More than a billion ... / by Michel Jancloes

More than a billion • • • JE ven though the number of inhabitants of our planet living in good sanitary conditions has considerably increased during the last two decades, we have to admit at the same time that the absolute total of people living in unacceptable conditions of poverty has Dr Michel Jancloes 1s Chief of the Office of Interna- tional Cooperati on at WH 0 Headqu a rte rs in Geneva. WHO/ ILO 4 by Michel Jancloes also risen. Today there are more than one billion such people. Where do they live? Sometimes at our very doorstep, hidden behind a fat;;ade of gentility. Sometimes whole cities of such people have grown up quite recently - and even whole provinces, whole regions of large coun- tries. All these have to be added to those who live in what we call the least developed countries. It is estimated that close to 2,200 million people live in a state of severe poverty, and among these more than 700 million belong to the category of extreme poverty. Almost 60 per cent of the inhabitants of the least developed countries (LDCs) survive under very precarious conditions, but in the developing countries generally the total of under-served people share the same fate and the same characteristics: - large families; Famine victims in Africa; what chance have they and their like of even staying alive until the year 2000? Facing page: A congested slum in the Western Pacific. Ever greater numbers are herded together in urban "ghettos" that lack satisfactory sanitation. WOR LD HEALTH. March 1990 - extremely low earnings; - 75 per cent of this population live in the countryside while the remainder are grouped together in urban "ghet- tos" lacking in decent sanitary facilities; - 80 per cent of their earnings are spent on food, and yet malnutrition is widespread; - nine out of ten people have no access to safe drinking water; - the level of health is very low, and the targets of primary health care have not been achieved; - out of every 1,000 live births, 130 babies never reach their first birthday; - nearly one child in four is of low birth weight, while fewer than half of the mothers will have received ade- quate care from qualified personnel during their pregnancies; - only one child in seven will have the good fortune to receive the right vaccinations against diphtheria, tetanus and whooping-cough; - life expectancy at birth is no more than 4 7 years. The list could run on much longer. Equally, we could look for some sort of explanation, if not justification; we could blame the remoteness of coun- tries or regions, economic depen- dence, political instability, management WORLD HEALTH, March 1990 problems, susceptibility to external factors - whether climatic or economic. But in the end, we are left with men, women and children who would have just the same chance as anyone else to live in a dignified manner if only the technological means that we already have could be applied to reduce the yawning gap between the haves and the have-nots. No lack of resources This situation does not lend itself to improvement since - on a global scale - the human, financial and technologi- cal resources are already quite suffi- cient to prevent the tragic consequences listed above. In such an environment of deeply entrenched poverty, activities in the field of health development take on a very special meaning. These activities do not only serve to meet a fundamen- tal right of every human being; they are at the same time the only valid strategy to break the vicious cycle of sickness- poverty-more sickness, and to create instead an upward spiral of health-and- development capable of crystallising the forward advance of each com- munity's social and economic system. Least developed countries The term "least developed (among developing) countries" - abbre- viated as LDC - has a collective meaning and is the specific term that applies only to those countries recog - nised as such by the General Assembly of the United Nations. As from the start of November last year. the list of the least developed countries included the following 42 nations Afghanistan. Bangladesh. Benin. Bhutan. Botswana. Burkina Faso. Burundi. Cape Verde. Central African Republic. Chad. Comoros. Democratic Yemen. Djibouti. Equatorial Guinea. Ethiopia. Gambia. Guinea. Guinea- Bissau. Haiti. Kiribati. Lao People's Democratic Republic. Lesotho. Malawi. Maldives. Mali. Mauretania. Mozambique. Myanmar (formerly Burma). Nepal. Niger. Rwanda. Samoa. Sao Tome and Principe. Sierra Leone. Somalia. Sudan. Togo. Tuvalu. Uganda. United Republic of Tanzania. Vanuatu. Yemen. • International solidarity an·d coop- eration must respond to this challenge which every day faces all those of us fortunate enough to be able to appre- ciate life in all its beauty. • 5