The massive inequalities in the distribution of resources for health globally will be brought increasingly into focus in the coming months, with the upcoming G8 meeting and the UN review of the Millenium development goals. With it will grow debates on the interpretation of the causes of and remedies for these inequalities, particularly for Africa. If we are to apply values of fairness and equity to this situation there is no doubt that global funds for health must flow southwards to African communities and public sector health services. As the editorial below by Vandana Shiva indicates, the situation calls for more however - it calls for social and economic justice. We must confront the deliberate policies that lead to net resource outflows from poor communities, underfunded public sector services and countries in Africa. EQUINET training, meetings and research in the coming months will focus on options for confronting these outflows in relation to health workers, health finances and trade policies. Please contact us at admin@equinetafrica.org if you would like to know more about any of these areas of work or visit our website at www.equinetafrica.org.

EQUINET in 1998 identified, as part of the understanding of equity in health, the importance of the relative control and authority that different people, communities and countries have over how the resources for health are distributed. At the end of the year, after the G8, after the UN Summit and after the WTO Hong Kong Ministerial, we will be asking ourselves - are African households, African public health planners and African countries more or less in control of the resources for health, including those we produce, but no longer consume, in Africa?

How To End Poverty: Making Poverty History And The History Of Poverty
Vandana Shiva
Source: www.zmag.org
http://www.zmag.org/Sustainers/Content/2005-05/11shiva.cfm

The cover story of the Time Magazine of March 14, 2005 was dedicated to the theme, "How to End Poverty". It was based on an essay by Jeffrey Sachs "The End of Poverty", from his book with the same title. The photos accompanying the essay are homeless children, scavengers in garbage dumps, heroin addicts. These are images of disposable people, people whose lives, resources, livelihoods have been snatched from them by a brutal, unjust, excluding process which generates poverty for the majority and prosperity for a few.

Garbage is the waste of a throwaway society - ecological societies have never had garbage. Homeless children are the consequences of impoverishment of communities and families who have lost their resources and livelihoods. These are images of the perversion and externalities of a non-sustainable, unjust, inequitable economic growth model.

In "Staying Alive, I had referred to a book entitled "Poverty: the Wealth of the People" in which an African writer draws a distinction between poverty as subsistence, and misery as deprivation. It is useful to separate a cultural conception of simple, sustainable living as poverty from the material experience of poverty that is a result of dispossession and deprivation.

Culturally perceived poverty need not be real material poverty: sustenance economies, which satisfy basic needs through self-provisioning, are not poor in the sense of being deprived. Yet the ideology of development declares them so because they do not participate overwhelmingly in the market economy, and do not consume commodities produced for and distributed through the market even though they might be satisfying those needs through self-provisioning mechanisms.

People are perceived as poor if they eat millets (grown by women) rather than commercially produced and distributed processed junk foods sold by global agri-business. They are seen as poor if they live in self-built housing made form ecologically adapted natural material like bamboo and mud rather than in cement houses. They are seen as poor if they wear handmade garments of natural fibre rather than synthetics.

Sustenance, as culturally perceived poverty, does not necessarily imply a low physical quality of life. On the contrary, because sustenance economies contribute to the growth of nature's economy and the social economy, they ensure a high quality of life measure in terms of right to food and water, sustainability of livelihoods, and robust social and cultural identity and meaning.

On the other hand, the poverty of the 1 billion hungry and the 1 billion malnutritioned people who are victims of obesity suffer from both cultural and material poverty. A system that creates denial and disease, while accumulating trillions of dollars of super profits for agribusiness, is a system for creating poverty for people. Poverty is a final state, not an initial state of an economic paradigm, which destroys ecological and social systems for maintaining life, health and sustenance of the planet and people.

And economic poverty is only one form of poverty. Cultural poverty, social poverty, ethical poverty, ecological poverty, spiritual poverty are other forms of poverty more prevalent in the so called rich North than in the so called poor South. And those other poverties cannot be overcome by dollars. They need compassion and justice, caring and sharing.

Ending poverty requires knowing how poverty is created. However, Jeffrey Sachs views poverty as the original sin. As he declares:

A few generations ago, almost everybody was poor. The Industrial Revolution led to new riches, but much of the world was left far behind.

This is totally false history of poverty, and cannot be the basis of making poverty history. Jeffrey Sachs has got it wrong. The poor are not those who were left behind, they are the ones who were pushed out and excluded from access to their own wealth and resources.

The "poor are not poor because they are lazy or their governments are corrupt". They are poor because their wealth has been appropriated and wealth creating capacity destroyed. The riches accumulated by Europe were based on riches appropriated from Asia, Africa and Latin America. Without the destruction of India's rich textile industry, without the take over of the spice trade, without the genocide of the native American tribes, without the Africa's slavery, the industrial revolution would not have led to new riches for Europe or the U.S. It was the violent take over of Third World resources and Third World markets that created wealth in the North - but it simultaneously created poverty in the South.

Two economic myths facilitate a separation between two intimately linked processes: the growth of affluence and the growth of poverty. Firstly, growth is viewed only as growth of capital. What goes unperceived is the destruction in nature and in people's sustenance economy that this growth creates. The two simultaneously created 'externalities' of growth - environmental destruction and poverty creation - are then casually linked, not to the processes of growth, but to each other. Poverty, it is stated, causes environmental destruction. The disease is then offered as a cure: growth will solve the problems of poverty and environmental crisis it has given rise to in the first place. This is the message of Jeffrey Sachs analysis.

The second myth that separates affluence from poverty, is the assumption that if you produce what you consume, you do not produce. This is the basis on which the production boundary is drawn for national accounting that measures economic growth. Both myths contribute to the mystification of growth and consumerism, but they also hide the real processes that create poverty.

First, the market economy dominated by capital is not the only economy, development has, however, been based on the growth of the market economy. The invisible costs of development have been the destruction of two other economies: nature's processes and people's survival. The ignorance or neglect of these two vital economies is the reason why development has posed a threat of ecological destruction and a threat to human survival, both of which, however, have remained 'hidden negative externalities' of the development process.

Instead of being seen as results of exclusion, they are presented as "those left behind". Instead of being viewed as those who suffer the worst burden of unjust growth in the form of poverty, they are false presented as those not touched by growth. This false separation of processes that create affluence from those that create poverty is at the core of Jeffrey Sachs analysis. His recipes will therefore aggravated and deepen poverty instead of ending it.

Trade and exchange of goods and services have always existed in human societies, but these were subjected to nature's and people's economies. The elevation of the domain of the market and man-made capital to the position of the highest organizing principle for societies has led to the neglect and destruction of the other two organizing principles - ecology and survival - which maintain and sustain life in nature and society.

Modern economies and concepts of development cover only a negligible part of the history of human interaction with nature. For centuries, principles of sustenance have given human societies the material basis of survival by deriving livelihoods directly from nature through self-provisioning mechanisms. Limits in nature have been respected and have guided the limits of human consumption. In most countries of the South large numbers of people continue to derive their sustenance in the survival economy which remains invisible to market-oriented development.

All people in all societies depend on nature's economy for survival. When the organizing principle for society's relationship with nature is sustenance, nature exists as a commons. It becomes a resource when profits and accumulation become the organizing principle for society's relationship with nature is sustenance, nature exists as a commons. It becomes a resource when profits and accumulation become the organizing principles and create an imperative for the exploitation of resources for the market.

Without clean water, fertile soils and crop and plant genetic diversity, human survival is not possible. These commons have been destroyed by economic development, resulting in the creation of a new contradiction between the economy of natural processes and the survival economy, because those people deprived of their traditional land and means of survival by development are forced to survive on an increasingly eroded nature.

People do not die for lack of incomes. They die for lack of access to resources. Here too Jeffrey Sacks is wrong when he says, "In a world of plenty, 1 billion people are so poor, their lives are in danger". The indigenous people in the Amazon, the mountain communities in the Himalaya, peasants whose land has not been appropriated and whose water and biodiversity has not been destroyed by debt creating industrial agriculture are ecologically rich, even though they do not earn a dollar a day.

On the other hand, even at five dollars a day, people are poor if they have to buy their basic needs at high prices. Indian peasants who have been made poor and pushed into debt over the past decade to create markets for costly seeds and agrichemicals through economic globalisation are ending their lives in thousands.

When seeds are patented and peasants will pay $1 trillion in royalties, they will be $1 trillion poorer. Patents on medicines increase costs of AIDS drugs from $200 to $20,000, and Cancer drugs from $2,400 to $36,000 for a year's treatment. When water is privatized, and global corporations make $1 trillion from commodification of water, the poor are poorer by $1 trillion.

The movements against economic globalisation and maldevelopment are movements to end poverty by ending the exclusions, injustices and ecological non-sustainability that are the root causes of poverty.

The $50 billion of "aid" North to South is a tenth of $500 billion flow South to North as interest payments and other unjust mechanisms in the global economy imposed by World Bank, IMF. With privatization of essential services and an unfair globalisation imposed through W.T.O, the poor are being made poorer.

Indian peasants are loosing $26 billion annually just in falling farm prices because of dumping and trade liberalization. As a result of unfair, unjust globalisation, which is leading to corporate, take over of food and water. More than $5 trillion will be transferred from poor people to rich countries just for food and water. The poor are financing the rich. If we are serious about ending poverty, we have to be serious about ending the unjust and violent systems for wealth creation which create poverty by robbing the poor of their resources, livelihoods and incomes.

Jeffrey Sachs deliberately ignores this "taking", and only addresses "giving", which is a mere 0.1% of the "taking" by the North. Ending poverty is more a matter of taking less than giving an insignificant amount more. Making poverty history needs getting the history of poverty right And Sachs has got it completely wrong.