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Every country, rich and poor, should ensure
universal coverage of primary healthcare, including
safe childbirth, nutrition, vaccines, malaria
control, and clinical services. Each year, nearly
nine million children die of conditions that could
be prevented or treated, and nearly 400,000 women
die because of complications during pregnancy.
Almost all of these deaths are in the world’s
poorest countries. Ending these deaths would not
only reduce suffering, but would also unleash
economic prosperity in impoverished and unstable
societies.
The greatest barrier in doing so is that the poorest
countries cannot afford universal primary
healthcare, even though the cost per person is very
low. Using immunisations, modern medicines,
state-of-the-art diagnostics, mobile phones, and
other new technologies, universal primary healthcare
is now highly effective and very inexpensive,
costing around 54 dollars per person per year in the
poorest countries.
Yet, because of their very low incomes, the poorest
countries can afford only around 14 dollars per
person from their national budgets. Financial help
from abroad is needed to cover roughly 40 dollars
per person per year. With approximately one billion
impoverished people still lacking primary
healthcare, the total sum needed is around 40
billion dollars per year. Foreign donors, including
the United States, the European Union, and Japan,
are currently contributing around one third of that,
roughly 14 billion dollars per year.
The remaining annual financial gap is therefore
about 26 billion dollars. With that money, the lives
of many millions of mothers and children could be
saved each year.
This is not a lot of money for the rich countries,
but they fail to come up with it. The most obvious
gap is in the Global Fund to Fight AIDS,
Tuberculosis, and Malaria, a global initiative to
help the poorest countries fight these killer
diseases. The Global Fund is desperately short of
money, yet the Obama Administration and other
governments are not responding to the financial
need.
The rich countries could easily come up with the
money. The United States could end its expensive and
failed war in Afghanistan, which is costing around
100 billion dollars per year. If the US gave a tiny
fraction of that 100 billion dollars in development
aid for Afghanistan, it would be far more successful
in achieving peace and stability in that war-ravaged
country.
For example, the US could give 25 billion dollars in
development aid each year and another 25 billion
dollars for global health, and still save 50 billion
dollars each year to reduce the US budget deficit.
Afghanistan, and hence the US, would be far safer,
the world would be far healthier, and the US economy
would benefit enormously.
A
second approach would be to tax the big
international banks, which are earning excessive
profits on their speculative trading. Even after
Wall Street nearly wrecked the world economy, the US
government coddled and protected it, enabling its
return to huge profits, perhaps 50 billion dollars,
last year.
The bankers again paid themselves huge bonuses, more
than 20 billion dollars for 2009. This money should
have gone to the world’s poorest people rather than
to the bankers, who certainly did not earn it.
It
is time for an international tax on bank profits,
perhaps implemented as a levy on international
financial transactions, which would raise tens of
billions of dollars each year. In pressing the case
for such a tax, the developing countries should not
accept the meagre excuses offered by the US and
other countries in order to protect their bankers.
A
third approach would be to obtain increased
contributions from the world’s richest people.
Several of them, including Bill Gates, George Soros,
Warren Buffett, and Jeffrey Skoll, are already mega
philanthropists, committing huge sums for the
world’s good. Yet other billionaires have yet to
make comparable donations.
According to the most recent Forbes list, there are
1,011 billionaires in the world, with a combined net
worth of 3.5 trillion dollars. This means that if
each billionaire would contribute 0.7pc of their net
worth, the total sum would be 25 billion dollars per
year. Just imagine, 1,000 people could ensure
primary healthcare for one billion impoverished
people.
A
fourth approach should be to look to a company like
Exxon-Mobil, which earns billions of dollars each
year in Africa but, according to one of the
company’s online reports, spent only around five
million dollars per year on malaria control
programmes in Africa from 2000 to 2007. Exxon-Mobil
could and should be funding much more of the
continent’s urgently needed primary health services,
either out of royalties paid by the company or out
of corporate philanthropic donations.
Finally, new donor countries, such as Brazil, China,
India, and Korea, have the vision, energy, economic
dynamism, and diplomatic interest to expand their
donor support in the poorest countries, as well as
in the poorest parts of their own countries. If the
US and Europe are too neglectful to do their part,
the emerging economies can and will pick up part of
the slack. Fortunately, these new donors are
becoming trusted partners in Africa.
The rich world lacks the money to do more, it says,
but what it lacks is imagination, not resources. The
US should divert its wasteful military spending to
new health financing. The world should implement a
global bank tax. The billionaires should step up
their philanthropy. The oil companies should pay
more. New donor countries like China can fill the
financing gap left by the traditional donor
countries.
The money is there. The needs are urgent. The
challenge is one of morality and vision. |
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