Mind the gap: It’s all about inequality
Nangina Yadav, aged 18 months and weighing just 6 pounds, didn’t make it back for her second appointment at the Varanasi district health centre in India’s eastern Uttar Pradesh. Her mother, a landless agricultural labourer, couldn’t afford the $12 fee for antibiotics – and Nangina became another grim statistic in India’s annual body count of 2 million children.
Cases like Nagina’s are the reason global leaders gathered in 2000 and set concrete, goals for improving the lives of the world’s poorest and most deprived. Although we’ve made progress since then, we’ve still got a long way to go – mainly because governments are failing to tackle the extreme inequalities that trap many people in poverty, illiteracy, hunger and disease.
Leaders from around the world are meeting at the United Nations in New York to assess progress on the targets established 10 years ago – the Millennium Development Goals (MDGs).
Almost every country has endorsed these goals, which range from cutting child deaths by two-thirds to halving poverty malnutrition and achieving universal primary education. But we are falling shamefully short of meeting our ambitions.
What has gone wrong? Many critics point the finger squarely at the failure of aid donors to keep their promises – and they have a point. In 2005, rich countries pledged to increase aid to sub-Saharan Africa by $25 billion by next year. The region is now expected to receive less than half that amount.
Shortfalls in aid will consign the MDG project to failure at enormous human cost. But the narrow focus on aid misses the bigger picture. The real elephant in the room in New York is inequality and the systematic failure of governments to tackle deep-rooted social disparities.
Too many countries are leaving behind their most vulnerable and disadvantaged populations. In northern Nigeria, girls from poor rural households average just six months in school, whereas wealthy, urban boys average 10 years. It is inequalities like this that explain why, on current trends, there will still be over 50 million kids out of school in 2015 – and why progress towards universal enrolment is slowing.
It’s the same story on child survival. We are set to miss the target for cutting under-five mortality by a margin equivalent to 4 million additional deaths. Most fatalities occur in poor households. In India, children who are born into poor homes are seven times more likely to die than those born into rich households. Yet as a recent Save the Children report documented, social disparities in child survival are widening in many countries. The real reason: poor children are the first in line for the risks posed by killer diseases, but last in line for basic health services.
It doesn’t need to be like this. Brazil provides an instructive example of what can be done. While the country may be growing more slowly than India, it is cutting poverty, hunger and child deaths more rapidly – and is now on track to meet most millennium targets. The reason: the government has backed sound economics with the transfer of 1% to 2% of gross domestic product to poor households through social programmes. It’s called redistribution. It’s a powerful antidote to poverty. And other countries, including several rich ones, should try it.
Aid donors should be prepared to sign on for credible financial commitments, and to back calls for an MDG tax on financial markets. But an aid boost needs to go hand in hand with a pledge by governments in developing countries to get serious about tackling social disparities through more equitable public spending, targeted support in health and education, and strengthened social protection.
The summit in New York should put fairness and equity at the heart of the MDG agenda. After all, the MDGs themselves are a collective commitment to the world’s poor. One small step in the right direction would be to adopt a supplementary MDG commitment to halve by 2015 the gap between poor and rich when it comes child survival and school attendance. That would help to turn the spotlight on children who are being left behind – and on the governments who are leaving them there.
This could be a summit with a difference. It provides an opportunity not just to ensure that millions of kids avoid the fate of Nangina Yadav, but to give the poor a voice – and to build communities and societies where widespread poverty, hunger and disease are consigned to history.