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Editorial
8-9/2005 |
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Inevitable costs
Disputes over money have left their mark on the international debate on the United Nations’ Millennium Development Goals. Does it make sense to double aid by 2015? That is what both UN expert Jeffrey Sachs and the British government are demanding. But sceptics state that billions have already been invested without any noticeable result. Others warn that it is pointless to simply throw money at problems as only well spent funds will make any meaningful difference.
Sadly, the debate tends to run along the beaten path. For instance, all involved – donors, recipients, private sector managers, scientists, and civil society activists alike – stress the importance of local ownership. In a way, that is promising as nothing will ever be accomplished without locally responsible people. On the other hand, it does seem telling that such an obvious statement bears repetition over and over again. Obviously, the urge to fight poverty is not as prevalent in developing countries as it should be.
In the meantime, there is a simple reason for aid becoming more expensive: AIDS. Ever since the dispute over pharma patents, the legitimacy of the entire world trade system has hinged on the provision of innovative antiretroviral drugs to patients in poor countries. These drugs postpone the outbreak of the disease and allow infected persons to lead relatively normal lives. The price of the pharmaceuticals has dropped considerably. The simplest version, which, unfortunately, is not applicable in all cases, only costs around 50 cents per patient and day. But even this sum, though small by international standards, amounts to a fortune for those who subsist on one dollar per day. Moreover, procuring pills is not enough. Composing the right mix requires complicated diagnoses. Staff must be trained – and need up-to-date equipment in Africa’s remote areas. Of course, prevention must stay high on the agenda too.
AIDS is a recent phenomenon, devastating because it affects the sexually active generation – the workforce, in other words. HIV/AIDS deserves special attention, even though other plagues (malaria, for instance) may claim more lives. Nonetheless, the health institutions of poor countries have to perform all their tasks convincingly. Otherwise, resource disputes will rule out sustainable success. Nobody can convince the general public of spending great sums on treating HIV-infected persons, who do not yet suffer from any symptoms, while the seriously ill remain unsupported. Moreover, rich countries face opportunity costs hardly understood so far. The migration of doctors and nurses from poor countries must stop, or adequate treatment will not be possible there. More aid for the health sectors of developing countries may therefore imply more personnel shortages in donor countries.
And yet, we know that health and education are crucial for human development. That is why specific indicators – along with monetary ones – determine the UNDP’s renowned Human Development Index. The health objectives of the MDGs lay the basis for general poverty reduction. Doing so successfully should justify spending substantial sums.
We have given D+C/E+Z a new structure. The contents page and the sequence of sections have become more accessible. From now on, the “Monitor” section at the start of the journal will provide an overview of the latest developments, while “Debate” at the end will provide critical reflection on recent trends.
Dr. Hans Dembowski
Editor in Chief of D+C Development and Cooperation/E+Z Entwicklung und Zusammenarbeit
euz.editor@fsd.de
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