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The art of development

Development (Aid)


The 1970s was the Decade of the Conference. In 1972 we had the first World Conference on the Environment in Stockholm, followed by World Conferences on Food (Rome 1974), Population (Bucharest 1974), Women (Mexico City 1975), Employment (Geneva 1976), Housing and Cities (Vancouver 1976), Water (Mar del Plato 1977), Health (Alma Ata 1978), Land Reform (Rome 1979), Science and Technology (Vienna 1979), plus three United Nations Conferences on Trade and Development (Santiago 1972, Nairobi 1976, Manila 1979) and two Special Sessions of the U.N. General Assembly (New York 1974 and 1977).

It is easy to be cynical about such conferences. Hypocrisy and humbug have run through them all; airlines, hotel chains and restaurateurs have been their most immediate beneficiaries; and increasing bureaucracy and paper have been their most tangible results.

But it is equally hypocritical to subscribe to the theory that nations should sit down and talk about their problems rather than stand up and fight about them, and then to criticise the forums in which this happens as 'talkshops'. And it is surely naive to expect organisations which are responsible to over one hundred and fifty governments, facing every barrier of linguistic, historical, cultural, economic and ideological difference, to be unbureaucratic.

On the positive side, these set-piece conferences have served as sponges to soak up the experience and perceptions of governments, national and international organisations, research institutions and experts, action groups and committed individuals. And what has been wrung out of them is a new understanding about global problems.

If there is one common conclusion to be drawn from what has been learnt it is that the old solutions have been rubbed threadbare. At the beginning of the decade it was widely and confidently assumed that public and private investment, plus the aid the technology of the developed nations, would lead to economic growth in the developing world and that this in turn would seep down to the poor majority of their populations and solve the problems of poverty and malnutrition, illiteracy and ill-health.

On that premise the prospects looked good. Many developing countries looked to be entering a period of sustained economic growth and the armoury of available or about-to-be available technologymiracle seeds, wonder drugs and contraceptive pills looked impressive and hopeful.

The Seventies were not more than a few years old when this dream began to turn sour. Far from narrowing, the economic gap between developed and developing nations was seen to be widening - and widening quickly.

Within the developing world itself unprecedented rates of economic growth brought little or no benefit to the poorest 40% to 50% of its population. Studies in India, Pakistan, Brazil and the Philippines, where the average incomes rose as a result of economic growth rates reaching 6 per cent a year or more, revealed a stagnant standard of living for the poorest half of their people. "When you rip aside the confusing figures on growth rates," wrote World Bank economist Mahbub ul Haq in 1974, "you find that for at least two-thirds of humanity the increase in income has been less that $1.00 a year for the last twenty years.'

The other half of the bargain - technological ingenuity - also failed to live up to its promises. The development of cheap, safe and effective contraceptive methods did not solve the problem of rapid population growth; the development of new strains of wheat and rice did not stop the numbers of malnourished people from increasing the impressive list of medical breakthroughs were seen to be beyond the physical or financial reach of the 1'/z billion people whose need was greatest.

And as it became clear that the forces which create and control economic growth and technical advance are not neutral, when it comes to its distribution, so it became apparent that the problems are not technical but structural relationships both between rich and poor countries and between the rich and the poor within those countries.

Scapegoat of the '70s

The rate of world population growth peaked at some point around the middle of last decade and has since stalled. Latest estimates from the UN Population Division suggest that total world population, which now stands at just over 4 billion, will touch 6 billion by the end of the century.

At the very beginning of the 70s it was widely believed that rapid population growth in the developing world was the most important cause of continuing poverty. The population 'explosion', it was argued, was wiping out any economic development which the developing countries managed to achieve. 'No other problem casts a darker shadow over the prospects for international development than the staggering growth of population,' said the Pearson Commission Report on 'Co-operation for Development', published in 1970.

But as the decade progressed this view began to give ground under repeated attacks from a Third World which was profoundly suspicious of the convenient Western argument which laid the blame for poverty at the feet of the improvident poor.

The counter-argument ran like this. Large families and rapid population growth are in themselves a result of poverty. In the absence of social security, unemployment pay, sickness benefits and old age pensions, poor people need children to look after them when they are out of work, sick or old. Secondly, the millions of poor people who live in the rural areas of the Third World need children to help with the daily 'survival' jobs of collecting wood and water and looking after animals, which commonly take up to twelve hours a day every day and which children can and do perform throughout the developing world.

To all these commonsense reasons for large families is added the pressure of child mortality rates which still mean that up to one child in three born in the developing world will die before reaching his or her fifth birthday.

Here was the explanation of the fact that the poor people of the world have on average about twice as many children per family as the rich and that the 29 poorest nations in the world have the highest birth-rates.

From this base it was possible to argue that improving living standards - in nutrition, health, education, employment, incomes and housing - were the keys to falling birth rates. 'Development is the best contraceptive' became the new slogan and its advocates backed it up by pointing to the historical experience of the industrialised world itself where family size had begun to fall rapidly after improvements in living standards and before the massavailability of effective methods of contraception.

The clash between these opposing views of the relationship between population and poverty culminated at the 1974 World Population Conference in Bucharest, Rumania. Out of the turmoil that followed, an uneasy concensus emerged. Almost every developing country now accepts that the availability of the means and the knowledge to plan family size is an important part of any development strategy. Similarly it is also widely accepted that family planning will only make an impact in the context of economic and social change which benefits the majority of the people. 'It has been made clear,' says Rafael Salas, Executive Director of the UN Fund for Population Activities, 'that even the broadest family planning campaigns on their own are largely ineffective in producing a lower rate of population growth.'

Once again the idea that a major global problem could be solved by technology and policy changes without the need for more fundamental economic and political changes had been exposed as inadequate.

Let them eat flowers

In 1970 the UN Food and Agriculture Organisation estimated that there were approximately 400 million people severely malnourished. By 1975 that figure had risen to nearer 460 million - half of them children.

In the early years of the decade the favoured remedies were birth control and the upgrading of agriculture through farm mechanisation and the use of highyielding varieties of wheat and rice. In the meantime, staving, off even worse famine would have to depend upon the continued generosity of food-aid suppliers, principally the United States.

As the 1970's wore on this analysis began to look increasingly shaky.

Food aid, which was in any case under attack for depressing prices in receiving countries and driving small farmers out of business, began to look even less dependable as a means of averting famine. In 1973, within a few days of President Ford agreeing to sell 2.2 million tons of grain to the Soviet Union, his Secretary of State, Henry Kissinger, was telling the government of India that the US could only afford to sell 0.5 million tons of grain to that hungry sub-continent.

At about the same time, it was becoming clear that the Green Revolution was faltering in its promise to reduce malnutrition. To make a success of the new high-yielding varieties, a farmer must have the knowledge and the means to take the risk, to buy the seeds and to apply the necessary fertiliser, pesticides and irrigation. By definition, this restricted the benefits of the green revolution to the richer farmers.

Successful use of the new seeds by larger farmers often had the effect of depressing prices and many subsistence farmers were forced into debt and eventually into selling their land.

By the end of the 1974 World Food Conference in Rome, the idea that hunger results from too many mouths and too little land had been comprehensively shot down. A few facts will illustrate why:

* Despite rapid population growth, world food production had kept pace. Indeed per capita food production grew at 0.2% a year between 1970 and 1976. * Even in the hungriest years of the decade the world produced enough food in grains alone to provide more than enough calories for every man, woman and child on earth.

* China and Taiwan, which have many more people per cultivated acre of land than India and Bangladesh, were seen to have little or no malnutritio

* In some countries, half of the people were manlourished whilst half of the agricultural land was growing crops for export to the rich world. In Colombia, for example, large landowners were switching from wheat to cutflowers (exporting over $18 million dollars-worth of carnations in 1975 alone).

It was under the weight of such facts that the conventional wisdom on world hunger collapsed. Thereafter poverty, not population growth, moved to centre stage. Only the poor starve. And they starve because they are poor, because they do not have the means to grow food or the money to buy food. In short, because of structures which put economic demand before human need.

'The market playing freely,' summed up the then Director General of FAO at the end of the World Food Conference of 1974, 'will always feed the rich'.

Since that time world hunget has come to be seen more and more as a structural problem. Successful solutions, whether in left-wing. countries like China or right-wing countries like South Korea, have depended on the redistribution of land and the means to grow or buy food.

A New Prescription

Supported by the developed countries most developing nations have spent their health budgets on training westernstyle doctors and building hospitals for them to practice in.

But over the last decade it has become clear that such a cure for the Third World's health problems was bypassing the majority of its populations.

A sample of the facts from the 70s which brought down yet another branch of the tree of conventional wisdom: -

* 80 per cent of the health budgets of the developing nations were being spent on expensive city-based curative medicine serving only 20 per cent of the population.

* 70 per cent of the population, meanwhile, had no access to modern medical care at all.

Inadequate nutrition, water supply, sanitation, immunisation and health education probably account for 90 per cent of illness in the poor world, • Every year, according to UNICEF, 250,000 children go blind in the developing world because of a lack of Vitamin A which could be rectified by 'a daily handful of green vegetables'.

Such examples of skewed priorities flooded in during the second half of the 70s. And out of them came the concept of Primary Health Care. As an idea, it was an unashamed crib from China's, 'barefoot doctor' approach.

The basic principle of Primary Health Care (PHC) is cheap prevention for the majority rather than expensive cure for the few. At the international level, the new thinking surfaced at the 1978 World Conference on Primary Health Care held at Alma Ata in the Soviet Union and jointly sponsored by the World Health Organisation and UNICEF.

It simply does not need seven years of training and sophisticated hospitals, the argument ran, in order to be able to prevent or treat the major causes of ill-health among the vast majority of the world's poor.

Instead, the front line of the battle for improved world health should be manned by tens of thousands of Primary Health Care workers who, in a few months and at a cost of around $1000 each, could be trained to immunise people against infectious diseases; to advise on maternal and child health and discuss family planning, treat common illnesses and injuries, and educate their communities in the need for and the means of providing improved nutrition, safe water and hygienic sanitation. Backed up with training and referral services by the medical profession, such strategies could make drastic improvements in community health for as little as $2 per head.

If the priority is the greatest health of the greatest number, then the case for such a Primary Health Care strategy is clearly overwhelming. But just as it can be in the interest of those who control the land to grow flowers rather than food, so it can be in the interest of those who make the decisions on health priorities to train western-style doctors rather than invest in Primary Health Care.

Therefore the switch from curative medicine for the few to preventative health care for the many, requires not only a technical change or a policy decision, but a more fundamental structural change in the decision-taking process itself - in the distribution of economic and political power - if the needs of the poor majority are to be reflected in the allocation of health resources.

The Chosen Few

In September of 1977, UNESCO announced that, for the first time, more than half of the children of primary school age in the developing world were actually attending school.

But because 40 per cent of the poor world's population is under the age of fifteen (as opposed to only 27 per cent in the industrialised world) an even greater effort will be called for in the 1980s if enrolment rates are to be even maintained at present levels. On the most optimistic projections, the number of adults without the ability to read and write is due to increase by about 46 million between 1980 and 1990, even though the percentage of illiterate people in the developing world will fall from about 52 per cent to about 49 per cent in the same period.

Faced with such facts, the SouthEast Asian Ministers of Education Organisation has already said that 'The formal school system cannot meet the demand of the rising school population for general education, let alone cover the wide range of skills needed for social and economic development.'

In other words, education has somehow to be rationed. And, once again, the issue moves out of the classroom and into the political arena. For priorities in education inevitably reflect the present structure and the future aims of the society which set those priorities.

In most developing countries today, more than half of all the resources available for education are being used to create an educated minority for the modern sector of the economy. School examinations, and thereby school curricula, are usually designed to give pupils the beginnings of the skills required to be engineers, scientists, accountants, doctors, civil servants and administrators - and to select out those few who are capable of acquiring those skills at secondary schools and universities.

As a concept of education, it is like a religion in which many are called but few are chosen. And the net result is that the 80 per cent of pupils who do not qualify for secondary school are left with a sense of failure and frustration, and with the beginnings of an education geared to the needs of a small minority and largely irrelevant to the mainly rural and agricultural occupations which are the only opportunities open to almost three-quarters of the developing world's school-leavers.

Towards the end of the 1960s, Tanzanian President Julius Nyerere challenged this patterns of priorities and outlined an alternative: 'The education given in our primary schools must be a complete education in itself. Instead of primary school activities being geared to selecting the few who will go on to secondary school, there must be a preparation for the life which the majority of children will live. They must prepare people for life and service in the villages and rural areas of this country. For in Tanzania, the only true justification for secondary education is that it is needed by the few for the service of the many'.

In the Third World as a whole, this plea has gone unheeded. The annual rates of increase in enrolment have been greater in higher education than in secondary, and greater in secondary than in primary. Foreign aid programmes have reinforced this trend, with only 6 per cent of aid for education currently going to primary schools.

But the 1970s have also witnessed some important pioneering attempts to introduce 'Basic Education' geared to the needs of the majority. Examples of subjects on the 'Basic Education' syllabus:
* Literacy and numeracy.
* Preventative health and hygiene.
* Nutrition education.
* Techniques for increasing food production.
* Child-care, home-management and family-planning.
* House-improvement and construction skills.
* Appropriate technology.
* Local resources and environment.
* Participation in the community and political life.

The most basic need

The answer to poverty is a fourletter word: jobs. With productive and remunerative work to do, people can meet their own and their family's needs and contribute to and benefit from their country's development.

The conventional strategy of employment through growth is visibly failing. Despite sustained high rates of economic growth in many developing countries, unemployment and serious underemployment (which means earning less than $50 a year) is flickering between 25 and 30 per cent of the Third World's labour force. And it is getting worse. The ILO estimates that about 1,000 million new jobs will need to be created by the end of the century.

The debate on the New International Economic Order, which has been the focal issue of international development discussions in the 1970s (see pages 20-23) is essentially about jobs. 'The New International Economic Order will remain, an empty slogan on a piece of paper': says Hungarian Professor of Development Studies Taman Szentes 'unless it gets real meaning and lasting content by giving birth to a new worldwide division of labour.'

In practice this means lowering tariff-barriers and opening up the markets of the industrialised world to the manufactured products of the developing countries - shoes, textiles, paper products, furniture, glass-ware, vegetable oils, plywood, veneer, processed foods and many others. That would help to create employment in the Third World, but with seventeen million unemployed in the developed world it is unlikely to happen in the foreseeable future. And that is where and why the New Economic Order debate is stuck.

The 1976 World Employment Conference in Geneva concluded bluntly that a redistribution of opportunities for economic growth from the rich world to the Third World was necessary for job creation in the Third World and that job creation was necessary to alleviate poverty. But it also said that a parallel redistribution of income and opportunity was also needed within the developing countries themselves.

If a small number of people have a large surplus of wealth above their needs, the argument ran, then they tend to spend it on imported luxury consumer goods from the West or on investment abroad - and this does nothing for the balance of payments, nothing for selfreliance, nothing for local employment and nothing for the alleviation of poverty. If, on the other hand, a very large number of people have just a small surplus over and above their minimum needs then they are more likely to spend that surplus on basic necessities - a new roof or new furniture for the home, a small threshing machine or new tools for the farm, more and better food - so creating a pattern of industrial demand which is more likely to be met by local skills, local resources and appropriate technologies, so helping the balance of payments, increasing self-reliance, creating employment, and reducing poverty.

'Employment is the best way to do something about income distribution' said Louis Emmerij, Director of the World Employment Programme in 1955, 'and income distribution is the best way to do something about employment.'

This, the most basic of issues, has again come back to structural change and a redistribution of economic power within and between countries.