Transcript Diapositiva 1 - Norman Girvan

INTERNATIONAL COOPERATION
Before focusing hopeful eyes on the future, you must be
grounded in reality. And the reality of international
cooperation is fundamentally perverse, and that’s why it
must be changed.”
Ximena de la Barra.
International Consultant, United Nations
“This is the battle of solidarity against egotism”
Fidel
Third World Countries:
Economic Situation
GROWTH of GDP (%)
FOREIGN DEBT
(trillions USD)
2005
5,9
2,8
2004
6,6
2,7
2003
6,1
2,7
2002
4,8
2,5
2001
4,0
2,4
2000
5,9
In 1980, the foreign
debt was 600 billion
dollars
The developed world spends USD $ 68 billion annually in development; developing countries
spend 378 billion servicing their debt. (5.4 times what they receive).
In 2004, Latin America received 6.843 billion in official development assistance and had net
transfer of resources abroad of 77.826 billion (10 times the aid received).
Latin America alone owes 780 billion in foreign debt, and the more it pays, the more it owes. In
2005, negative resource transfers from Latin America and the Caribbean were – 67. 494 billion.
(Source: ECLA)
Official Development Assistance
Only 5 countries fulfilled the promise of 0.7% of GNI for official development
assistance (Norway, Sweden, Luxembourg, Holland and Denmark), and the
average among the 22 countries was 0.33 %.
The USA is in next-to-last place with only 0.21 % of GNI.
Cooperation and Development Aid vs. Military Aid
Worldwide
One trillion for military aid
68 billion for development aid
47% of this
from the USA
Latin America
Receives proportionately less than any other
region in development aid
13.6%
115 millon
(+340%)
In 2005,
122 million
3.4 million
11.6%
1993
2003
Consequences for the World’s Population
A more unjust and unequal world.
Of the 6 billion people in the world:
 815 million are hungry (13.5 %) (300 million of them children).
 Every 3.6 seconds a person starves to death, the great majority
children under 5.
 2.4 billion people have no basic sanitation (40%).
 Over 1 billion lack clean drinking water. 5 million people, mainly
children, die every year from waterborne diseases.
 854 million are illiterate (14.2%).
 4.8 billion are poor people (80%).
In 1992, the income difference between rich and poor
countries was 60-fold. Today, it is 74-fold.
Consequences for the World’s Health
 40 million with HIV-AIDS (0.6%). Of those, 63% in Africa.
 AIDS has left 13.2 million orphans in the world – 12.1 million of them living in
Sub-Saharan Africa (Tanzania alone has 500,000 orphans).
 16,000 persons are infected daily with HIV-AIDS.
 11 million children under 5 die every year from preventable diseases (0.1%).
 Every 30 seconds, a girl or boy somewhere in the world dies from malaria90% of them in Africa.
 Africa has 11% of the world’s population, 25% of the disease burden and only
3% of he world’s health workforce.
 In 2005, life expectancy in Europe was 68 for men and 77 for women; but in
Africa it only reached 46 for men and 48 for women. In the next ten years, in
Botswana it will reach 29; in Swaziland, 30; and in Namibia and Zimbabwe, 33.
Global Crisis in Human Resources and Medicines
 The WHO estimates a world shortfall of 4.3 million doctors, midwives, nurses and
other health workers.
 The Americas has over 35% of the world’s health workforce, and spends over of
50% of the world’s funds dedicated to health. 57 African countries have only 3% of
the world’s health workforce, and make only 1% of the world’s health expenditures.
 There are 50,000 doctors for Sub-Saharan Africa’s 700 million people.
(1 x 14,000 inh).
 Medicine sales are concentrated in the industrialized countries. In 2005, only 13.1%
were made to developing countries; of these, 4.4% to Latin America and 1.1% to
Africa.
 The WHO budget for medicines is US $ 51.5 million annually. Reports from WHO
indicate 58% (29 million) were spent in normative regulations, global policy and
headquarters expenses.
Tendencies in Global Health Cooperation
Industrialized Countries and
Most NGO’s
1. Minimize their historical responsibility for
deteriorated development of our countries,
condition aid to “good government”, “respect
for human rights and the law”. Aid tied to
structural adjustment and economic interests of
donors.
2. Channeled thru private sector and NGO’s, often
ignoring the role of government and thus the
use of its infrastructure (lack of replicability and
sustainability)
Cuba
1. Based on national consensus and
political will; cooperation as key
element in foreign policy as a
means to real integration.
2. Mainly channeled thru central and
local governments; aims to
strengthen or create sustainable
infrastructure.
3. Main contribution is financial, technological
(often outdated), and smaller human resource
development programs.
3. 80% of cooperation devoted to
providing highly qualified human
resources, dedicated to service and
humanistic values; to training of
human resources and transfer of
modern technology.
4. 80% of financial resources contributed actually
return to industrialized countries.
4. Developed as the sum of potential
contributions from the countries
involved, on a not-for-profit basis.
Tendencies in Global Health Cooperation
Industrialized Countries and
Most NGO’s
5. Aid does not always meet needs of receiving
countries; frequently masks political and
economic objectives.
6. For implementation, requires lengthy process,
project proposals, exchange of experts, and
finally signing of complex agreements.
7. Generally develop pilot or small programs,
benefitting limited populations, and usually in
the cities.
Cuba
5. Guided by the principle of responding to
needs stated by authorities of the
receiving countries.
6. Tends to develop quickly, without
complicated formulations. Cooperation
agreements signed in which local
experts provide assistance.
7. Because of its institutional nature,
attempts to benefit largest possible
population, and is developed in
poorest, most remote regions.
Cuban Global Cooperation: Current Situation (2006)
1. Cooperation with 155 countries; 1846 organizations of solidarity; and 228
political parties.
2. Over 800 projects in implementation.
3. 38,524 Cubans serve in 111 countries; of those 29,594 (76.8%) do so in the
health sector in 68 countries.
4. Literacy program in 20 countries.
5. 27,235 young people from 120 countries study in Cuba.
• 21,964 (80.6%) study medicine; 10,585 from 10 countries enrolled in
the new community medicine program.
• In Venezuela, the same program enrolls 14,185 students.
6. 536 students enrolled in schools founded with Cuban assistance in
Gambia, Equatorial Guinea, Eritrea, Guinea Bissau and East Timor.
7. Vision restoration (Operación Milagro) developed in 29 countries in Latin
America and the Caribbean, including Cuba.
Total Personnel Collaborating Abroad, Agency and Geographic
Region (May 31, 2006)
ÁREAS GEOGRÁFICAS
Total
(111
countries)
%
17
6566
17.04
0
0
301
0.78
17
6
0
182
0.47
68
15
0
17
468
1.21
184
98
144
59
9
518
1.34
3
120
16
0
39
1
179
0.46
Sugar Ministry
0
148
5
14
0
0
167
0.43
Agriculture
Ministry
0
285
1
9
0
1
296
0.77
Construction
Ministry
0
37
31
75
0
54
197
1.51
Steel Ministry
0
36
18
0
2
0
56
0.15
Total
27
7714
310
611
169
99
8,930
100.0
Public Health
Ministry*
2
26228
10018
1925
5
416
29594
76.8
Total
29
33942
1328
2536
174
515
38524
100.0
N.
America
(2 countries)
Latin
America(
17 countries)
Caribbean
(23 countries)
Africa
(40
countries)
Europe
(15
countries)
Asia
(14
countries)
Sports Institute
0
6380
70
36
63
Armed Forces
Ministry
0
0
0
301
Higher Ed. Ministry
0
146
3
Education Ministry
0
368
Cooperation
Ministry
24
Culture Ministry
Agency
Cuba’s Health Programs: Summary
MODALITY
COUNTRIES
IN-COUNTRY
PERSONNEL
PHYSICIANS
%
TECHNICAL
PERSONNE
L
COMPENSATED
COOPERATION
37
1,065
699
65.6
366
COMPREHENSIVE
HEALTH PROGRAM
28
3126
2206
70.6
920
SUBTOTAL
65
4191
2905
66.5
1286
SPECIAL PROGRAM:
VENEZUELA
1
23803
15485
65.1
8318
SPECIAL PROGRAM:
BOLIVIA
1
1276
1020
79.9
256
HENRY REEVE
CONTINGENT
INDONESIA
1
135
78
57.8
57
VISION RESTORATION
(OPERACIÓN MILAGRO)
18
189
110
58.2
79
TOTAL *
68
29594
19598
66.2
9661
* Total is 68, since some countries have more than one modality.
GLOBAL HEALTH PROGRAMS: SOCIAL IMPACT
Medical Attention
1. Office visits: 259,594,529 (in 7 years).
2. Home visits: 89,857,702.
3. Lives saved: 1,433,649 (five times the 285,700 lives lost in recent
disasters in Central America, Indonesia, Sri Lanka, Pakistan and
Indonesia).
4. Surgeries: 1,983,429.
5. Medical and paramedical equipment repaired: 59,568 (for a saving
of USD $ 35,500,800 to the receiving countries)
6. 600 comprehensive diagnostic centers (CDC) and rehabilitation
centers (CRC); and 35 high-technology centers (HTC).
• CDC – 125 completed. CRC – 145 completed, of these 133
operating; 12 in startup. HTC – 4 operating, 4 in startup, 11 in
construction, 16 in project phase.
GLOBAL HEALTH PROGRAMS: SOCIAL IMPACT
7. Community optical services in Venezuela: 4,785,525 cases seen, resolving health
problems of 3,602,504 (75.3%). One of every 8 inhabitants has received this service.
8. Vision restoration: benefitted 327,586 patients, of whom 36,703 from Latin America,
18,843 Caribbean, 71 816 Cuba, and 200,224 Venezuelan (one of 1393 inh. of these
countries).
9. Henry Reeve Disaster Contingent: 3,989 sent to Guatemala, Pakistan and Bolivia.
10. In Pakistan: 32 mobile hospitals donated by Cuba.
Human Resource Training
11. Since 1961: 45,352 graduates from 129 countries.
• 30,109 (66,4%) from 41 Sub-Saharan countries.
• 8,718 (19,2%) from 18 Latin American countries.
12. Cuban medical teams abroad have graduated 3,392 paramedical and technical health
workers.
GLOBAL HEALTH PROGRAMS: SOCIAL IMPACT
11. Opening of the Caribbean Nursing School in Dominica with 150 students; preparations
for second school in Belize.
12. Literacy: 2,451,509 persons learned to read and write in 13 countries. Declared
illiteracy-free: Venezuela and Canton Cotacachihi.