The Relationship Between Wealth and Health

The BBC reports on fascinating new research, which concludes that “economic growth does not necessarily translate into improvements in child mortality.” There are two points I wish to make about this: First, it illustrates an important trend in the development literature regarding the correct metric to use to determine, and compare, levels of well-being worldwide. Historically, well-being has been captured by the crude instrument of Gross National Product (GDP) per capita, but the realization that, for many reasons, the measure was too crude to be a satisfactory indicator of well-being development led to the introduction of other measures, the most useful of which is the Human Development Index (HDI) put out by the United Nations Development Program (UNDP). (Why might GDP per capita be a misleading indicator of well-being?)

The second point follows from the first; one’s policy prescriptions vis-a-vis issues of development are to a large extent determined by just which indicator of well-being one believes best captures the essential nature of that elusive concept. As such, IGOs such as the World Bank, have focused attention on overall economic growth, while scholars such as Amartya Sen (who champions the “capabilities approach”) do not view growth tout court as a magical anti-poverty elixir.

From the BBC article:

Ten million children still die every year before their fifth birthday, 99% of them in the developing world, according to Save the Children.

A study comparing economic performance with child mortality reveals that some countries have not translated wealth into improvements across society.

Survival is too often just a “lottery”, said Save the Children’s David Mepham.

He said that even the poorest countries can cut child mortality by following simple policies, but at the moment “a child’s chance of making it to its fifth birthday depends on the country or community it is born into”.

Lagging behind

Angola comes at the bottom of a new “Wealth and Survival” league table drawn up by the UN Development Programme (UNDP).

The figures for child mortality in India are shocking
Shireen Miller
Save the children India

There are few countries in the world where there are such stark wealth contrasts as there are between the wealth of oil-rich coastal strip around the Angolan capital Luanda, and the war-ravaged interior.

UNDP statisticians calculate that more than half of the babies who die in Angola could be saved were the country to spread its wealth more fairly.


Click on the map to be taken to the Johns Hopkins Bloomberg School of Public Health’s Magazine for an article on child mortality.

[Each orange dot is equivalent to 5,000 child deaths.]


It Just Keeps on Getting Worse: Violence Escalates in Chad

From the BBC, we learn that the situation in the African state of Chad is going downhill quickly. According to the Failed States Index compiled by the Fund For Peace, Chad was the 5th most failed state in 2007. Chad has been affected negatively by the ongoing conflict and genocide in the neighboring state of Sudan.

Thousands of people are fleeing the Chad capital, N’Djamena, after two days of fierce fighting between government and rebel forces in the city.

chad.jpgThe government says it has pushed the rebels out of the city but they say they withdrew to give civilians the chance to evacuate. Aid workers report that fighting is continuing outside the city, while dead bodies litter the streets.

The UN Security Council has urged member states to help the government. The BBC’s Laura Trevelyan at the UN in New York says this non-binding statement gives the go-ahead to France and other countries to help President Idriss Deby’s forces against the rebels.

Chad’s former colonial power France has a military base in Chad and has previously helped the government with logistics and intelligence. Thousands of people have been streaming across the Ngueli bridge, which separates Chad from Cameroon.

Local officials have told the UN refugee agency that thousands were also crossing at the border town of Kousseri. “We’re expecting a lot more people coming,” said UNHCR spokesman Ron Redmond. He also said he was extremely concerned for the 240,000 Darfur refugees in Chad.

The International Crisis Group released a report back in 2006 detailing the situation in Chad and fearing a return to war in that country. You can view the executive summary here, where there is a link to the full report (the full report is only in French, however). Here is a snippet from that summary:

The April 2006 rebel offensive brought Chad to the brink of all-out civil war. The victory that President Idriss Déby ultimately achieved in pushing the United Front for Democracy and Change (FUCD) back from the gates of the capital, N’Djamena, to its Darfur sanctuary settled nothing on the military front and underscored the political fragility of the regime. The army’s success was primarily due to French logistical and intelligence support, while the setback paradoxically may encourage the armed opposition groups to forge closer links in order to pursue a war of attrition in the north, the east and along the border with the Central African Republic. The crisis is far from resolved, and is likely to be an enduring one.

Only weeks before the 3 May presidential elections, Déby had to fight off spectacular defections of senior figures from the army and the political elite as well as assassination attempts, all likewise aimed at preventing him from gaining a third term but he won the controversial elections with 64.67 per cent of the vote.[1] Though opposition groups challenged the result, France and the wider international community hastily accepted it to avoid further destabilisation, while declaring that they now expected the president to democratise his regime.

Chad (red on the map) is in north-central Africa and is on the eastern border of Sudan.


Centrist wins run-off Election for Serbian Presidency

The BBC reports that centrist candidate Boris Tadić has won more than 50% of the vote in the second round of the Serbian presidential elections held on Sunday. Turnout was high and the Serbian electorate has, with a slight majority, signaled its intention of looking towards the future and the West, rather than returning to the nationalist rhetoric and policies of Serbia’s recent past.

Serbian President Boris Tadic, 3 February 2008

Mr Tadic wants to push forward his European integration agenda

Serbia’s pro-Western president, Boris Tadic, has won a second round election run-off against nationalist challenger Tomislav Nikolic, who conceded defeat. Mr Tadic was re-elected by more than 50% of voters in a contest that saw a high voter turnout.

Car horns could be heard around Belgrade as Tadic supporters took to the streets of the Serbian capital to celebrate the victory.

The election was seen as a referendum on Serbia’s relations with Europe.

“Serbia has shown its great democratic potential,” said Mr Tadic said in his victory speech, in which he lauded Mr Nikolic for his performance in the knife-edge contest, and said the country still had hard work ahead.

Timor Leste (East) and Nation-Building

The International Crisis Group (ICG) has a new report on the situation in Timor Leste. Some of you may be aware that Timor Leste broke away from Indonesia four years ago following a brutal war of secession, during which forces loyal to the Indonesian government were alleged to have committed horrendous crimes against humanity. Thanks to UN intervention, the killing stopped and the small state of Timor Leste gained its independence. Recently, however, the UN-directed nation-building exercise in Timor Leste has imploded, along with domestic order.

According to the ICG.

Four years after Timor-Leste gained independence, its police and army were fighting each other in the streets of Dili. The April-June 2006 crisis left both institutions in ruins and security again in the hands of international forces. The crisis was precipitated by the dismissal of almost half the army and caused the virtual collapse of the police force. UN police and Australian-led peacekeepers maintain security in a situation that, while not at a point of violent conflict, remains unsettled. If the new government is to reform the security sector successfully, it must ensure that the process is inclusive by consulting widely and resisting the temptation to take autocratic decisions. A systematic, comprehensive approach, as recommended by the UN Security Council, should be based on a realistic analysis of actual security and law-enforcement needs. Unless there is a non-partisan commitment to the reform process, structural problems are likely to remain unresolved and the security forces politicised and volatile.

The problems run deep. Neither the UN administration nor successive Timorese governments did enough to build a national consensus about security needs and the kind of forces required to meet them. There is no national security policy, and there are important gaps in security-related legislation. The police suffer from low status and an excess of political interference. The army still trades on its heroism in resisting the Indonesian occupation but has not yet found a new role and has been plagued by regional (east-west) rivalry. There is a lack of transparency and orderly arrangements in political control as well as parliamentary and judicial oversight with respect to both forces.

The situation in Timor Leste illustrates–from the perspective of comparative politics–the importance of the state and its crucial role in facilitating stability by consolidating political power and maintaining, to paraphrase Weber, a monopoly on the legitimate use of political violence. From an IR perspective, we see the difficulty of imposing legitimate order on a society from outside, whether–as is the case here–through intergovernmental organizations (IGOs) like the United Nations, or–as in Iraq–through unilateral, or multilateral means.

Here’s a report from the BBC on the upheavals of April-June 2006.