Guyana and the wider world
Duality
by Dr Clive Thomas
Stabroek News
July 15, 2001
It is part of the intrinsic duality of globalisation that the emergence of the threat of HIV/AIDS to the world's population occurs at a time when substantial progress has been made in human survival and the expectation of a long and healthy life. For the world as a whole, life expectancy at birth has risen from approximately 60 years during the six-year period 1970-75, to 67 years over the last six years. Among the developing countries as a group, the improvement has been from 55.6 years to 64.4 over the same period. For the rich countries as a group with their already higher life expectancy, the improvement has been from 72 to 78 years over the same period.
The striking inequality in life expectancy outcomes, highlights the role that poverty plays in human survival and the expectation of a long and healthy life. We see this in the case of the least developed countries as a group. Here the increase was from 44.2 to 51.6 years over the same period. In Sub-Saharan Africa the situation was far worse. While there was a modest increase from a low of 44 years to 49 years, life expectancy remains far below that attained elsewhere.
Underlying Data
The underlying demographic data support these outcomes. Thus the infant mortality rate for the world as a whole, fell from 110 to 64 per 1,000 live births between the period 1970-75 period and the most recent six-year period. In the least developed countries the decline was from 150 to 104 per 1,000 live births. For the rich countries, the decline was from 21 to six per 1,000 live births. At this point of time therefore, a child in the least developed country has a 17 times greater chance of dying at birth than a child in one of the rich countries.
The figures for under- five mortality are worse. For the world as a whole, while this mortality rate was halved over the same period, it still remains very high. The decline has been from 168 to 93 per 1,000 live births. In Sub-Saharan Africa the figure remains stunningly large showing also only a modest improvement. The decline was from 226 to 172 per 1,000 live births, over the same period. Meanwhile, in the rich countries as a group, the already low rate of only 26 per 1,000 live births was further reduced to 6. In effect therefore, a child in Sub-Saharan Africa had a 29 times greater chance of dying before age five than a child in a rich country.
In this broader context the effect of HIV/AIDS is staggering. For the world as a whole, the estimated 'adult rate' for HIV/AIDS was 0.99 per cent in 1997. In the rich countries as a group, the rate was about one-third this amount, namely 0.37 per cent. By contrast, in the least developed countries the rate was 4.13 per cent. And, in Sub-Saharan Africa the rate was even higher - 7.58 per cent.
AIDS and poverty
HIV/AIDS and poverty combine in a vicious cycle of death and destruction. Poverty is both a major contributory factor to the risk of contracting HIV/AIDS and the outcome of having contracted the disease. There are many reasons for this. The poor are often less well educated and informed about the disease and therefore run greater risks in their behaviour. The poor also suffer more from nutritional deficits, and this also places them at greater risk. When contracted, the disease invariably drives poor households into deeper poverty. The worsening poverty situation in turn increases the risks of unsafe behaviour, poor diets, and so on. At the same time, poor persons usually have far less access to health care than the rich ones. The virus therefore perpetuates itself in a vicious cycle centred on poverty.
The full cultural impact of the disease is still uncertain. However, all indications at present suggest that it is likely to be considerable. Everywhere it seems to place stress on the social bonds within the family and community. The long term consequence of this is perhaps most dramatically evident in the growing phenomenon of 'orphaning.'
Orphaning
Never before in human history have there been so many orphans created in such a short space of time. In Sub-Saharan Africa, it is estimated that there are already 42 million orphans. Although children strictly become orphans only after the death of their parents, the process of orphaning commences well before that. Usually, it starts soon after the onset of the disease in the first parent.
Orphans grow up without the socializing support of their families. As a rule, they are less likely to receive a 'normal' education. The lack of family care and reduced access to education create enormous psychological and social problems. Given the scale of the problem, in turn this threatens the social stability and progress of the countries concerned.
Full Circle
It is ironic, that what is at present perhaps the greatest threat to security and humanity is the tiny HIV virus, which we have yet not mastered. Alongside this, we find that poverty and inequality favour its expansion and growth. In so far as globalisation is associated with widening gaps in income and wealth, and fails to alleviate poverty dramatically, it helps to feed our destruction.
This phenomenon which we see in health, parallels the other doomsday phenomena we have pointed out in our culture, and earth's ecosystems. The root causes of all these problems are human. Their correction will not be possible without deliberate, conscious human effort aimed at removing the inequalities and injustices which feed them. Globalisation is a twin-edged sword. It brings both progress and destruction at the same time. Which of these tendencies will prevail, we cannot tell. But if left only to the blind processes of the market, destruction is by far the likelier outcome. When we can so clearly see the dangers that lie ahead, the time for human intervention and action is now.