Our generation has witnessed unprecedented progress in the field of development. In the last 20 years alone the number of people living in hunger on the planet has been reduced by around 200 million. The number of child deaths in 2012 was 4.4 million less than in 1990, and in a large part of the world today girls are receiving primary school education. But these positive changes have gone hand in hand with an unparalleled increase in the disparity between social groups. Fundamental rights—such as health and education—are largely determined by income levels, ethnicity and geographic location. We could liken this process to the uncoupling of the carriages at the rear of a train: millions of people are being left behind. And this situation is also destroying opportunities for progress and recovery in dozens of countries, including Spain. Consequently, the task of identifying and addressing these inequities will be a priority for the global development agenda in the coming years.
These arguments form the basis of a short document published a few days ago by Kevin Watkins, a world authority in this field and the director of the Overseas Development Institute, a British think tank. In his contribution to the ongoing discussion on the future of the Millennium Development Goals and the best strategy against poverty, Watkins proposes placing equity at the centre of the debate: “Being a poor rural girl in Pakistan more than triples the risk of being out of school. These are the type of disparities that the post-2015 framework has to address.”
The notion of a development framework that openly posits the reduction of inequalities is subject to all kinds of economic considerations. But the main obstacle is political: in poor countries no public official in their right mind is opposed to accepting development funding in exchange for commitment to a programme aimed at improving the health and education of their voters. However, committing to measures that would take a bite out of the privileges of their own caste would be a very different matter. Nonetheless, when such measures have been implemented, the results have been tangible: both Brazil and India doubled the size of their economies between 1990 and 2007, but while the population living in hunger in Brazil was reduced by half in that period, whereas in India it increased by 65 million people.
This should serve as a lesson for the whole world. Ricardo Fuentes, head of research for Oxfam GB, makes the point that the last decade has been good to the super rich, and there is a risk that we will see an even greater increase in social inequity over the next decade. Research carried out by the University of California, Berkeley, shows that 95% of the USA’s economic recovery has been captured by the people earning the top 1% incomes, and in Spain we are starting to see a similar phenomenon: growth in stock market profits and regressive tax benefits in an economy marked by the consolidation of high unemployment and a reduction in social protection. In the long-awaited Spanish “recovery”, some people are “recovering” much better than others, and the model of social cohesion left in the wake of the crisis will be much weaker than before.
It was the need to discuss these issues that inspired the seminar organised by ISGlobal together with the Open Society Foundations to be held in Barcelona at the beginning of November. Using global health as a starting point, experts from diverse fields and different parts of the world will discuss the challenges of social inequity and the threat it poses to the universal right to health and a decent life. Can we identify common patterns in the risks that threaten those in the “uncoupled wagons” in poor, emerging and developed countries? Is it possible to build a global social contract that would guarantee the right to a decent and healthy life? What political, institutional and fiscal structure could underpin such a contract. Some of the sessions will be streamed live and all the seminar material will be available on the ISGlobal website. We invite you come and take a look.
Seminar: Building a Global Health Social Contract for the 21st Century