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Brute Luck, Option Luck or Politics?


Mohan Rao

PUBLIC HEALTH, ETHICS AND EQUITY
Edited by Sudhir Anand, Fabienne Peter and Amartya Sen
Oxford University Press, New Delhi, 2006, pp. 316, Rs. 595.00

VOLUME XXXI NUMBER 3 March 2007

The world has never before been as rich as it is today. Yet substantial populations of the world are bereft of resources to ensure a modicum of health. Nearly 1.3 billion people, overwhelmingly in the formerly colonized countries of the South, live on less than a dollar a day and close to one billion cannot meet their basic calorie requirements. More than 800 million people lack access to health services, and 2.6 billion people to basic sanitation. Although people are living longer today than at any time in the past, around 1.5 billion people are not expected to survive to age 60. Indeed life expectancy in some countries of sub-Saharan Africa is only around 40 years.   One familiar reason given for the widespread poverty and ill-health in poor countries is of course, over-population, a red herring. Despite population growth, per capita food production increased by nearly 25 per cent between 1990 and 1997. The per capita daily supply of calories rose from less than 2,500 to 2,750 and that of proteins, from 71 to 76 grams. In other words, not one person in the world needs to go to bed hungry. Yet given the fact that the overall consumption of the richest fifth of the world’s population is 160 times that of the poorest fifth, 840 million people, 160 million of them children, are undernourished. Close to 340 million women are not expected to survive to age 40.   The over-population argument also elides the fact that there occurs a net transfer of close to 180 billion dollars annually from the countries of the South to those of the North. Indeed this figure has increased substantially over the last three decades. During this period, marked by the demise of actually existing socialism and of Keynesianism, along with the rise of the neo-liberal policies, inequalities within and between countries have risen sharply: the income gap between the world’s richest and poorest has more than doubled. In 1960 the 20 per cent of the world’s people in the richest countries had 30 times the income of the poorest 20 per cent; today they command 74 times more. The same richest 20 per cent of the population command 86 per cent of the world GDP while the poorest 20 per cent command merely 1 per cent. More than 80 countries have per capita incomes lower than they were a decade or more ago; 55 countries, mostly in sub-Saharan Africa, Eastern Europe and the former Soviet Union, have had declining per capita incomes.   These changes in the global economy have been accompanied ...


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