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Originally published in healthmatters issue 33, Spring 1998, pages 18-19
Feature

How sustainable is the UK’s new development policy?

New Labour’s approach to international aid marks a significant shift away from tied aid to a focus on ‘real needs’ and eliminating poverty. But will actions follow the words? Rachel Dixey reports

Just before last year’s British elections, a Ghanaian friend in Accra asked me how life would be better under a Labour Government. A year later, armed with Clare Short’s White Paper, Eliminating World Poverty: a challenge for the 21st century, I could answer him.

Those concerned with inequalities in health know the importance of global poverty, and that our own relative good health and quality of life is diminished when a quarter of the world’s population live in extreme poverty, surviving on less than 65p per day. What New Labour is proposing to do about this should concern us all. It is of vital interest to poor countries like Ghana which are heavily dependent upon British policy.

The White Paper, published in November 1997, is the first on international development since 1975; the greater priority given to development has already been signalled by the creation of the new Department for International Development (DfID) and a Cabinet post for the Secretary of State for International Development. Clare Short and her department are committed to halving the number of people living in extreme poverty by 2015. In this, she is reiterating the aims of the UN 1997 Human Development Report which claims that elimination of poverty is feasible given the progress of the last 50 years.

In that time, child death rates in developing countries have more than halved, malnutrition rates have declined by a third, and the proportion of rural households with no access to safe water has fallen from nine-tenths to about a quarter. Life expectancy has increased, together with access to basic social services. So although we still see images of abject poverty, it is possible, by taking a longer view, to say that life in the poor countries has improved.

But huge challenges clearly remain: 2 billion people still lack safe sanitation; 1.5 billion lack safe water; 1 in every 100 pregnancies in sub-Saharan Africa ends in death for the mother (in the UK the figure is 1 in 11,000), and for every woman who dies in childbirth, 30 more suffer serious illness or permanent disability. The DfID has given £9m over the next six years to Malawi’s Safe Motherhood Programme, which will include access to better quality obstetric care. While this money is welcome, what is the strategy behind Clare Short’s desire to eliminate poverty?

“Major reorientation in UK policy is insisting that foreign governments address the real needs of poor people”

Money is needed — obviously. A short-term goal is to restore the proportion of GDP devoted to aid. The Tories reduced this from 0.51 per cent to 0.27 per cent. The UN’s target is 0.7 per cent, which Clare Short has described as a ‘tiny commitment’.

A second goal is reducing tied aid — that is, aid which is tied to the recipient country buying British goods. Tying aid diminishes the effectiveness of development efforts but is done to promote British business interests on the assumption that these lie primarily in export sales. The DfID argues that it is time for a new partnership with the private sector, and wants to find fresh ways to mobilise finance. The poorest 50 countries attract little or no private investment, which instead flows to the 12 most developed of the developing countries.

Partnership is the new buzz word.1 This is a tacit acknowledgement that many development projects do not benefit the people they are designed to help, but line the pockets of vested interests within and without the poor country. ‘Partner governments must be committed to the creation of the right economic and political environment — which includes dealing with corruption — if sustainable development is to thrive.’2 There is a clear signal to governments that they must reduce corruption — which many Africans and Asians readily admit exists on a large scale — and commit themselves to human rights. In the West, human rights are taken narrowly to mean the right to political dissent and free speech, but the original concept of human rights was more prosaic, focusing on the right to a livelihood, to education, to health care.

Previous UK strategy was to strengthen governments in poorer countries as a good thing in itself, but the new DfID wants to ‘look at government from the perspective of poor and disadvantaged people’.3 Again, this recognises that the powerful people in ‘Third World’ countries do not always serve the needs of the poor — on the contrary, there have been spectacular examples of the abuse of power. Clare Short also wants to see more women involved in government; their exclusion from decision making, is, she says, ‘a large part of the explanation of the poor governance of the world.’3

So a major re-orientation in UK policy is insisting that foreign governments address the real needs of poor people, signalling a move away from show-piece projects, like dams and so on. Instead, ‘if we ask they (the poor) tell us that they want basic services, for health including reproductive health, primary education, clean water, and sanitation. They would like these services to be delivered in a practical and timely way which suit their circumstances, and without undue harassment or discrimination on the basis of gender, religion or ethnic distinction’.3 This has been known for a long time but now we appear to have a British government prepared to act on this knowledge.

Economic growth in poor countries is seen as the way out of poverty but this can be blocked by the need to repay debts; debt repayment accounts for a large proportion of the GDP of poor countries, and can deter investors. As the ‘debt crisis’ is so crucial, it is disappointing that the White Paper does not give it greater prominence. It says only that debts will be cancelled ‘where possible’, reduced ‘to levels they can cope with’ or converted to grants.4

Another major goal in the medium term is to reform the Common Agricultural Policy (CAP). The effect of massively subsiding European farmers is to give them huge advantage in the global markets because agricultural exporters in poor countries cannot compete.

“Nowhere is it stated that over-consumption rather than over-population is what really threatens the global environment”

The new approach highlights ‘the environment’ and sustainability; DfID wants to ‘promote sustainable agriculture which tackles hunger and poverty but at the same time does not damage the environment’.4 The White Paper recognises that it is developed countries which damage the environment more than poor countries but nowhere is it stated that over-consumption (by the North) rather than overpopulation (in the South) is what really threatens the global environment.

What does all this mean for a country like Ghana where 32 per cent of the population lives in poverty? If the DfID’s strategy works, this should have been reduced to 16 per cent by 2015. Britain is Ghana’s principal trading partner and main source of foreign capital. Ghana relies heavily on its cocoa exports — the second largest foreign exchange earner after gold — and so is dependent on the world price for cocoa.

Inflation was running at 60 per cent in 1995 but is now down to 10 per cent. The country is politically relatively stable — President Jerry Rawlings won his mandate by pledging to put the people’s interest first – and levels of corruption are low by African standards. Ghana may benefit from Clare Short’s announcement that all future support for the Special Programme of Assistance for Africa will be untied aid and that its commitment to bilateral aid to basic education, basic health care and the provision of safe drinking water in Africa will increase by 50 per cent over the next three years.

A debate I followed in Ghana’s Parliament was about the need to borrow in order to pay off the interest on loans — thus perpetuating the familiar cycle of debt. Writing off loans could be the single most important act by our new government towards Ghana. It may also need help with ‘civil service reform, revenue mobilisation and financial management so that they are better able to deliver services to the poor’.5

The UK government has put eliminating poverty at the heart of its international development programme — but Health For All remains a long way in the future.

Clare Short has said she wants ‘to create a new form of patriotism’ and ‘mobilise the political will for poverty elimination... a reformed and more effective UN, a better World Bank... and a revitalised Commonwealth.’5 We must follow the White Paper’s progress and hope that New Labour sticks to its commitments.

References

1 Development and the Private Sector: a partnership for change. Speech by Clare Short, Institute of Directors, 8 July 1997.

2 The role and functions of the Department for International Development. Speech by Clare Short. School of Oriental and African Studies, 28 May 1997.

3 Democracy, Human Rights and Governance. Speech by Clare Short, University of Manchester, 30 June 1997.

4 Department for International Development. Eliminating World Poverty: a challenge for the 21st century. A Summary. HMSO, 1997.

5 Eliminating Poverty: a challenge for the new millennium. Speech by Clare Short, Commonwealth Institute, 26 June 1997.

Rachel Dixey is senior lecturer in health promotion at Leeds Metropolitan University

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