Lees ook:
‘Corruptie bedreigt millenniumdoelen’ (Wereldomroep)

Bron: Metrotime

Bericht van Transparency International

Persistently high corruption in low-income countries amounts to an “ongoing humanitarian disaster”

Against a backdrop of continued corporate scandal, wealthy countries backsliding too

Berlin, 23 September 2008

With countries such as Somalia and Iraq among those showing the highest levels of perceived corruption, Transparency International’s (TI) 2008 Corruption Perceptions Index (CPI), launched today, highlights the fatal link between poverty, failed institutions and graft. But other notable backsliders in the 2008 CPI indicate that the strength of oversight mechanisms is also at risk among the wealthiest.

“In the poorest countries, corruption levels can mean the difference between life and death, when money for hospitals or clean water is in play,” said Huguette Labelle, Chair of Transparency International. “The continuing high levels of corruption and poverty plaguing many of the world’s societies amount to an ongoing humanitarian disaster and cannot be tolerated. But even in more privileged countries, with enforcement disturbingly uneven, a tougher approach to tackling corruption is needed.”

The 2008 Results

The Transparency International CPI measures the perceived levels of public-sector corruption in a given country and is a composite index, drawing on different expert and business surveys. The 2008 CPI scores 180 countries (the same number as the 2007 CPI) on a scale from zero (highly corrupt) to ten (highly clean).

Denmark, New Zealand and Sweden share the highest score at 9.3, followed immediately by Singapore at 9.2. Bringing up the rear is Somalia at 1.0, slightly trailing Iraq and Myanmar at 1.3 and Haiti at 1.4.

While score changes in the Index are not rapid, statistically significant changes are evident in certain countries from the high to the low end of the CPI. Looking at source surveys included in both the 2007 and 2008 Index, significant declines can be seen in the scores of Bulgaria, Burundi, Maldives, Norway and the United Kingdom.

Similarly, statistically significant improvements over the last year can be identified in Albania, Cyprus, Georgia, Mauritius, Nigeria, Oman, Qatar, South Korea, Tonga and Turkey.

Strengthening oversight and accountability

Whether in high or low-income countries, the challenge of reigning in corruption requires functioning societal and governmental institutions. Poorer countries are often plagued by corrupt judiciaries and ineffective parliamentary oversight. Wealthy countries, on the other hand, show evidence of insufficient regulation of the private sector, in terms of addressing overseas bribery by their countries, and weak oversight of financial institutions and transactions.

“Stemming corruption requires strong oversight through parliaments, law enforcement, independent media and a vibrant civil society,” said Labelle. “When these institutions are weak, corruption spirals out of control with horrendous consequences for ordinary people, and for justice and equality in societies more broadly.”

Global fight against poverty in the balance

In low-income countries, rampant corruption jeopardises the global fight against poverty, threatening to derail the UN Millennium Development Goals (MDGs). According to TI’s 2008 Global Corruption Report, unchecked levels of corruption would add US $50 billion (€35 billion) – or nearly half of annual global aid outlays – to the cost of achieving the MDG on water and sanitation.

Not only does this call for a redoubling of efforts in low-income countries, where the welfare of significant portions of the population hangs in the balance, it also calls for a more focussed and coordinated approach by the global donor community to ensure development assistance is designed to strengthen institutions of governance and oversight in recipient countries, and that aid flows themselves are fortified against abuse and graft.

This is the message that TI will be sending to the member states of the UN General Assembly as they prepare to take stock on progress in reaching the MDGs on 25 September, and ahead of the UN conference on Financing for Development, in Doha, Qatar, where commitments on funding aid will be taken

Prof. Johann Graf Lambsdorff of the University of Passau, who carries out the Index for TI, underscored the disastrous effects of corruption and gains from fighting it, saying, “Evidence suggests that an improvement in the CPI by one point [on a 10-point scale] increases capital inflows by 0.5 per cent of a country’s gross domestic product and average incomes by as much as 4 per cent.”

Corporate bribery and double standards

The weakening performance of some wealthy exporting countries, with notable European decliners in the 2008 CPI, casts a further critical light on government commitment to reign in the questionable methods of their companies in acquiring and managing overseas business, in addition to domestic concerns about issues such as the role of money in politics. The continuing emergence of foreign bribery scandals indicates a broader failure by the world’s wealthiest countries to live up to the promise of mutual accountability in the fight against corruption.

“This sort of double standard is unacceptable and disregards international legal standards,” said Labelle. “Beyond its corrosive effects on the rule of law and public confidence, this lack of resolution undermines the credibility of the wealthiest nations in calling for greater action to fight corruption by low-income countries.” The OECD Anti-Bribery Convention, which criminalises overseas bribery by OECD-based companies, has been in effect since 1999, but application remains uneven.

Regulation, though, is just half the battle. Real change can only come from an internalised commitment by businesses of all sizes, and in developing as well as developed countries, to real improvement in anti-corruption practices.

Fighting corruption: A social compact

Across the globe, stronger institutions of oversight, firm legal frameworks and more vigilant regulation will ensure lower levels of corruption, allowing more meaningful participation for all people in their societies, stronger development outcomes and a better quality of life for marginalised communities.

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click to see the CPI table and Sources
click to download the complete media pack

Bron: Tranparency International

Gepost op: Updaid - nieuws over ontwikkelingslanden

In arme landen is corruptie humanitaire ramp

Since 2004 Doing Business has been tracking regulatory reforms aimed at improving the ease of doing business by measuring their impact on 10 indicator sets. Nearly 1,000 reforms have been captured since that time. For the fifth year in a row, Eastern Europe and Central Asia has led the world in Doing Business reforms—the region accounts for a third of all reforms observed since Doing Business 2004. In 2007 Eastern Europe and Central Asia surpassed East Asia and Pacific in the average ease of doing business and has maintained its place this year. Around the world, more regulatory reforms were recorded between June 2007 and June 2008 than in any previous year—113 economies implemented 239 reforms.

While Eastern Europe and Central Asia led in the share of economies with at least 1 reform, East Asia and Pacific achieved the biggest pickup in the pace of reforms. Two-thirds of its economies reformed, compared to less than half last year. The Middle East and North Africa, Sub-Saharan Africa, and Latin America and Caribbean also all saw a larger share of economies implementing at least 1 reform. Only South Asia and the OECD economies saw a deceleration in the pace of reforms from Doing Business 2008 to Doing Business 2009.

Doing Business ranks economies based on 10 indicators of business regulation that record the time and cost to meet government requirements in starting and operating a business, trading across borders, paying taxes, and closing a business. The rankings do not reflect such areas as macroeconomic policy, quality of infrastructure, currency volatility, investor perceptions, or crime rates.

The most popular reform measures in Doing Business 2009 fell once again in the category of starting a business. Forty-nine economies simplified start-up and reduced the cost, with Yemen as the top reformer. Yemen abolished its minimum capital requirement—the second largest in the world at $15,225—and activated a one-stop shop. These and other reforms reduced the number of procedures to start a business by 5 and the time by 50 days. Overall, Eastern Europe and Central Asia led in the total number of reforms easing business start-up, while Sub-Saharan Africa was second.

After starting a business, the most popular reforms by indicator set in Doing Business 2009 are paying taxes and trading across borders. In 2007/08, 36 economies made it easier to pay taxes. Most frequently, the profit tax rate was reduced, while a number of economies also introduced or improved electronic filing and payment systems. Thirty-four economies also made it easier to trade in 2007/08. Electronic submission of customs documents proved the most popular for the trading across borders indicator. Between 2005 and 2008, reforms with an impact on this indicator have reduced the average time to export by 3 days.

Regulatory reforms tracked by Doing Business over the past 5 years have had a number of payoffs. For example, reforms of property registration have been followed by increases in registration. Six months after Egypt reformed its property registry, title registration increased and revenue rose by nearly 40%. After reductions in minimum capital requirements, new company registration increased by 55% in Georgia and 81% in Saudi Arabia. Research also suggests that reforms in Mexico have had a positive payoff: the number of registered businesses rose by 6%, employment increased by 2.6%, and prices fell by 1% due to competition from new entrants.

The key to regulatory reform—and its benefits—is commitment. The reforms captured by Doing Business reflect a broader, sustained approach to improving competitiveness. Economies that have demonstrated this kind of commitment can serve as examples to others. As Dr. Mahmoud Mohieldin, Egypt’s minister of investment, explains:

It’s not exaggeration when I say I checked the top 10 in every [Doing Business] indicator and we just asked them, “What did you do?” If there is any advantage to starting late in anything, it’s that you can learn from others.

Bron: Doing Business

Gepost op: Updaid - nieuws over ontwikkelingslanden

Doing Business 2009: Five years of Doing Business reforms

* Google Map – Results by Country

The World Bank Group’s New Deal on Global Food Policy has been endorsed by 150 countries. The New Deal embraces short, medium and long-term responses, including safety nets such as school feeding, food for work, and conditional cash transfers; increased agricultural production; a better understanding of the impact of biofuels; and action on the trade front to reduce distorting subsidies and trade barriers.

• Conducting rapid needs assessments for countries impacted by the crisis, including Burkina Faso, Burundi, Eritrea, Guinea, Guinea-Bissau, Kenya, Liberia, Malawi, Mali, Mauritania, Niger, Sierra Leone, and Togo.
• Creating a new $1.2 billion rapid financing facility—the Global Food Response Program (GFRP)—to speed assistance to the neediest countries. GFRP has approved and begun disbursing $130 million in 15 countries to date: Afghanistan ($8 million), Burundi ($10 million), Central African Republic ($7 million), Djibouti ($5 million), Haiti ($10 million), Honduras ($10 million), Kyrgyz ($10 million), Liberia ($10 million), Madagascar ($10 million), Moldova ($7 million), Niger ($7 million), Rwanda ($10 million), Sierra Leone ($7 million), Tajikistan ($9 million), and Yemen ($10 million) to feed poor children and other vulnerable groups, or provide for nutritional supplements to pregnant women, lactating mothers, infants and small children. Another project totaling $7 million is pending approval. An additional $278 million is being earmarked for programs in 13 countries.
• Providing $200 million to Bangladesh in the coming months to help address the food crisis.
• Providing $100 million to hard-hit Burkina Faso, Burundi, Côte d’Ivoire, Ghana, Madagascar, Mali, and Niger to meet additional expenses of food imports and to buy seeds for the new season.
• Working on irrigation and water management in Ethiopia, fertilizer use in Malawi, market access for smallholders in Senegal, and crop diversification in Mali and Uganda.
• Boosting overall agricultural lending to $6 billion over the next year.
• Launching risk management tools and crop insurance to protect poor countries and small-holders.
• Nearly doubling agricultural lending to Africa from $450 million to $800 million; and to Latin America from $250 million to $400 million.
• Supporting over $1 billion in new projects in agriculture and rural development in South Asia.
• Doubling lending for social protection, nutrition and food security, and social risk mitigation to $800 million over the next year.
• Urging major grain-producing countries to lift or refrain from bans on food exports.
• Working with other donors and agencies on the African Union’s New Partnership for Africa’s Development Program for agriculture development in sub-Saharan Africa.

Bron: World Bank

Gepost op: Updaid - nieuws over ontwikkelingslanden

What the World Bank is Doing

• Officiële Belgische overheidshulp (ODA).xls (2003-2007)
• ODA-uitgaven van DGOS per sector (binnenkort beschikbaar)
• Top-50 van de ontvangende landen van de Belgische overheidshulp.xls (2006)

Belgische overheidshulp per continent (2003-2007)

• Afrika.xls
• Amerika.xls
• Azië.xls
• Europa.xls
• Oceanië.xls

ODA-uitgaven per partnerland (2003-2007)

Algerije – Benin – Bolivia – Burundi – DR Congo – Ecuador – Mali – Marokko – Mozambique – Niger – Palestijnse gebieden – Peru – Rwanda – Senegal – Tanzania – Uganda – Vietnam – Zuid-Afrika

ODA-uitgaven van de belangrijkste niet-partnerlanden (2003-2007)

Landen uit de top-50 van 2007:

Afghanistan – Bangladesh – Brazilië – Burkina Faso – Cambodja – China – Colombia – Cuba – Dominicaanse Republiek – Ethiopië – Filipijnen – Gambia – Ghana – Guatemala – Haïti – Honduras – India – Indonesië – Irak – Ivoorkust – Jamaïca – Kameroen – Kenia – Laos – Libanon – Madagascar – Malawi – Mauritanië – Mongolië – Nicaragua – Sierra Leone – Somalië – Sri Lanka – Sudan – Togo – Tunesië – Zimbabwe

Wat is officiële ontwikkelingssamenwerking of “ODA” (Official Development Assistance)?

Officiële ontwikkelingssamenwerking omvat enkel giften of leningen aan ontwikkelingslanden die:

• betaald worden met overheidsgelden
• de economische en sociale ontwikkeling als hoofddoelstelling hebben
• een pure gift zijn of, in het geval van leningen, een gift-element inhouden van ten minste 25%.

Giften en leningen voor militaire doeleinden zijn uitgesloten.

De concrete gedetailleerde regels voor de ODA-aanrekenbaarheid staan vervat in drie basisdocumenten van de OESO, samen goed voor een honderdtal bladzijden. Meer informatie kan u vinden bij Aid Statistics, DAC’s Glossary.

Wanneer mag een interventie als ontwikkelingssamenwerking aangerekend worden?

Er moet aan elk van de volgende vier voorwaarden voldaan worden:

1. Het is Official: de betalingen gebeuren vanuit de overheidsgelden

2. Het betreft Development: heeft de economische en sociale ontwikkeling als hoofddoelstelling

3. Het is Assistance: het is hulp (geen commerciële transactie aan marktvoorwaarden)

4. Én:

• Óf – (4a) de hulp gaat naar een land (of landengroep) op de DAC-lijst. Enkel hulp aan deze landen mag als ODA worden aangerekend. Zie de lijst in www.oecd.org/dataoecd/43/51/35832713.pdf (EN) of www.oecd.org/dataoecd/43/52/35832722.pdf (FR).
• Óf – (4b) de hulp gaat naar structurele bijdragen (“core”) van internationale instellingen die opgenomen zijn in de DAC-lijst. Zie de lijst in www.oecd.org/dataoecd/36/16/31724727.pdf (EN) of www.oecd.org/dataoecd/14/27/31742485.pdf (FR).

Wat betekent de 0,7 norm?

De overheidshulp van rijke aan arme landen moet volgens de akkoorden van de Verenigde Naties naar 0,7% van het Bruto Nationaal Inkomen (BNI) evolueren. Dit percentage is door het grote publiek gekend als maatstaf van de inspanningen op het gebied van ontwikkelingssamenwerking.

Evolutie van de ontwikkelingssamenwerking als % van het Bruto Nationaal Inkomen (BNI)

Het Comité voor Ontwikkelingshulp van de OESO (“DAC”) maakt sinds 1970 statistieken over het bereiken van de 0,7-doelstelling. Het DAC is ook een denktank over vele onderwerpen die te maken hebben met ontwikkelingssamenwerking (bv. armoedebestrijding, gelijke kansen voor mannen en vrouwen, goed bestuur, fragiele staten en conflictpreventie, lokaal eigenaarschap van hulp, partnerschap tussen Noord en Zuid, harmonisering, de Verklaring van Parijs,…)

De Belgische regering heeft zichzelf de wettelijke verplichting opgelegd om tegen 2010 minstens 0,7% van het BNI te besteden aan ontwikkelingshulp.

Wie verzamelt de ODA-informatie in België?

De dienst D0.2 van DGOS/Buitenlandse Zaken doet elk jaar een rondvraag naar de inspanningen op het vlak van ontwikkelingssamenwerking van alle federale en regionale overheidsinstanties in België (inclusief andere FOD’s, gewesten, gemeenschappen, provincies, gemeenten, Nationale Bank, Delcredere). Daarnaast worden ook de gegevens uit de DGOS-boekhouding en van de uitvoerende instellingen (BTC, VVOB, VLIR, CIUF, APEFE, ngo’s,…) geanalyseerd.

Sinds 2005 beschikt de dienst D0.2 over een Projectdatabank waarin alle Belgische ODA-gegevens vanaf 1987 zijn opgeslagen en ondersteunt zij het databeheer en de opvolgingssystemen van alle diensten binnen DGOS. De resultaten worden gebruikt om de Belgische en internationale statistieken op te maken, statistische vragen van gespecialiseerde instellingen of van het publiek te beantwoorden, en de evolutie van de hulp op te volgen.

Afkortingen:

ODA: Overheidssteun voor ontwikkelingssamenwerking
OESO: Organisatie voor Economische Samenwerking en Ontwikkeling
DAC: Comité voor ontwikkelingssamenwerking
BNP: Bruto nationaal product
BNI: Bruto nationaal inkomen
BBP: Bruto binnenlands product

Bron: DGOS

Gepost op: Updaid - nieuws over ontwikkelingslanden

Belgische overheidshulp – algemene overzichtstabellen

QUICK LINKS
Global databank on world trade in creative products

UNCTAD´s new global databank provides trade statistics on creative goods and services based on official data from more than 130 countries and covering the period 1996-2006.

The databank is intended for use by governments, businesses, academia, the media, international institutions, and members of the creative community, including independent artists and creators. It comprises factual data by country or region on some 235 products in the categories of arts and crafts, the visual arts, audiovisuals and media, and design and creative services.

The statistics are a starting point for improving market transparency and supporting governments in policy-making. They will also facilitate better understanding of the interface between culture, trade and technology as drivers of the creative economy.

Users may view, analyse and browse the data by choosing from tabular reports, country profiles, selected products, key players in major markets, and a variety of tables and charts.

Bron: UNCTAD

Gepost op: Updaid - nieuws over ontwikkelingslanden

UNCTAD launches global databank on world trade in creative products

A child born in a Glasgow, Scotland suburb can expect a life 28 years shorter than another living only 13 kilometres away. A girl in Lesotho is likely to live 42 years less than another in Japan. In Sweden, the risk of a woman dying during pregnancy and childbirth is 1 in 17 400; in Afghanistan, the odds are 1 in 8. Biology does not explain any of this. Instead, the differences between – and within – countries result from the social environment where people are born, live, grow, work and age.

These “social determinants of health” have been the focus of a three-year investigation by an eminent group of policy makers, academics, former heads of state and former ministers of health. Together, they comprise the World Health Organization’s Commission on the Social Determinants of Health. Today, the Commission presents its findings to the WHO Director-General Dr Margaret Chan.

“(The) toxic combination of bad policies, economics, and politics is, in large measure responsible for the fact that a majority of people in the world do not enjoy the good health that is biologically possible,” the Commissioners write in Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. “Social injustice is killing people on a grand scale.”

“Health inequity really is a matter of life and death,” said Dr Chan today while welcoming the Report and congratulating the Commission. “But health systems will not naturally gravitate towards equity. Unprecedented leadership is needed that compels all actors, including those beyond the health sector, to examine their impact on health. Primary health care, which integrates health in all of government’s policies, is the best framework for doing so.”

Sir Michael Marmot, Commission Chair said: “Central to the Commission’s recommendations is creating the conditions for people to be empowered, to have freedom to lead flourishing lives. Nowhere is lack of empowerment more obvious than in the plight of women in many parts of the world. Health suffers as a result. Following our recommendations would dramatically improve the health and life chances of billions of people.”

Inequities within countries

Health inequities – unfair, unjust and avoidable causes of ill health – have long been measured between countries but the Commission documents “health gradients” within countries as well. For example:

• Life expectancy for Indigenous Australian males is shorter by 17 years than all other Australian males.
• Maternal mortality is 3–4 times higher among the poor compared to the rich in Indonesia. The difference in adult mortality between least and most deprived neighbourhoods in the UK is more than 2.5 times.
• Child mortality in the slums of Nairobi is 2.5 times higher than in other parts of the city. A baby born to a Bolivian mother with no education has 10% chance of dying, while one born to a woman with at least secondary education has a 0.4% chance.
• In the United States, 886 202 deaths would have been averted between 1991 and 2000 if mortality rates between white and African Americans were equalized. (This contrasts to 176 633 lives saved in the US by medical advances in the same period.)
• In Uganda the death rate of children under 5 years in the richest fifth of households is 106 per 1000 live births but in the poorest fifth of households in Uganda it is even worse – 192 deaths per 1000 live births – that is nearly a fifth of all babies born alive to the poorest households destined to die before they reach their fifth birthday. Set this against an average death rate for under fives in high income countries of 7 deaths per 1000.

The Commission found evidence that demonstrates in general the poor are worse off than those less deprived, but they also found that the less deprived are in turn worse than those with average incomes, and so on. This slope linking income and health is the social gradient, and is seen everywhere – not just in developing countries, but all countries, including the richest. The slope may be more or less steep in different countries, but the phenomenon is universal.

Wealth is not necessarily a determinant

Economic growth is raising incomes in many countries but increasing national wealth alone does not necessarily increase national health. Without equitable distribution of benefits, national growth can even exacerbate inequities.

While there has been enormous increase in global wealth, technology and living standards in recent years, the key question is how it is used for fair distribution of services and institution-building especially in low-income countries. In 1980, the richest countries with 10% of the population had a gross national income 60 times that of the poorest countries with 10% of the world’s population. After 25 years of globalization, this difference increased to 122, reports the Commission. Worse, in the last 15 years, the poorest quintile in many low-income countries have shown a declining share in national consumption.

Wealth alone does not have to determine the health of a nation’s population. Some low-income countries such as Cuba, Costa Rica, China, state of Kerala in India and Sri Lanka have achieved levels of good health despite relatively low national incomes. But, the Commission points out, wealth can be wisely used. Nordic countries, for example, have followed policies that encouraged equality of benefits and services, full employment, gender equity and low levels of social exclusion. This, said the Commission, is an outstanding example of what needs to be done everywhere.

Solutions from beyond the health sector

Much of the work to redress health inequities lies beyond the health sector. According to the Commission’s report, “Water-borne diseases are not caused by a lack of antibiotics but by dirty water, and by the political, social, and economic forces that fail to make clean water available to all; heart disease is caused not by a lack of coronary care units but by lives people lead, which are shaped by the environments in which they live; obesity is not caused by moral failure on the part of individuals but by the excess availability of high-fat and high-sugar foods.” Consequently, the health sector – globally and nationally – needs to focus attention on addressing the root causes of inequities in health.

“We rely too much on medical interventions as a way of increasing life expectancy” explained Sir Michael. “A more effective way of increasing life expectancy and improving health would be for every government policy and programme to be assessed for its impact on health and health equity; to make health and health equity a marker for government performance.”

Recommendations

Based on this compelling evidence, the Commission makes three overarching recommendations to tackle the “corrosive effects of inequality of life chances”:

• Improve daily living conditions, including the circumstances in which people are born, grow, live, work and age.
• Tackle the inequitable distribution of power, money and resources – the structural drivers of those conditions – globally, nationally and locally.
• Measure and understand the problem and assess the impact of action.

Recommendations for daily living

Improving daily living conditions begins at the start of life. The Commission recommends that countries set up an interagency mechanism to ensure effective collaboration and coherent policy between all sectors for early childhood development, and aim to provide early childhood services to all of their young citizens. Investing in early childhood development provides one of the best ways to reduce health inequities. Evidence shows that investment in the education of women pays for itself many times over.

Billions of people live without adequate shelter and clean water. The Commission’s report pays particular attention to the increasing numbers of people who live in urban slums, and the impact of urban governance on health. The Commission joins other voices in calling for a renewed effort to ensure water, sanitation and electricity for all, as well as better urban planning to address the epidemic of chronic disease.

Health systems also have an important role to play. While the Commission report shows how the health sector can not reduce health inequities on its own, providing universal coverage and ensuring a focus on equity throughout health systems are important steps.

The report also highlights how over 100 million people are impoverished due to paying for health care – a key contributor to health inequity. The Commission thus calls for health systems to be based on principles of equity, disease prevention and health promotion with universal coverage, based on primary health care.

Distribution of resources

Enacting the recommendations of the Commission to improve daily living conditions will also require tackling the inequitable distribution of resources. This requires far-reaching and systematic action.

The report foregrounds a range of recommendations aimed at ensuring fair financing, corporate social responsibility, gender equity and better governance. These include using health equity as an indicator of government performance and overall social development, the widespread use of health equity impact assessments, ensuring that rich countries honour their commitment to provide 0.7% of their GNP as aid, strengthening legislation to prohibit discrimination by gender and improving the capacity for all groups in society to participate in policy-making with space for civil society to work unencumbered to promote and protect political and social rights. At the global level, the Commission recommends that health equity should be a core development goal and that a social determinants of health framework should be used to monitor progress.

The Commission also highlights how implementing any of the above recommendations requires measurement of the existing problem of health inequity (where in many countries adequate data does not exist) and then monitoring the impact on health equity of the proposed interventions. To do this will require firstly investing in basic vital registration systems which have seen limited progress in the last thirty years. There is also a great need for training of policy-makers, health workers and workers in other sectors to understand the need for and how to act on the social determinants of health.

While more research is needed, enough is known for policy makers to initiate action. The feasibility of action is indicated in the change that is already occurring. Egypt has shown a remarkable drop in child mortality from 235 to 33 per 1000 in 30 years. Greece and Portugal reduced their child mortality from 50 per 1000 births to levels nearly as low as Japan, Sweden, and Iceland. Cuba achieved more than 99% coverage of its child development services in 2000. But trends showing improved health are not foreordained. In fact, without attention health can decline rapidly.

Is this feasible?

The Commission has already inspired and supported action in many parts of the world. Brazil, Canada, Chile, Iran, Kenya, Mozambique, Sri Lanka, Sweden, and the UK have become ‘country partners’ on the basis of their commitment to make progress on the social determinants of health equity and are already developing policies across governments to tackle them. These examples show that change is possible through political will. There is a long way to go, but the direction is set, say the Commissioners, the path clear.

WHO will now make the report available to Member States which will determine how the health agency is to respond.

Comments from the Commissioners

Fran Baum, Head of Department and Professor of Public Health at Flinders University, Foundation Director of the South Australian Community Health Research Unit and Co-Chair of the Global Coordinating Council of the People’s Health Movement: “It is wonderful to have global endorsement of the Australian Closing the Gap campaign from the CSDH established by the WHO. The CSDH sets Closing the Gap as a goal for the whole world and produces the evidence on how health inequities are a reflection of the way we organize society and distribute power and resources. The good news from the CSDH for Australia is that it provides plenty of ideas on how to set an agenda that will tackle the underlying determinants of health and create a healthier Australia for all of us”

Monique Begin, Professor at the School of Management, University of Ottawa, Canada, twice-appointed Minister of National Health and Welfare and the first woman from Quebec elected to the House of Commons: “Canada likes to brag that for seven years in a row the United Nations voted us “the best country in the world in which to live”. Do all Canadians share equally in that great quality of life? No they don’t. The truth is that our country is so wealthy that it manages to mask the reality of food banks in our cities, of unacceptable housing (1 in 5), of young Inuit adults very high suicide rates. This report is a wake up call for action towards truly living up to our reputation.”

Giovanni Berlinguer, Member of the European Parliament, member of the International Bioethics Committee of UNESCO (2001–2007) and rapporteur of the project Universal Declaration on Bioethics: “A fairer world will be a healthier world. A health service and medical interventions are just one of the factors that influence population health. The growth of inequalities and the phenomena of increased injustice in health is present in low and middle income countries as well as across Europe. It would be a crime not to take every action possible to reduce them.”

Mirai Chatterjee, Coordinator of Social Security for India’s Self-Employed Women’s Association, a trade union of over 900 000 self-employed women and recently appointed to the National Advisory Council and the National Commission for the Unorganised Sector: “The report suggests avenues for action from the local to national and global levels. It has been eagerly awaited by policy-makers, health officials, grassroot activists and their community-based organizations. Much of the research and evidence is of particular relevance to the South-East Asian region, where too many people struggle daily for justice and equity in health. The report will inspire the region to act and develop new policies and programmes.”

Yan Guo, Professor of Public Health and Vice-President of the Peking University Health Science Centre, Vice-Chairman of the Chinese Rural Health Association and Vice-Director of the China Academy of Health Policy: “A man should not be concerned with whether he has enough possessions but whether possessions have been equally distributed”, this is a time-honored teaching in China. Constructing a harmonious society is our shared aspiration, and equity, including health equity, composes the prerequisite for a harmonious development. Eliminating determinants that are adverse to health under the efforts from all of the society, promoting social justice, and advancing human health are our shared goals. Let’s join our hands in this grand course!”

Kiyoshi Kurokawa, Professor at the National Graduate Institute for Policy Studies, Tokyo, Member of the Science and Technology Policy Committee of the Cabinet Office, formerly President of the Science Council of Japan and the Pacific Science Association: “The WHO Commission addresses one of the major issues of our global world – health inequity. The report’s recommendations will be perceived, utilized and implemented as a major policy agenda at national and global levels. The issue will increase in importance as the general public become more engaged via civil society movements and multi-stakeholder involvement.”

Alireza Marandi, Professor of Pediatrics at Shaheed Beheshti University, Islamic Republic of Iran, former two-term Minister of Health and Medical Education, former Deputy Minister and Advisor to the Minister and recently elected to be a member of the Iranian Parliament: “According to the Islamic ideology, social justice became a priority, when the Islamic revolution materialized in Iran. Establishing a solid Primary Health Care network in our country, not only improved our health statistics, but it was an excellent vehicle to move towards health equity. Now through the final report of the CSDH and implementing its recommendations we need to move much faster in our own country toward health equity.”

Pascoal Mocumbi, High Representative of the European and Developing Countries Clinical Trials Partnership, former Prime Minister of the Republic of Mozambique, former head of the Ministry of Foreign Affairs and the Ministry of Health: “The Commission on Social Determinants of Health report will help African leaders adapt their national development strategies to address the challenges to health. These are derived from the current systemic changes taking place in the global economy that affects heavily on the poorest segments of Africa’s population.”

Amartya Sen, Lamont University Professor and Professor of Economics and Philosophy at Harvard University, awarded the Nobel Prize in Economics in 1998: “The primary object of development – for any country and for the world as a whole – is the elimination of ‘unfreedoms’ that reduce and impoverish the lives of people. Central to human deprivation is the failure of the capability to live long and healthy lives. This is much more than a medical problem. It relates to handicaps that have deep social roots. Under Michael Marmot’s leadership, this WHO Commission has concentrated on the badly neglected causal linkages that have to be adequately understood and remedied. A fuller understanding is also a call for action.”

David Satcher, Director of the Center of Excellence on Health Disparities and the Satcher Health Leadership Institute Initiative, formerly the United States Surgeon General and Assistant Secretary for Health and also Director of the Centers for Disease Control and Prevention: “The United States of America spends more on health care than any other country in the world, yet it ranks 41st in terms of life expectancy. New Orleans and its experience with Hurricane Katrina illustrate why we need to target social determinants of health (SDH) — including housing, education, working and learning conditions, and whether people are exposed to toxins—better than any place I can think of right now. By targeting the SDH, we can rapidly move towards closing the gap that unfairly and avoidably separates the health status of groups of different socio-economic status, social exclusion experience, and educational background.”

Anna Tibaijuka, Executive Director of UN-HABITAT and founding Chairperson of the independent Tanzanian National Women’s Council: “Health delivery is not possible for people living in squalor, in dehumanizing pathetic conditions prevailing in the ever growing slum settlements of cities and towns in developing countries. Investment in basic services such as water and education will always remain constrained if not wasted unless accompanied by requisite investment in decent housing with basic sanitation.”

Denny Vågerö, Professor of Medical Sociology, Director of CHESS (Centre for Health Equity Studies) in Sweden, member of the Royal Swedish Academy of Sciences and of its Standing Committee on Health: “Countries of the world are presently growing apart in health terms. This is very worrying. In many countries in the world social differences in health are also growing, and this is true in Europe. We have been one-sidedly focused on economic growth, disregarding negative consequences for health and climate. We need to think differently about development.”

Gail Wilensky, Senior Fellow at Project HOPE, an international health education foundation. Previously she directed the Medicare and Medicaid programmes in the United States and also chaired two commissions that advise the United States Congress on Medicare: “What this report makes clear is that improving health and health outcomes and reducing avoidable health differences—goals of all countries– involves far more than just improving the health care system. Basic living conditions, employment, early childhood education, treatment of women and poverty all impact on health outcomes and incorporating their effects on health outcomes needs to become an important part of public policymaking. This is as true for wealthy countries like the United States as it is for many of the emerging countries of the world, where large numbers of people live on less than $2 per day.”

For more information or interviews, please contact:

Sharad Agarwal
Communications Officer
WHO, Geneva
Tel.: +41 22 791 1905
Mob.: +41 79 621 5286
Email: agarwals@who.int

Felicity Porritt
Head, Communications
CSDH, UCL Secretariat
London
Mob.: +44 773 941 9219
Email: felicity.porritt@mac.com

WHO
Closing the gap in a generation: Health equity through action on the social determinants of health

Bron: WHO

Gepost op: Updaid - nieuws over ontwikkelingslanden

Inequities are killing people on a “grand scale” reports WHO’s Commission

Voor hun onderzoek combineerde de Wereldbank 657 studies uit 116 arme landen.

Bron: HLN

Gepost op: Updaid - nieuws over ontwikkelingslanden

Wereld telt 1,4 miljard armen

Volgens de Wereldbank zijn er echter grote successen geboekt bij de bestrijding van extreme armoede. In 1981 leefden nog 1,9 miljard mensen in ontwikkelingslanden onder de armoedegrens: de helft van de bevolking. In 2005 gold een op de vier mensen in de Derde Wereld als arm. Grote verbeteringen vonden plaats in het oosten van Azië, met China als koploper.

Het aangepaste minimumbedrag van 1,25 dollar is de gemiddelde nationale armoedegrens in de armste tien tot twintig landen.

Bron: Telegraaf

Gepost op: Updaid - nieuws over ontwikkelingslanden

Derde Wereld armer dan gedacht

Vanaf deze week zal UPDAID regelmatig Engelstalige artikelen publiceren, maar het betreffen alleen belangrijke en kernachtige issues.

• World Bank poverty estimates strengthened by better cost-of-living data
• 400 million more people live in poverty than earlier thought
• Developing world still on track to halve poverty from its 1990 levels by 2015
• Wide regional differences seen in poverty reduction trends

Looking at the new estimates from the perspective of the Millennium Development Goals, a set of internationally agreed development targets, the developing world is still on track to halve extreme poverty from its 1990 levels by 2015. This is the first of eight critical goals.

“However, the sobering news—that poverty is more pervasive than we thought—means that we must redouble our efforts, especially in Sub-Saharan Africa,” said Justin Lin, Chief Economist of the World Bank and Senior Vice President, Development Economics.

Updated poverty estimates are published by the Bank every few years, based on the most recent global cost-of-living data as well as on country surveys of what households consume.

Improved cost-of-living data for developing countries

“Our latest revision of poverty numbers is the largest revision yet because of important new data revealing that the cost of living in the developing world is higher than we thought,” said Martin Ravallion, director of the World Bank’s Development Research Group.

Ravallion refers to new information published earlier this year on the comparative prices of goods and services (such as food, housing, transport and so on) across many countries, expressed as internationally comparable exchange rates known as purchasing power parities (PPPs).

The latest PPPs—for 2005—were made available by a global statistical initiative called the International Comparison Program (ICP). The improvements in the design, implementation and analysis of the ICP price surveys for 2005 mean that the new PPPs are more reliable than older data from 1993 and 1985, which underestimated the cost of living in developing countries.

More accurate estimates of poverty

In the light of these new data, the Bank’s estimates of the extent of poverty in the developing world have also been revised upward across the entire period of research (1981 to 2005).

“The new estimates are a major advance in global poverty measurement because they are based on far better price data for assuring that poverty lines are comparable across countries,” said Shaohua Chen, senior statistician in the Development Research Group.

An earlier estimate of poverty—of 985 million living below the former international poverty line of $1 a day in 2004, down from 1.5 billion in 1981—was based on 1993 cost-of-living data which was the best available at the time.

The new poverty numbers, which show that 400 million more people lived below the poverty line in 2005 than earlier thought, are benchmarked to the revised international poverty line of $1.25 a day in 2005 prices. This line is a good standard for assessing extreme poverty because it is the average of the national poverty lines for the world’s poorest 10 to 20 countries.

“The new international poverty line is not intended to replace national poverty lines,” said Ravallion. When measuring poverty and discussing appropriate policies in a specific country one should naturally use a poverty line considered appropriate to that country, which need not accord with our international line.”

A forthcoming supplement to World Development Indicators will report poverty estimates using both the national poverty lines for each country as well as the new international poverty line that helps assess poverty comparably across all regions and countries.

By mid-September, complete country-level data will also be available on PovcalNet, a website that is currently being updated. This interactive research tool can be used to replicate Bank poverty estimates and test alternative assumptions, such as the poverty line or country groupings.

Overall progress at the global level

Ravallion’s paper on the new numbers, co-authored with Shaohua Chen, is titled “The developing world is poorer than we thought, but no less successful in the fight against poverty.” (Read the paper, or the shorter, bulleted brief.)

The authors find that, though the estimate of the number of poor has increased, the rate of poverty reduction in the developing world is still as strong as when poverty was viewed from the lens of the 1993 price data.

Poverty has been declining at the rate of about one percentage point a year, from 52 percent of the developing world’s population in 1981 to 26 percent in 2005. This is no small achievement, given that the number of poor fell by 500 million in this period.

“Yet even at this rate, about a billion people will still live on less than $1.25 a day in 2015,” said Ravallion. “And many of those who escaped 1.25-a-day poverty across 1981-2005 would still be poor by the standards of rich or even middle-income countries.”

Also, lags in survey data availability mean that the new estimates do not yet reflect the potentially large impact on poor people of rising food and fuel prices since 2005.

An uneven picture across developing regions

Poverty in East Asia—the world’s poorest region in 1981—has fallen from nearly 80 percent of the population living on less than $1.25 a day in 1981 to 18 percent in 2005 (about 330 million), largely owing to dramatic progress in poverty reduction in China.

$1.25 a day poverty in South Asia has also fallen, from 60 percent to 40 percent over 1981-2005, but this has not been enough to bring down the region’s total number of poor, which stood at about 600 million in 2005.

In Sub-Saharan Africa, the $1.25 a day poverty rate has shown no sustained decline over the whole period since 1981, starting and ending at 50 percent. In absolute terms, the number of poor people has nearly doubled, from 200 million in 1981 to 380 million in 2005. However, there have been signs of recent progress; the poverty rate fell from 58% in 1996 to 50% in 2005.

In middle-income countries, the median poverty line for the developing world—$2 a day in 2005 prices—is more relevant. By this standard, the poverty rate has fallen since 1981 in Latin America and the Middle East & North Africa, but not enough to reduce the total number of poor.

The $2 a day poverty rate has risen in Eastern Europe and Central Asia since 1981, though with signs of progress since the late 1990s.

A constant effort to improve data

“Data are never perfect, though they are getting better over time,” said Shaida Badiee, Director of the Bank’s Development Data Group. “The World Bank works constantly with partners in developing countries to improve data quality and access to data.”

An example of statistical improvement is the addition of price surveys for China to the 2005 round of the ICP. Many developing economies did not participate in earlier ICP rounds, but the 2005 ICP covered 146 countries including China.

The quality of the price data being collected has also improved over time, with product listings being specified in much greater detail. For example, in the 2005 ICP surveys, six different kinds of rice were classified by eight price-determining characteristics to ensure comparability between countries. In total, more than 1,000 products were included in the price surveys.

Ravallion notes that the scope and availability of household surveys of income and consumption have also improved vastly. “The latest poverty estimates draw on 675 household surveys for 116 developing countries, representing 96 percent of the developing world,” he said. “Yet 20 years ago we could only do these calculations properly for 22 countries. That is great progress in our knowledge about poverty in the world.”

Bron: Worldbank

Gepost op: Updaid - nieuws over ontwikkelingslanden

World Bank Updates Poverty Estimates for the Developing World