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  3. Poverty and Health The link between health and economic outcomes has always been a central issue for both economists and soc

Poverty and Health The link between health and economic outcomes has always been a central issue for both economists and soc

admin2012-09-10  79
问题                      Poverty and Health
    The link between health and economic outcomes has always been a central issue for both economists and sociologists. Most experts believe that there is a strong causal link between health and economic prosperity. For example, those earning higher incomes have more money to invest in human capital such as improving and maintaining health. This means that their standard of living improves as their earning power increases and they are able to invest in better diets, improved sanitation and better health care. A healthy worker is less likely to contract disease, and this means productivity at work improves with the resultant opportunity to command higher earnings.
    A clear example of the link between economic productivity and poor health is Uganda, which is situated in the east of central Africa. Recent surveys have indicated that 46% of the population is forced to live on less than $1.00 per day. Only 49% of households in Uganda have access to health care facilities. The current average life expectancy is 48 years from birth, which is estimated to be about 45 for males and 50.5 years for females. An assessment of the burden of disease in Uganda in 1995 demonstrated that 75% of life years lost as a result of premature death were due to entirely preventable diseases: perinatal and maternal conditions accounted for 20%; malaria for 15.4%; acute lower respiratory tract infections 10.5%; AIDS 9.1%; diarrhoea 8.4%. In addition, 38% of under five year olds are stunted, 25% are underweight and 5% wasted. These factors accounted for the extremely high mortality rate experienced in this age-group.
    A recent report from Healthcare Worldwide makes the clearest and strongest case yet that disease has a fundamental and disastrous effect on the economies of countries and, in the long run, at the global level. The report concludes that funding increases for health from affluent and poorer countries alike are vital. Although the extra expenditure from poorer countries would be difficult to find, the report concluded that the benefits received would be worth it. It is estimated that this injection of funds into the healthcare systems of the poorer countries would result in a significant increase in productivity because people would be healthier and more able to work. The report also urges a focus on the biggest killers, from childbirth and AIDS, and on medical care at a local clinic level rather than in prestigious hospitals.
    To this end, the Ugandan government has pursued a comprehensive poverty reduction strategy which has addressed the issues of access to appropriate and adequate health care by utilising the existing political structure of the country. This strategy has resulted in the incidence of poverty in Uganda falling from 56% in 1992 to 35% in 2000. The Multinational Finance Corporation (MFC) has praised the East African country for the progress it has made towards reducing poverty and has just announced its approval of a staggered $21 million loan which will be made available in three equal parts over three years beginning in 2002.
    This incentive means that Uganda has become the first country this year to benefit from a Poverty Reduction Support Credit (PRSC). This is a new approach to World Bank lending, available exclusively to low-income countries with strong policy and institutional reform programs, which allows poverty reduction strategies to be carried out.
    However, the MFC notes that although the Ugandan economy has performed relatively well during 2001-2002 in achieving a 5.5% growth, Uganda would still continue to rely heavily on donor assistance. The United Nations Human Development Report for 2002 ranks Uganda as 150th out of 173 countries, and reports it is "far behind" in its attempts to gain the anticipated 10% increase. It may also be unable to reach the hoped for Millennium Development goal of halving the proportion of people suffering from hunger by 2015.
    The Ugandan government is also dedicated to the control of AIDS through the Uganda AIDS Commission. In 1993, Uganda reported the highest rate of AIDS cases per population in Africa and, therefore, the world. HIV, the name given to the preliminary stages of AIDS, and AIDS, the fully developed form of the disease, are still one of the leading causes of death in Uganda. Currently, about 2.4 million people in the country are HIV positive while another 0.9 million have the fully developed form. To make matters worse, the majority of those affected with the disease are within the 15 and 40 year age group, which is where the majority of the labour force comes from. Therefore the economy suffers. However, since the introduction of the Uganda AIDS Commission, there has been a major decrease in the incidence of the disease.
    The struggle to maintain adequate and appropriate levels of health care in underdeveloped countries will continue to represent a major challenge to organizations such as Healthcare Worldwide and UNICEE However, through the involvement of the more affluent countries and the development of a global fund set up by the United Nations, hope is present and there is an air of optimism about the future.
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