Intro to Global Health Exam Midterm

Economic Approach

Expansive view

Usually measured by GDP

• Gross Domestic Product (GDP) = value of
goods and services produced and
consumed in a country (shows size of
economic activity)

• GDP per capita = GDP divided by
population

• Size of economy relative to
population

• GDP growth rate = percent change

• Shows how much economy is
expanding

• Problems with economic growth/GDP as
Development

In simple terms:

Development = economic growth, usually in terms of GDPent as economic
growth but it does not account for income distribution, environmental sustainability, or social well-being.

Poverty Alleviation Approach

• But what is poverty?

• Absolute poverty = having less than
amount needed to survive (meet basic
needs for food, water, shelter)

Currently, the World Bank sets at
$2.15/day

Relative poverty = not having enough
to fully participate in society

• How poverty is measured in
  developed/wealthy countries

• Poverty is about MORE than a lack of money

In simple terms:

Development = alleviating poverty and ensuring economic growth
reaches the poor

Amartya Sen

• Development as
  creating conditions
  that allow people to
  thrive
  

• Conditions include
  resources to meet
  basic needs,
  individual self-
  esteem and dignity,
  freedom of choice,
  national autonomy

In simple terms

Increase in individual freedom to lead lives they value, ability to make choices and act on them (capability)

Seers and Goulet

• Development as
  increase in
  individual freedoms
  or the ability to lead
  lives they value

• Ability to make
  choices and act
  on them

• Low income doesn’t
  necessarily mean
  low capabilities

In simple terms:

Creating conditions that allow people to thrive, including meeting
basic needs, individual self-esteem, freedom of choice, national
autonomy

SDGs

UN-led efforts to set concrete goals and
timelines for multidimensional
development in wealthy and poor
countries

• Sustainable Development Goals
  (SDGs) start in 2015 supposed to
  be met by 2030, include views of
  developing countries, tackles
  causes of underdevelopment

In simple terms

• 17 global goals to address poverty, inequality, education, ill health,
  and environmental degradation

Sid Israel

• Development =
  progress that
  increases level
  and quality of
  life

• Expand income
  and
  employment
  without
  damaging
  environment

• Create
  conditions to
  sustain

In simple terms:

Progress that increases quality of life, expands employment and income without hurting environment

Barder

• Development =
  process of
  creating social
  change that
  allows people
  to achieve their
  human
  potential

• It is political
  because it’s
  about power –
  who can do
  what to whom

In simple terms:

Improvements in wellbeing and capacity of political, economic,
and social systems to sustain it

SOAS

• Development = improvements in wellbeing and capacity of political,
  economic, and social systems
  to sustain that
  wellbeing

  \

  
  • Wellbeing is
  more than
  income
  

  In simple terms:

Bring about social change that allows people to achieve their
potential

Right to Development

• Development = constant improvement of the population’s well-being based on participation
  and fair distribution of
  benefits

• Economic, social, cultural, and political the process

In simple terms:

Constant improvement in population's wellbeing based on
participation and fair distribution of benefits

Similarities between Development Definitions

• Well-being as more than income

• Provision of basic services

• Freedom of choice

• Long-term change

Differences between Development Definitions

• What is most important – income, wellbeing,
  sustainability, rights, equality, power

• What needs to change – social systems,
  economy, everything

• Individual vs. population

• End goal or constant improvement

Venezuela

Petro state – very dependent on oil for economy

• Government controls and little investment in other areas

• When oil prices plummet, Venezuela screwed

• Wealthiest to poorest country in S. America within 2 years

• Very high inflation
  

Political problems – dictatorships

• Maduro is a functional dictator

• Political unrest

• Globally isolated, except for Russia and China

  
  •• All services deteriorate

Haiti

Food insecurity – more than 40% of population

• 5.2 million need help with food and shelter, getting
  worse

• Poor infrastructure

Vulnerable to natural disasters

• Hurricanes, earthquakes

•• Political instability

• President was assassinated in 2021, and there has been no election since

• Rise in violence and gang activity

More than half of people live in poverty

• Lack of services and access to services long-term
  problems

History of foreign intervention and abuse

Somalia

Political instability – civil war

• Terrorist groups – Al Shabaab

Economic instability due to political issues

Natural disasters due to climate change

• Drought → food insecurity, 700,000 people nearly starving

• Floods afterwards also problematic, displacement, spreads disease

Poor infrastructure

• Sanitation, water, health

Yemen

Active civil war since 2011

• Government vs. Houthi

• Political instability
  

Religious and cultural differences

• 2 different countries until 1991→ unrest

• Foreign interference

Less aid to Yemen after COVID

Humanitarian crisisHumanitarian crisis

• 3 out of 4 people need aid

• 4 million displaced

• High malnutrition → long-term consequences

• 2.5 million kids out of school
  

Afghanistan

US and NATO withdrawal → Taliban in power

• Western aid cut → humanitarian crisis

  • Hunger, poverty, economic stagnation, very little money for government, food insecurity

Opium economy banned by Taliban

• Makes crisis worse
  

Serious gender inequality under TalibanSerious gender inequality under Taliban

Infrastructure deteriorates without aidInfrastructure deteriorates without aid

War for 20 years also problem

Graveyard of Empires – lots of wars due to foreign interference

Papua New Guinea

Some economic growth, but lots of mismanagement of economy

• Lack of infrastructure – health, education, sanitation, water

• Causes lots of problems

Wellbeing issues

• 40% of the population is in poverty

• Very high maternal and child death rate

• Not much investment in improving well-being – a lack of skilled workers, underfunded health system

• High rates of diabetes, TB, malaria

• Really low literacy rates, but gendered
  

Violence

• Domestic violence towards women and children

• Discrimination against folks with disabilities

• Police violence, ethnic violence
  

Political instability – electoral corruption, ethnic divisions

Moldova

Government corruption

• Massive embezzlement scandal → no money to fund government services

• Poor infrastructure, limited investment → health and sanitation
  issues

Landlocked country, relies on agriculture

• Not very remunerative

Affected by the war in Ukraine and COVID

• High inflation, everything harder

Small population and high rates of immigration → small
workforce

• Demographic crisis

Breakaway region → political unrest

• Worse with Ukraine war because it’s backed by Russia

Common themes amongst “less” developed countries

• Conflict and violence

• Political Instability

• Climate Change and Disasters

• Economic Instability

• Social Underinvestment

• Foreign Interference

Inequality

Disparities between groups, denial of equivalent
enjoyment of rights, and/or arbitrary discrepancies in worth,
status and dignity

Some definitions of development require
equality in countries

• Explicit: Right to Development, SDGs

• Implicit: SOAS, Sen

Inequality makes development harder

• Undermines prospects for long-term economic growth by keeping some groups from improving

• Makes society more unstable by increasing tension

• May violate human rights to equal treatment

Wealth vs Income

Income: The money you earn from your job

Wealth: is acquired through property, stocks, bocks 

Wealth is much more easily distributed than income 

Why? 

• Discrimination; certain  generations 

• It is usually expensive to use income to invest in wealth

Enlightenment

Move away from tradition to a society ruled by reason

Reason

• logic based on empirical
  (observable) phenomenon

• Valued progress and change

• Saw religion as stagnant tradition,
  valued secularism

• Believed in equality for some people

West is Best

The West seen as more modern compared
to the rest of the world

• West was where reason/light held most sway

• “the Rest” were dominated by
  tradition/darkness

So the Rest should be more like the West → development and modernization = Westernization

Thought achievements and trajectory of the
West were universal

• Ignored cultural specificity of values and
  beliefs

• Ignored contributions of other societies

Science

• Many development projects still involve
  using Western science and technology to
  improve the Rest

• Developers assume that science and
  technology work same everywhere

Colonialism

Civilizing Mission

• The Rest” were inferior and
  needed to progress, be more like
  West

• West as more civilized and
  reasoned, had duty to “improve”
  other places even if by force

Colonizer Benefits

All colonization projects focused on
extracting profit for ruling country

• Usually through exporting minerals or
  agricultural products

Negative Legacies

• All relied on violent conquest and threat
  of violence to maintain power

• All increased tensions within colonized
  societies by creating winners and losers

Western values, practices, technology still seen as better

Missionary

Focusing on European and American Christian
missionaries working between 1600s and 1900s

• LOTS of denominations sent missionaries
  – Reached very remote places, often before colonial
  officials

• Missionaries worked alongside or in advance of
  colonialism

Service Delivery

• Many missions also provided
  services to people around them

  • Part of convincing people of
    power of Christianity

  • Also part of desire to help others
    and live religions ideals

• Biomedicine = healing system
  based on scientific knowledge

Westernization

Mission schools taught “Western” cultural
norms along with academics

• Required children to wear Western clothes and
  learn colonizer’s language

• Most focused on Euro-American history and
  culture, some also celebrated colonization

Missionary societies sent people from
colonies to other countries for
seminary

• One of few ways for colonized to access
  higher education

Self-Sacrifice

Truman doctrine

Point Four introduced a new vision

Help other countries acquire the knowledge and technology to
improve incomes, agriculture, manufacturing

First 3 points reaffirmed commitments to supporting the UN, the Marshall Plan and NATO (a military alliance with non-communist Europe)

Underdevelopment

• Countries that lack enough food, health, income, or
  industry = underdeveloped, economically “backward”

• Seen as natural state, not caused by colonialism or
  Western economic growth

• Lack of development is threat to peace

Development

• Sharing technology and scientific knowledge from the
  developed world to fix underdevelopment

• No need to conquer and control countries to develop
  them, can work collectively

• Main aim of development = economic growth

does not acknowledge providing money

Marshall Plan

• The plan to reconstruct Europe

• Huge amount of resources and money

Major Development Institutions

United Nations

World Bank

International Monetary Fund (IMF)

United Nations

Help countries work together on a variety of things

• Avoiding conflict

• International laws

• Human rights

• Development

• Sent groups of experts to advise
  developing countries

• Gave scholarships for technical training
  to people from developing countries

• Multilateral aid – aid funded by multiple
  countries (member countries of UN)

Focuses on giving out loans

World Bank

Development

Created to help fund reconstruction in Europe

• WB looking for new mission (Helping development countries )

Focuses on giving out loans

IMF

Stabilize the global economy

• created to keep world economy stable after WWII

• Both located in Washington, DC – new
  center of global power

• Both get involved in development through
  giving loans to developing countries (also
  multilateral aid)

• IMF looking to keep global economy
  stable

National Development Agencies

Come along later

Government agencies that fund development projects in foreign countries

Composed of mostly western countries to help fund development

Bilateral aid – aid from one country to another

Overall idea of Major development Instit.

Nearly all development efforts until the 1980s were associated with the UN, WB, IMF or a national development agency in cooperation with developing country governments

Largely designing, implementing, and funding, development

(UN not so much with funding)

IMF and World Bank are considered sister

BOTH Focuses on giving out loans

Modernization

Developemnt = industrialization

• All societies pass through five stages of growth based on what
  happened in the West

• Move from traditional agriculture to an industrialized consumer economy though technological advancement

Planned based on Western aid and help

Criticism of Mondernization Theory

• Assumes everyone goes through same stages in same
  order, but not true for all countries

• Doesn’t fit experience of colonized countries – no longer traditional

• Focused on economic growth, not population’s well-being

Import Substitution Industrialization (ISI)

To try to substitute domestic made goods for all imports (wanted to make their own stuff and not just buy it from the West

Government-supported expansion of manufacturing

• Mostly done by former colonies wanting to be less dependent on “the West” for manufactured goods

• Replace imported goods with locally made goods

Starts with easy to make goods like processed

• food and clothing

• Then durable consumer goods (appliances, cars)Then durable consumer goods (appliances, cars)

• Large countries eventually made expensive, technologically complex goods like steel and airplanes

How do they pay for this though?

• Domestic taxes

• Private foreign investment

• Technical assistance from the UN or Western
  development agency

Exported- Oriented Industrialization

Government support of industrialization in certain industries
 State or market discipline to ensure standards to keep
support met

 Support policies change over time

 Encouraged exports after industries established domestically

 Industries became more internationally competitive so were
more likely to survive without support

Issues with EOI

Dependence on exports leaves countries
vulnerable to downturns in global markets

 Asian Financial Crisis of 1997 slowed
economic growth and devalued currencies
across the region

Growth can’t last forever and sometimes
doesn’t pay to be economically prudent
 Japan’s Lost Decade – growth slowed
dramatically from 1991-2001 because of drop
in property values and anti-inflation policies

Neoliberalism

Grow economy through competitive advantages and openness to
international markets