Elementary! My Dear Watson?

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by Anwaar Hussain

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Last month John Bolton, the controversial new US ambassador to the UN, submitted a whopping 750 amendments calling for wholesale changes to the draft declaration for this month’s summit to strengthen the UN and review progress towards its Millennium Development Goals to halve world poverty by 2015.

It may be recalled that John Bolton is the same gent who in 1994 asserted that “there is no such thing as the United Nations” and later that “if the UN Secretariat building in New York lost ten stories, it wouldn’t make a bit of difference.”

The world’s reaction to the Bolton Amendments, though amounting to throwing water on a duck’s back, has been stinging. All over the globe newspaper headlines accused him variously of throwing the upcoming U.N. summit into “disarray”, attempting to “upset” a world agreement on poverty and trying to “ruin” U.N. reform plans by showing America’s “scorn” through these amendments.

The proposed changes would erase provisions in the draft calling for action against global warming, and remove endorsements of the international criminal court and the comprehensive test-ban treaty - both of which are opposed by the Bush administration. Instead, Washington is pushing for more emphasis on international measures against, what else, but the same old ‘terrorism’ and the proliferation of ‘weapons of mass destruction’.

In his amendment proposals, Mr. Bolton, a bitter long time UN critic who is on a temporary appointment to the same organization, played down the importance given to reducing poverty, and wipe out all references to the millennium development goals, including the target for wealthy countries to donate at least 0.7 % of national income to the developing world. America currently gives less than 0.2% in such aid. Those optimistic goals were a statement of recognition by the world leaders that all people have the right to be free from misery, malnourishment and preventable diseases and that those able to pay have some responsibility to lessen the human suffering.

While most of Europe is moving closer to the 0.7% target, the United States has long lagged and last year managed only 0.16% of national income to foreign aid. Bolton’s amendments, if incorporated, would not only amount to a brazen whack in the face for the aid organizations and international donors that have been working for years toward meeting the Millennium Development Goals, but would also mean a death knell for millions in the Third World now groaning under the yoke of unimaginable poverty and, ironically, whose representatives mostly sit in the same 10 stories of the UN whose supposed loss made ‘not a bit of a difference’ to John Bolton, the US ambassador to the UN.

On 7th September 2005, the badly mauled UN, whose strength and credibility were sapped by the US and Britain first in the run up to Iraq war, and then in the oil for food scandal, countered back a la the last effort of a dying man. In a searing Human Development Report for the year 2005 released on 7th September, the United Nations revealed some astonishing data about the only Super Power on planet earth.Following are some snapshots.

Although the United States leads the world in healthcare spending, 13% of its national income, and on a per capita basis the United States spends twice the world average on healthcare yet “some countries that spend considerably lesser than the United States have healthier populations”. US public health indicators, the report says, are blighted by deep inequalities linked to “income, health insurance coverage, race, ethnicity, geography and—critically—access to care”.

Furthermore, key US health indicators are far below those that might be anticipated on the basis of national wealth. For example, “infant mortality trends are especially troublesome”. The infant mortality rate in the US, the report says, “is now higher for the United States than for many other industrial countries. Malaysia—a country with an average income one-quarter that of the United States—has achieved the same infant mortality rate as the United States. And the Indian state of Kerala has an urban infant death rate lower than that for African Americans in Washington, DC.”

“Wide differences in health across socioeconomic groups partly explain the poorer health outcomes in the United States than in other industrial countries” the report suggests. From the cradle to the grave the health of US citizens shows “extreme divergence”. As if to explain the overwhelming showing of African Americans in the Katrina disaster images, the report hits out at the long suspected and talked about racial and ethnic health disparities in the US that have resulted in differences in insurance coverage, income, language and education, among other factors, the report reveals that “African American mothers are twice as likely as white mothers to give birth to a low birthweight baby. Their children are twice as likely to die before their first birthday. Income differences are closely correlated with health differences. A baby boy from a family in the top 5% of the US income distribution will enjoy a life span 25% longer than a boy born in the bottom 5%”.

Ironically, the report says, “the United States is the only wealthy country with no universal health insurance system. Its mix of employer-based private insurance and public coverage has never reached all Americans. While more than half the population have health insurance coverage through their employers and almost all the elderly are covered through Medicare, more than one in six non-elderly Americans (45 million) lacked health insurance in 2003. Over a third (36%) of families living below the poverty line are uninsured”. Talking of health insurance coverage that varies widely across the 50 states, depending on the share of families with low incomes, the nature of employment and the breadth of each state’s Medicaid programme for low-income people, the report says that, “Hispanic Americans (34%) are more than twice as likely to be uninsured as white Americans (13%), and 21% of African Americans have no health insurance”.

More than in any other major industrial country throughout the world, “the cost of treatment is a major hurdle to access in the United States”, the report says. “Over 40% of the uninsured do not have a regular place to receive medical treatment when they are sick, and more than a third say that they or someone in their family went without needed medical care, including recommended treatments or prescription drugs, in the last year because of cost”.

“Unequal access to healthcare has clear links to health outcomes. The uninsured are less likely to have regular outpatient care, so they are more likely to be hospitalized for avoidable health problems. Once in a hospital, they receive fewer services and are more likely to die than are insured patients. They also receive less preventive care. The Institute of Medicine estimates that at least 18,000 Americans die prematurely each year solely because they lack health insurance. Being born into an uninsured household increases the probability of death before age 1 by about 50%”, continues the damning indictment highlighting the unequal access to healthcare and its powerful effect on health inequalities.

While the US has already spent upwards of US $ 250 billion on Iraq war, with the cost estimated to top a trillion US dollars if that fiasco continues for a further five years, and spends the highest in the whole world on its overdeveloped military muscle, the report states that, “One study finds that eliminating the gap in healthcare between African Americans and white Americans would save nearly 85,000 lives a year. To put this figure in context, technological improvements in medicine save about 20,000 lives a year”.

The frank and bold data highlights an inconsistency not only at the heart of the US health system but also across the board at the entire governmental priorities. While the high levels of personal healthcare spending reflect the America’s cutting-edge medical technology and treatment, the social inequalities, interacting with inequalities in health financing and other misplaced priorities, limit the reach of medical advance to all and sundry.

The 7th September UNDP report is a clear challenge to Washington.

Is the report a mere tit for tat from a dying UN or an honest stating of plain old elementary facts my Dear Watson?

What say you spin masters out there?

~*~

Essential Reading: Of Nuclear Giants and Ethical Infants also by Anwaar Hussain



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Anwaar’s articles appear simultaneously here at Truth Spring and at Soul Vibes in The Pakistan Tribune.


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