Poverty reduction is a central feature of the international development agenda and contemporary poverty reduction strategies increasingly focus on ‘targeting the poor’, yet poverty and inequality remain intractable foes. This paper argues that this problem exists because many current approaches to reducing poverty and inequality fail to consider key institutional, policy and political dimensions that may be both causes of poverty and inequality, and obstacles to their reduction. Moreover, when a substantial proportion of a country’s population is poor, it makes little sense to detach poverty from the dynamics of development. For countries that have been successful in increasing the well-being of the majority of their populations over relatively short periods of time, the report shows, progress has occurred principally through state-directed strategies that combine economic development objectives with active social policies and forms of politics that elevate the interests of the poor in public policy. The report is structured around three main issues, which, it argues, are the critical elements of a sustainable and inclusive development strategy: patterns of growth and structural change that generate and sustain jobs that are adequately remunerated and accessible to all, regardless of income or class status, gender, ethnicity or location; comprehensive social policies that are grounded in universal rights and that are supportive of structural change, social cohesion and democratic politics; and protection of civic rights, activism and political arrangements that ensure states are responsive to the needs of citizens and the poor have influence in how policies are made.
Poverty and health
This paper argues that poverty and social analysis should inform the monitoring and evaluation frameworks of policies and programmes in order to demonstrate the distributional impact of initiatives. Indicators need to be identified and progress should be monitored in a disaggregated way – that is, not just how much more trade, income or employment was generated as a result of an initiative, but also for whom the initiative generated trade, income or employment. Policymakers should design policies or programmes in a way that caters to differentiated needs. For example, they should ensure that trade-related infrastructure (e.g. roads, telecommunications and electrification) reaches and benefits typically poorer trading groups, such as female traders, informal traders and those in remote rural areas. They should also support complementary policies that help tackle identified binding constraints to trade and which enhance people’s abilities to engage with and benefit from trade (e.g. access to land, access to credit and financial services, access to business education and marketing support). They should support mitigating measures that manage the adverse impacts that may stem from trade policy changes and consider activities that cushion or manage these impacts, such as vocational training to enable laid-off workers to diversify their income streams and shift into sectors with export potential.
This special report found that national burdens of disease, undernutrition, ill health, illiteracy and many protection abuses are concentrated in the most impoverished child populations. It argues that providing these children with essential services through an equity-focused approach to child survival and development has great potential to accelerate progress towards the Millennium Development Goals and other international commitments to children. An equity-focused approach could bring vastly improved returns on investment by averting far more child and maternal deaths and episodes of undernutrition and markedly expanding effective coverage of key primary health and nutrition interventions. Nearly 1.8 billion people have gained access to improved drinking water in the past two decades. HIV prevalence appears to have stabilized in most regions, and deaths from AIDS have fallen since 2004. And despite the global economic crisis, progress is still being made in reducing income poverty.
In response to food price riots in early September, the Mozambican government has laid on a range of price cuts and subsidies to make life easier for the poor, and has promised to do some belt tightening of its own. On 21 September 2010, two weeks after the first riots, it was reported that registered bakers would receive a subsidy for wheat flour and other relief measures included halving water connection fees for low-consumption households, considerably reducing the cost of piped water to the poor, and giving free electricity to low-consumption households consuming 100 kwh or less. Food prices for some basic items were also reduced and customs duties lowered on vegetable imports from South Africa. Analysts argue that a better long-term strategy to fight poverty and the rising cost of living would be for Mozambique to grow its own food, instead of relying on imports from South Africa. An increase in agricultural output would shelter the country’s food supply from volatile international markets.
This paper considers previous systematic assessments of educational attainment, and estimated the contribution of improvements in women's education to reductions in child mortality in the past 40 years. The authors compiled 915 censuses and nationally representative surveys, and estimated mean number of years of education by age and sex. They found that the global mean number of years of education increased from 4.7 years to 8.3 years for men and from 3.5 years to 7.1 years for women. For women of reproductive age (15-44 years) in developing countries, the years of schooling increased from 2.2 years to 7.2 years. By 2009, in 87 countries, women aged 25—34 years had higher educational attainment than had men in the same age bracket. Of 8.2 million fewer deaths in children younger than five years between 1970 and 2009, the paper estimates that 4.2 million (51.2%) could be attributed to increased educational attainment in women of reproductive age. In conclusion, the substantial increase in education, especially of women, and the reversal of the gender gap have important implications not only for health but also for the status and roles of women in society. The continued increase in educational attainment even in some of the poorest countries suggests that rapid progress in terms of Millennium Development Goal 4 might be possible.
According to this report, malnutrition levels in pastoralist districts of northeastern Kenya have remained high, despite recent rains that boosted livestock productivity, the mainstay of the local economy. Improvements in household food security have not translated into a decisive reduction in rates of child malnutrition in the northeastern districts, suggesting that causal factors of the unacceptably high rates go beyond availability of food at the household level. The Ministry of Health and its partners found Global Acute Malnutrition (GAM) levels above the World Health Organization's 15% emergency threshold in Mandera Central Districts, Wajir South and Wajir East. Mandera West recorded GAM rates above 25%. High illiteracy levels may mean that parents do not ensure their children receive a balanced diet, resulting in malnutrition. The report also emphasises the growing problem of urban poverty, with an estimated 3.5‐4.1 million (or up to 20%) out of 13.5 million urban households situated in high-density areas that are suffering various degrees of food insecurity. Further assessment of urban poverty in Kenya is already underway, according to the Ministry.
In the run-up to the United Nations’ (UN) three-day summit on the Millennium Development Goals (MDGs), held in New York from 20–24 September 2010, UN Member States underlined the vital role that democracy plays in reducing poverty. Democracy remains central to any development approach, Joseph Deiss, President of the General Assembly, told a meeting at UN Headquarters. He identified the pursuit of the MDGs – which include reducing poverty, fighting disease, halting environmental degradation and boosting health – along with UN reform and the promotion of environmentally sustainable development as key areas of focus for the Summit. In particular, he argued that stakeholders must bridge the gaps in the fight against hunger, child mortality and maternal health. He called for a sincere commitment from all world leaders taking part in the Summit and a genuine plan of action to ensure that the MDGs are reached. Member States are expected to come prepared to put forward concrete commitments on what they will do over the next five years to reach the MDGs.
In May 2010, the World Health Assembly adopted Resolution EB126.R11, its Global Strategy to Reduce the Harmful Use of Alcohol, based in part on an extensive amount of evidence on both alcohol's contribution to the global burden of disease and the policies capable of ameliorating the harm it causes. Now that the strategy has been adopted, this article calls for public health science to take on two new challenges. The first is to expand the evidence base so that it applies not just to the developed countries where most of the world's alcohol consumption is concentrated, but also to the low- and middle-income countries where alcohol consumption is increasing and where the policy response is still weak. The second challenge is to use scientific research to guide the adoption of effective alcohol policies at the national and international levels. The author of the article urges for a systematic investigation of the alcohol industry itself as a vector for alcohol-related disease and disability. Aggressive marketing of alcoholic beverages in low-consumption developing countries needs to be monitored, as does industry compliance with its own codes for responsible advertising. More stringent measures to protect young people from exposure to irresponsible advertising need to be considered, as self-regulation codes are easily circumvented and not enforceable.
Consumer anxieties over the rising cost of food in rich and poor countries alike are stoking fears of social unrest in impoverished parts of the world once again. On 1 September 2010, at least six people - including two children - were killed during violent demonstrations over soaring prices for basic necessities, including bread and fuel, in and around Maputo, the capital of Mozambique, one of Africa's poorest countries. The government has increased bread prices by 30% and protestors complained that they are struggling to feed themselves and their families. The violence echoes the food price crisis of 2007-2008, which helped push the number of hungry people in the world above a billion, and sparked protests and riots in nearly 40 countries. Surging wheat prices - mainly due to Russian restrictions on sales following a major drought there - drove international food prices up 5% in August, the biggest month-on-month increase since November 2009, according to the Food and Agricultural Organization (FAO). The FAO's Food Price Index - a basket of meat, dairy, cereals, oils, fats and sugar - has reached its highest level since September 2008, but is still 38% below its peak in June 2008. The FAO says the forecast for world cereal production this year has been lowered by 41 million tons to 2,238 million tons since June, but that would still be the third highest annual amount on record and above the five-year average.
According to this article, the absence of a threshold in the association between maternal education and child survival suggests that the obvious causal pathway - increased understanding of disease causation, prevention, and cure - might only be part of the explanation. This has led to investigations of many possible behavioural links, including better domestic hygiene, more intense mother-child interactions, and greater maternal decision-making power among mothers who are more educated than among those who are less educated. However, the use of child health services offers the strongest empirical support. Exposure to primary schooling increases a mother's propensity to seek modern preventive or curative services for her children. Schooling seems to engender in adults an increased identification with health institutions, and the confidence and skills to access services and comply with advice. It is likely that the symbiotic effect of schooling and health-service use indicates that improvements in the education of women of reproductive age might account for half of the reduction in mortality in children aged under five years. This contribution is far greater than increased income, a finding that is consistent with previous studies. Income and educational increases are only slightly correlated. Analyses of states that achieved high life-expectancies despite low-income levels (eg: China, Costa Rica, Kerala, and Sri Lanka) revealed a common characteristic: sustained political commitment to equitable access to primary schooling and health care for both sexes.