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Developed countries neglect poverty and social development.

The goal of the International Conference on Financing for Development held in Monterrey, Mexico last year was to devise a strategy to eradicate poverty, strengthen economic growth and promote sustainable development. However, talk of greater resolve and stronger partnerships failed to make any changes. This failure was made worse by the extraordinary hopes created by the Millennium Development Goals and the pledges made by G8 leaders at the Okinawa summit in 2000. There, politicians wanted to cut cases of HW/AIDS by 25%, TB deaths by 50% and the burden of malaria by 50%, all by 2010. The ambitious agenda called for a sizeable scaling up of action by the world's financial institutions. Recognising that their dismal record of loans would be under scrutiny in Monterrey, these institutions embarked on a public relations offensive to quell inevitable criticism of their work. Prior to Monterrey, the World Bank, in an assessment of the role and effectiveness of development assistance, claimed that overall progress has been remarkable. Yet 1.2 billion people still live on less that US$1 a day. The Bank calculated that $1 billion of efficiently targeted aid can lift 434,000 people above the poverty line. The US government promised an extra US$5 billion over three years from 2004, contingent on economic reforms in countries seeking aid. Using World Bank figures, this translates to only two million people brought out of poverty by 2006. To reach the target of 600 million people lifted out of poverty by 2015, the world's richest countries need to give US$1,382 billion or US$106 billion annually from 2003 to 2015. Current aid spending, however, is only US$6 billion a year. Even the World Bank points out that when inflation is taken into account, aid allocations by developed countries have fallen in the past decade. The politics of Monterrey were unusually destructive. The US government blocked efforts by some donor countries such as the UK to use the Millennium Development Goals to kickstart the debate. It also resisted discussing how countries might reach the UN target of 0.7% of national income spent on aid (the US spends about 0.1% of its GDP).

The obligation to advocate for and act on behalf of the poor rests not only with politicians but also with health professionals. Organisations representing doctors and other health workersfrom the most local to WHO-should be on the front line of this work. Yet the societies, centres, colleges, offices, clubs, institutes and councils of medicine have largely abandoned the poor, preferring instead to advocate for themselves. Where are the arguments supporting the wider responsibilities of medicine for the health and development agenda? Why are they not calling their political leaders to account? Most egregious, given its vast budget, resources and the international respect it commands, is the silence from the US National Institutes of Health (NIH) and its Fogarty International Center. On human development, NIH, whose budget has been increased by over a billion dollars for bioterrorism research, is quiet at a time when it has unprecedented political responsibility. The fact is that without substantial additional aid, there will be more deaths among the poor than the conscience of the rich should be able to bear. (1)

(1.) Horton R. The health (and wealth) of nations. At: <>, 26 September 2002.
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Title Annotation:Law and Policy; International Conference on Financing for Development
Publication:Reproductive Health Matters
Geographic Code:1MEX
Date:May 1, 2003
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