World Vision have sent me a briefing on a new campaign they are launching. I guess a blog has reached critical mass when such things
happen.
They say this World Vision aims to cut child deaths by two thirds in order to reach the Millennium Development Goals. and note:
¬? 8.8 million children die each year before the age of five, which equates to 24,000 deaths every day.
¬? The main causes of these deaths are largely preventable - an estimated two thirds of children could be saved through simple interventions such as low-cost vitamin and mineral supplements to prevent malnutrition and comprehensive postnatal care to prevent post pregnancy complications and infections.
¬? Rich countries need to increase their commitment to health from the current level of $16 billion a year to $42.5 billion by 2015 if they are to meet the Millennium Development Goals` outlined in 2000 — this is equivalent to five days of health spending in the USA.
¬? Progress and change is possible. Even in some of the poorest countries, significant progress has been achieved. For example, the improvements accomplished in Malawi, for every 1,000 babies born, 125 more children survived to their fifth birthdays in 2008 than they did in 1990.
These facts are shocking. I share the concern for them. They motivate a lot of what I do. It’s unacceptable that More than 24,000 children under the age of five die every day.
I’m not sure World Vision — a US charity — has got its analysis right though. They’re right to say:
World Vision believes that simple, proven measures — most of them low cost, such as vitamin and mineral supplements to prevent malnutrition and improved water and sanitation systems to give more people access to a treated water supply - can transform the opportunities of the world’s poorest and most vulnerable children.
The World Bank estimates that a further 2.8 million children could die between now and 2015 unless immediate action is taken, adding further urgency to the challenge of child health.
And this has truth in it:
Many of these problems persist due to political inaction and misdirected effort — they fail to attract much comment, or spark outcry from media, politicians and civil society. In short, the global child health emergency is too often greeted with fatal indifference from those people with the power to address it.
It only has elements of truth in it because they go on to say this:
The epicentre of the child health emergency is sub-Saharan Africa and South Asia, with approximately half of all deaths accounted for by just five countries: India, Nigeria, the Democratic Republic of Congo, Pakistan and Ethiopia. Without a concerted and sustained effort in these countries, there’s little prospect of MDG 4 being met at a global level.
Most high burden countries are poor, and many are poorly governed. All of them are characterised by high levels of health inequality, between rural and urban areas, and between rich and poor. For example, in Nigeria, children from the poorest fifth of the population are three times more likely to die than those from the wealthiest fifth. Reducing the health gap between rich and poor even within the poorest countries would have a dramatic impact on overall mortality rates.
In response to which they say:
The main drivers of change have to come from the developing countries. Experience tells us that significant change is often underpinned by popular demand and informed public debate. However, countries which are poorly governed and ill coordinated with levels of internal corruption need help to make these important changes.
I do not for a minute doubt World Vision’s plan for enhanced nutrition, maternal health and the prevention of easily controlled childhood diseases are all valid. My concern is that this is seen as a process of aid. And it is seen as a process in which developed countries take a lead. and it is seen that, without explanation, health inequalities, which are inextricably linked to wealth inequalities will be solved, as will corruption by the great hand of western largesse.
If only that were true. I applaud all efforts to solve these problems: World Vision’s motives are sound. But they have to ask:
- Why is there inequality?
- How can it be addressed?
- How does the corruption take place?
- Who facilitates it?
- Where do the proceeds end up?
- How can we stop that process?
The answer is, of course, that there is a market mechanism to facilitate these outcomes: the secrecy jurisdiction market.
Secrecy jurisdictions are places that intentionally create regulation for the primary benefit and use of those not resident in their geographical domain. That regulation is designed to undermine the legislation or regulation of another jurisdiction. To facilitate its use secrecy jurisdictions also create a deliberate, legally backed veil of secrecy that ensures that those from outside the jurisdiction making use of its regulation cannot be identified to be doing so.
It is secrecy jurisdictions that allow corruption to happen. They facilitate it, provide the mechanisms to let the funds flow, and provide the secrecy to ensure it is never discovered.
Yes, World Vision are right — this is a developed country problem. We have to close secrecy jurisdictions.
Then with country-by-country reporting we have to help force profits to be declared and tax be paid in these countries. Then they can overcome their own problems.
That is the only real solution.
I am posting this to show solidarity with World Vision — but am asking in return that they face the really big issue of why developed countries help strip the poorest nations on earth of their wealth and return what little goes back to the wealthiest who have no need or entitlement to it.
I hope they will rise to that challenge. Because if they don’t they too are guilty of turning a blind eye — and that won’t do.
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I’ve been given a copy of this: http://cje.oxfordjournals.org/cgi/content/abstract/27/4/597. Have only just started reading it – it’s a critique of the Tobin Tax: Sand in the wheels or spanner in the works?
Hi Richard,
Thanks for posting on this. Your analysis of taxation and development has been an important contribution to public understanding of the barriers to global poverty reduction, and the role that the UK government and business sector plays in maintaining many of those barriers. It’s great to have such a credible voice on board with our core campaign proposition – namely, the grotesque inequalities in life chances between rich and poor are a scandal, not least because they’re avoidable through some well-evidenced, and relatively simple and affordable solutions.
However, I don’t agree that we’ve got the analysis wrong.
First, aid is not the principal solution – we’re very clear in our campaign report -http://www.worldvision.org.uk/upload/pdf/CHN_Launch_Report.pdf – that the goal of cutting child deaths will not be achieved by what the World Bank, or the UK Department for International Development does. The report states clearly that the changes need to come first and foremost from within poor countries themselves. Through the stories of countries like Malawi and Liberia we show that national level commitment is critical. We’re also clear that getting health policy right requires the right kind of politics, with people in poverty and civil society organisations (not only NGOs, but media, religious organisations, professional bodies, unions and business groups) demanding their rights, and holding government to account for their commitments.
Where you’ve got these conditions in place, aid can be an invaluable spur
to progress, provided its given in a way that doesn’t undermine local
ownership. We’re clear in the report that aid for health on the whole has a lousy track record, and that there’s a mismatch between what donors are currently doing, and what’s needed. This is not about Western largesse, but as the report makes clear, about universal rights implying universal obligations.
You are right that health inequalities, which are covered in some detail
in the campaign report, are closely linked to wealth inequalities, and that behind this lies a story of governance, state capacity, and revenues.
Again, while we don’t go into governance issues in any detail in the
report, we’re clear that these are among underlying causes of the nine
million child deaths a year. Ultimately, development is complex, and
everything is inter-linked, but it’s also important to recognise that even within the current limitations created by poverty and bad governance, there’s a lot that can be done – especially at family and community level – to reduce child deaths.
Finally, a factual inaccuracy – World Vision is not a US charity (although it was founded there). It’s a genuinely global federated organisation, with two thirds of its income coming from outside the US.