The poor are too poor to stay alive

UN Economic and Social Council (ECOSOC) Forum: WHO/UNFPA Joint Panel on 'Health Priorities in Africa: Are we onthe right direction for achieving the MDG health goals in Africa?

By John Kiwanuka Ssemakula, July 4th 2002

According to Jeffrey Sachs, we are in the midst of a global health crisis, with Africa at its epicenter and this is manifesting itself with serious economic effects. In a presentation at the ECOSOC Forum: Health Priorities in Africa on 2nd July 2002, he said “Contrary to what people believe, we have the technology, the money, experience and knowledge to address these problems. This then begs the question, why are millions dying, if the means to save them are available?”

The poor are too poor

The answer is simple poor people are just too poor to stay alive.

The WHO calculated that a minimum figure of $30-40 dollar a year per person was needed to provide the basics of health care, which include prevention, immunization, clean water among other things. The current average amount of spending per person in USA is now $4,400 a year. In other words, the amount needed in poor countries is just one hundredth the amount spent in USA!

It all comes down to simple and basic arithmetic. How can this be illustrated? For example take Malawi one of the poorest countries. It has a per capita income of $190 dollars a year.

Divide the basic minimum health spending recommended by the WHO into the GNP of Malawi:

(40 / 190) x 100 = 21% of Malawi’s GNP.

No country in the world can afford this. Even the richest countries in the West spend no more than 10-12% of their GNP on health.

From this one can deduce Malawi is just too poor to stay alive. And this picture is not just limited to Malawi.

Rich countries are afraid to do basic arithmetic

It is all about economics and simple math. It is just not possible for these countries to fight malaria, TB, HIV/AIDS, reduce maternal mortality and all the other health problems at the same time without help.

People just don’t like doing mathematics, and the rich donor countries are no different. They have been afraid to do the basic math, because they think it would cost too much. If one calculates the revenue generating activities against the population and the needs of the population, it becomes quite clear. Speeches can be made about good governance, and fiscal responsibility, but the truth is, unless any help is given millions will continue to die.

How much is available?

In the rich West the average living standard is now $25,000 per capita and approximately 1 billion people live in the rich world. This equates to available capital of $25 trillion dollars ($25,000,000,000,000,000)!

The poorest of the poor are dying for the lack of the most basic interventions, and yet all it would take is a tiny percentage of the money in rich countries to help solve these problems.

How much would it take?

How much would it take to extend the life of a poor person? A study was done at the London School of Economics.

· The figure they came up for all of Africa’s problems was $17 – 18 billion dollars.

· If other LCD countries in the world were included the total price tag went up to $25 billion dollars.

· This works out to 1/1000^th the amount of money available in rich countries.

· It is equivalent to 1 penny for every $10 dollars of income.

· It would save 8 million lives a year.

At a time we are seeing the greatest burden in the history of the world, we are scrambling for just 1 penny out of $10 dollars!

Rich countries have been too afraid for too long to do the simple arithmetic. And yet it would not cost that much to solve these problems

How can this be achieved?

By going into communities, with public health and prevention programmes. To achieve substantial improvements in health does not require invention of new technologies. Even now there are examples of very successful programmes, DOTs (directly observed therapy), ITNs (insecticide treated nets), antiretroviral therapy (ART), antibiotics, immunization, the use of traditional birth attendants to bring down maternal mortality. All these things are achievable, but these countries need help