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Needed: Global Leadership For Poorest of the Poor

26 June, 00:00

By Jeffrey SACHS, Director of the Harvard Institute for International Development and Gallen Stone Professor of International Trade at Harvard University Times are tough for the world's poorest countries. Always marginalized in the world economic system, these countries are facing even more neglect than usual. After a breakdown in diplomatic approaches, the rich world is busy dropping bombs on Serbia, at a cost of billions of dollars per month, and will no doubt devote billions more to cleaning up and fixing the damage from the bombs once a diplomatic settlement is made finally. Meanwhile, the poor countries are told that there is little left for them. Debt relief for the poorest of the poor is likely to continue at a grossly insufficient pace, even with new proposals that will be launched at the G-8 summit. And many of the key international institutions that could actually help the poor countries are seeing their budgets relentlessly cut.

A recent spectacle in Geneva was particularly egregious. The World Health Organization, the leading institution charged with protecting global public health, has made very important reforms in the past year under the new leadership of Dr. Gro Bruntland, the former Norwegian Prime Minister. On the basis of those reforms, and a new WHO agenda on global health, Dr. Bruntland made the extremely modest request that the core WHO budget from donor countries should be raised sufficiently to absorb rising costs due to inflation and exchange rate changes. Yet even this modest request was rejected by donor governments. WHO will continue to be squeezed for funds, while the urgency of its mission rises by the day.

This decision, promoted mainly by the United States, reflects the sad dereliction of US leadership evident in so many parts of the world. The Clinton Administration has failed to pay US back dues to the UN, partly because of Republican opposition in the Senate, but partly because the Clinton administration simply hasn't been willing to champion worthy UN activities as a priority for the US. On the one side the US presses for reforms in the UN agencies, but when they happen, as at the WHO, the reforms are met with US calls for still more budget stringency.

The result is a continuing disaster for the poorest countries, where the burden of infectious disease is rising starkly, in diseases ranging from malaria, to HIV/AIDS and tuberculosis. But rich countries, including the US, should not kid themselves. Microbes do not respect national borders and do not wait for passport checks. The alarming rise in infectious diseases will burden the whole world, not just the poorest countries.

The sad irony is that recent scientific advances in biology and information technology actually make possible the development and use of innovative tools to face these killer diseases. Vaccine technology has leaped forward in the past decade. Vaccines for all three of these dread diseases are within scientific reach, but will requires some billions of dollars to bring through the research and development stages to actual use. Yet even at a cost of a few billion dollars, the human benefits per dollar saved would be among the greatest contributions possible for humanity. After all, the $10 billion or so it cost to bomb Kosovo this spring could probably have paid for the needed scientific work over the next few years on all three vaccines!

In area after area, including global climate change, public health, international debt relief, financial system reform, the neglect of the rich countries, and especially of the US, will sadly come home to roost. The attention span of the rich world is too focused and too limited. Our willingness to spend money seems to be much greater for war than for peaceful and preventative solutions to the great problems facing humanity, and especially those facing the poorest of the poor. It is high time for international leadership on these issues.

Newspaper output №:

№24, (1999)

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Day After Day