cannot afford even that for TB victims. The world knows how to
administer childhood vaccines, a simple and cheap measure that saves 3 million
lives a year. But in many nations, vaccine coverage is dropping because the
money is not there. In the world's 60 poorest nations, the average per capita
health spending every year is $13. The WHO report recommends
that as a minimum, this should rise to $34. In the United
States the figure is $4,500.
Improving the health of
poor countries would be an investment with payoffs for the U.S. A more
prosperous and stable Third World would experience fewer conflicts and would
eventually spend more money buying U.S. exports. But the chance to save lives
and reduce poverty should be incentive enough.
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©2002 by the President and Fellows of Harvard College.
Last revised 07/03/2002