The Urbanization Paradox

Over the course of the last 200 years, the increase in average standard of living has largely mirrored increased urbanization. In 1800, just 10 percent of the world’s population lived in urban areas. The UN believes that this number will reach 55 percent in 2015. According to The Economist, 64.1 percent of the developing world, and and 85.9 percent of the developed world will live in urban centers by 2050.

Extreme poverty rates have declined precipitously over the last 30 years, and increased urbanization in developed countries suggests that this trend is likely to continue. However, while urbanization might spell economic progress in developing countries, it also poses environmental and humanitarian challenges.

Urban centers draw heavily on natural resources. The population density of urban environments brings challenges in terms of water availability, waste disposal and energy consumption. In cities like Nairobi, unplanned urban development has forced many into squalor – 60 percent of Nairobi’s urban population has been squeezed into five percent of the city’s total land mass.

What’s more, countless studies have noted that urbanization can exacerbate climate change’s negative impact on stream ecosystems. Urbanization can also exacerbate the risks posed by environmental hazards. Coastal cities are especially vulnerable to flash flooding – a risk that is rising along with the sea level.

Whether the environmental and humanitarian challenges of urbanization are met will depend largely on the responsiveness of local governments in meeting the individual needs of their communities. It will be up to local policy makers to maximize the benefits of urbanization while limiting the depths of its pitfalls. In doing so, local governments will need to draw on the ingenuity of urban planners, who face a diverse array of challenges in protecting their communities from environmental hazards and resource scarcity.

Like sustainable development models, sustainable urban planning models resist definitive archetypes, as renowned British architect David Adjaye has noted. “It has become clear that modern singularity must be refashioned into nuanced dialogues between geography, technology and culture,” said Adjaye. Urban planners will be called upon to architect fine-spun solutions, tailor-made for the communities that they serve.

However, it could be difficult for governments to resist the temptation of the short-term economic dividends of rapid, albeit unsustainable, urban growth. In addition, many developing countries may lack the financial resources and scientific expertise necessary to urbanize in and environmentally and humanitarianly sound way. Accordingly, it is essential that the U.S. government do its best to provide technical and financial support to urbanizing nations.

– Parker Carroll

Sources: EPA, Huffington Post 1, Huffington Post 2, IRIN, New Security Beat
Photo: Flickr

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Transparency International Reveals Global Corruption Levels

History has shown that government and institutional corruption can greatly hinder progress in developing countries. A new study by Transparency International reports that countries with faster-growing economies are more prone to government corruption.

The research shows that governments in countries such as China, Turkey and Angola are becoming more corrupt with increased fraud and bribery while others are reducing corruption levels.

Corruption is a major issue that causes distress in the lives of the poor and impedes international efforts to bring countries out of poverty. Numerous international organizations stress that corruption causes major setbacks in development work. Transparency International also states that corrupt officials prevent progress and impair public trust in the government.

Chairperson of Transparency International, José Ugaz, emphasizes the severity of corruption, stating, “Grand corruption in big economies not only blocks basic human rights for the poorest but also creates governance problems and instability. Fast-growing economies whose governments refuse to be transparent and tolerate corruption create a culture of impunity in which corruption thrives.”

International aid has a large correlation with corruption in impoverished nations. While the causation for that corruption is debatable, the majority of researchers agree that foreign aid helps to increase national stability and to bring people out of desperate situations. The Transparency International Policy organization works to assure that foreign aid is not deterred by government corruption.

The organization’s recent report was developed from 13 data sources and the estimated perceptions of many businesspeople and experts. The index scores 175 countries from zero to 100, with zero comprising a “highly corrupt” public sector and 100 representing a “very clean” establishment.

Afghanistan, the Ivory Coast and Egypt made the most improvement in eliminating government corruption, though the countries still remain towards the bottom of the index. Almost all underdeveloped nations have scores below 50 (with zero being extremely corrupt and 100 very clean). Denmark has the lowest estimated level of corruption, while Somalia and North Korea are ranked as having the most corrupt governments, with a score of eight.

As the report shows that every country is affected, Transparency International warns that corruption is threatening economic growth across the globe. Higher levels of corruption are marked by widespread bribery and fraud, an absence of punishment for corruption and public institutions that fail to attend to citizens’ needs.

While some researchers disapprove of foreign aid, stating that in certain nations it has fostered corruption, Transparency International officials encourage the use of aid as a means to diminish corruption.

Peter Eigen, the founder of Transparency Interational, states that, “Additional aid resources are needed, but their delivery has to be structured in a way that takes account of the risk of corruption. At the same time, while developing countries need increased resources, both sides must work together to put an end to corruption.”

– Nina Verfaillie

Sources: The Guardian, World Bank, Transparency International 1, Transparency International 2
Photo: N.Y. Mag

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Cell Phones Improve Literacy Rates

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Out of the 7 billion people on the planet, 6 billion have a mobile phone. Cell phones have become widespread in developing countries, and that is not necessarily a bad thing. The mobile technology has become ubiquitous even in poverty-stricken areas and its impact on users is rapidly changing poor populations. Studies conducted in the past have shown that cell phones can provide literacy to the world’s poorest nations.

Literacy is known to be essential for economic development and fighting poverty. More than 1.2 billion people still live in extreme poverty, and nearly 2.5 billion people live on less than $2 a day. Studies have shown that literacy has a positive effect on GDP per capita. It is estimated that if all children from low-income nations could read, the poverty rate could drop by 12 percent.

Cell phones have been named the new important devices in the world. The mobile technology has even helped provide schools, teachers and parents with access to educational insights for success.

Moreover, cell phones help thousands of people in developing countries learn to read using their mobile phones. In fact, before the widespread use of cell phone technology, the adult literacy rate in all of Africa stood at 52 percent; by 2008, the literacy rate had increased to 63 percent.

Illiteracy is partially due to the lack of books in the developing world; an alternative solution to this problem is cell phones. Cell phones are inexpensive, convenient, cost-efficient and provide electronic books in the hands of developing nations.

Literacy not only empowers people, but it empowers the mind as well. When it comes to alleviating global poverty, literacy is important for development. Women who are involved in literacy programs and activities obtain a better knowledge of health and family planning. Additionally, children who have parents that are literate are more likely to be enrolled in an educational program and have extra support toward their studies.

Reports have also shown that low literacy costs the healthcare industry over $70 million each year. Children whose mothers can read are 50 percent more likely to survive past the age of five years old. To be able to read can be vital for survival; understanding medical guidelines or security instructions are crucial for a person’s health and safety.

Literacy also develops societies on a political level. People who are literate have the upper hand in becoming more educated, and therefore are more likely to become civically engaged. Whether they are involved in labor unions, politics, or community activities, they will have the opportunity to change the world. To be able to read, write and count contributes to an individual’s self-development, and allows each individual to have their own sense of personal freedom and better understand how to adapt to the constantly changing world.

– Sandy Phan

Sources: World Bank, Do Something, UNESCO
Photo: USA Today

Non-Communicable Diseases in the Developing World

The largest public health problem in the developing world is currently non-communicable diseases, or NCDs. NCDs like cardiovascular disease and cancer kill around eight million people before they are 60 years old each year in developing countries. NCD-attributed deaths make up about 90 percent of  premature deaths in the world.

Urbanization, higher life expectancy and global trade drive NCDs in developing countries. Even though developed countries may have similar public health issues, they are much more equipped to deal with them because they have better and less expensive prevention and management tools and more experience dealing with the diseases.

Non-communicable diseases cause early deaths and debilitation for those in poverty in both developing and developed countries. However, the people effected in developing countries are, on average, younger and have worse outcomes than their counterparts in developed nations.

On a global scale, NCDs will cost developing countries $21.3 trillion over the next 20 years. Even though global focus and aid goes towards communicable diseases like HIV/AIDS and tuberculosis, non-communicable diseases effect a much larger portion of the population and are growing quickly in middle- and low-income countries.

The last time a global public health crisis that disproportionately affected the developing world was attacked was the HIV/AIDS epidemic. The effort originated in the U.S. with PEPFAR and grew to a worldwide effort. While lessons can be gleaned from that effort, the growing NCD crisis presents different challenges. Of course, the U.S. cannot make resource allocation decisions or policy solutions for other countries. An effort to attack this crisis has to be at the national level with the help and support of the international community.

Because most NCDs are characterized by chronicity, they have devastating socio-economic consequences. Patients require more care for longer periods of time. This not only takes them out of the workforce and reduces productivity but also uses up scarce healthcare resources. With a sicker, smaller workforce, economic growth can be stunted and have reverberating economic, social and political impacts for the country and region.

– Caitlin Huber

Sources: Council on Foreign Relations, Harvard University
Photo: Business Insider

The Cycle of Poverty

Poverty is a complex, multidimensional topic that has many factors. Different aspects of poverty affect each other and oftentimes continue to reinforce the negative aspects. The cycle of poverty is perpetuated by so many factors: poor health and education outcomes, not enough capital, vulnerability to life changes and lacking a voice to participate in society.

First, health is important not only because it prolongs one’s lifespan, but also because it directly affects one’s income earning potential. It gives people the energy to focus on activities that can contribute to a higher earning potential such as school work, running the business or farming. With a higher income, people can move on from subsistence living and onto a life of purchasing goods they are interested.

Second, education is important because it teaches one to make wise health decisions, that will ultimately contribute to a better health outcomes and eventually higher incomes. The cycle of poverty is often perpetuated because there is a direct lack in education. For instance, people will not use clean sanitation practices have a higher chance of getting inflicted with a disease such as diarrhea or dysentery. Having a sickly body will prevent a child from attending primary school, for oftentimes they need to walk several miles. Instead of walking with a body in that kind of state, a child will most likely stay home, perpetuating the cycle of poverty.

Next, consumption is indicated by how much purchasing power people have, whether they buy food for sustenance or other material goods for pleasure. Consumption is dependent on the amount of income. However, higher income is not necessarily practical to measure because money has different purchasing power and prices are always changing.

Vulnerabilities refers to the level of risk that a household or individual is likely to experience an episode of health or income poverty over a given time. The more vulnerable a person is, the greater their chances of being affected by any number of risks, including violence, natural disasters and quitting school (whether due to no money to pay for tuition or too ill to attend classes). It is likely that the more vulnerable people are, the less cushion they have to recover quickly.

Lastly, giving a voice to the poor and ability to participate in society is vital to lifting them out of a cycle of poverty. Hearing their concerns allows us to pinpoint their needs and help them reach the health and education levels necessary to thrive.

According to Nobel Laureate Amartya Sen, an important aspect of addressing poverty is to allow people to expand their capabilities to do what they want, simply because doing what one wants holds value in it of itself. So whether a woman or man wants to live farming for the rest of his life or pursue a medical degree, all those have value. All they need is agency, which is the opportunity available for them to pursue their life path.

Efforts that help the poor reach higher health, education and income levels, or protect them from their vulnerabilities or give them a voice are all vital dimensions in ending the cycle of poverty.

– Christina Cho

Sources: Stanford University, World Bank
Photo: Flickr

Ten Most Unhealthy Countries

Every year, the Social Progress Imperative comes out with an index that measures how individual countries perform in basic human needs, foundations of well-being, and opportunity. One subset of the foundations of well-being category is health and wellness. This subset takes into account life expectancy, non-communicable disease deaths between the ages of 30 and 70, obesity, outdoor air pollution attributed deaths and suicide rates. Below is a list of the world’s ten most unhealthy countries in the world, based on this subset.

10. Bulgaria, 60.63

Bulgaria is in the eastern part of the Balkan Peninsula. The country has a high mortality rate from cardiovascular disease. Additionally, Bulgaria has the worst air quality in Europe, with some of the highest concentrations of particulate matter, carbon monoxide and sulfur dioxide.

9. Mozambique, 60.40

Mozambique’s main health problems are to due with high mortality rates due to drought, poverty and HIV/AIDS, as well as a lack of experienced health workers in the country. The HIV/AIDS epidemic continues to decimate portions of the population in the country. In addition, capacity building and risk reduction expertise are both low.

8. Swaziland, 60.29

Located in southern Africa, Swaziland has an extremely high prevalence of HIV/AIDS, reaching over 26 percent. Swaziland needs the most improvement in life expectancy and non-communicable disease deaths between 30 and 70.

7. Latvia, 59.97

Latvia, too, has problems with air quality that cause long-term health problems. Latvia also needs to address substance abuse problems such as alcohol and tobacco, which both contribute to ill health in the country at a disproportional rate.

6. Armenia, 59.36

Armenia’s health issues revolve around a broken, extremely expensive health care system that cannot meet the burden of care. With economic downturn, basic medicines and doctor visits can become too expensive.

5. Moldova, 58.00

Moldova is currently experiencing negative population growth. The two main causes of death are heart disease and cancer. Moldova has high rates of substance abuse-related deaths, like alcohol and tobacco. Tuberculosis, especially multi-drug resistant tuberculosis, is rapidly becoming a major health concern in the country.

4. Belarus, 56.56

The main areas that need improvement in Belarus are non-communicable diseases and suicide rates. The country, located in Eastern Europe, is also relatively polluted, which can cause long-term ill-health.

3. Russia, 51.99

Russia needs improvement in almost all categories, including life expectancy, non-communicable diseases, air pollution and suicide rates. Additionally, Russia experiences high rates of mortality due to smoking for both men and women. HIV/AIDS is also becoming more of a concern.

2. Ukraine, 51.82

Ukraine, located in Eastern Europe, has similar problems as its neighbors, mainly bad air quality, high levels of tobacco and alcohol abuse and high suicide rates. Additionally, Ukrainians spend about 13 percent of their lives in ill-health, which is much higher than most of their neighbors. Ukraine also has the highest rate of infectious diseases in Europe.

1. Kazakhstan, 49.93

Kazakhstan, located in Central Asia, is ranked as the unhealthiest country in the world, according to the Social Progress Imperative. Kazakhstan needs dramatic improvement in life expectancy, deaths related to non-communicable diseases, air quality and suicide rates. HIV/AIDS and tuberculosis have become growing concerns; TB, especially, is of great concern because of drug-resistance.

– Caitlin Huber

Sources: Social Progress Imperative, World Health Organization 1, World Health Organization 2, World Health Organization 3, World Health Organization 4, World Health Organization 5, New York Times, UNICEF, National Center for Biotechnology Information, Common Dreams, World Bank, University of Pittsburgh
Photo: Flickr

Obama’s Poverty Alleviation Strategy

The main problem with congress is that there is an inability for Democrats and Republicans to agree on how best to handle poverty in the U.S. and around the globe.

In 1964 Lyndon Baines Johnson addressed a joint session of congress and introduced his war on poverty. He introduced poverty alleviation strategies that left a lasting legacy in the minds of the American public. He stated, “Some because of their poverty, and some because of their color, and all too many because of both. Our task is to help replace their despair with opportunity. This administration today, here and now, declares unconditional war on poverty in America.”

Today many Americans and people around the world reside in poverty. Some experts say that LBJ’s war on poverty was not a success, although it did bring the issue to the center stage for the first time on a national scale.

Today, parallels are being drawn between LBJ and Obama in their conviction to eradicate poverty.

Author Sasha Abromsky notes that President Obama, “understands the impact of poverty on people’s lives better than almost any other of his predecessors.” LBJ’s $20 trillion dollar strategy was much more aggressive than Obama’s poverty alleviation strategy. Obama supported economic packages that benefit those living in poverty, for example, the 2009 stimulus package increased funding for services such as food stamps. The Affordable Care Act is a safety net for Americans unable to afford the rising price of health care. Not only have his policies been aimed aid the poor, they also have prevented millions of Americans from falling into poverty.

Today, bipartisanship in congress remains the biggest obstacle for government assisted social service programs that support low income families. The fundamental problem remains that conservatives and neo-liberals hold vastly different beliefs when discussing the root problems of poverty. Liberals and neo-liberals believe that long-term poverty within certain demographics correlates with long-term structural problems and ongoing economic inequality within society. On the other hand conservatives and, most notably, conservatives like Paul Ryan hold that poverty is associated mainly with culture.

These distinctly different ideologies shed light on one of the reasons why Republicans and Democrats support separate economic and social service policies. The new Republican congress is pressing to reverse Obama’s second term packages that focused on providing substantial packages that supported the lower and lower middle classes. Obama’s policies show that he is aware of how the increasing income gap aversely affects low-income Americans. The Republican majority House and Senate has the ability to repeal legislation enacted during Obama’s terms in office.

It is likely that many of his bills will be on the chopping block next year.

– Maxine Gordon

Sources: NPR, New York Magazine Washington Post
Photo: Flickr

Challenges Persist Within India’s Education System

Although India’s constitution guarantees all children under the age of 15 the fundamental right to free education, this goal has yet to become a tangible reality. Several major social and economic forces continue to strain the Indian education system, depriving many children—especially girls—of access to basic primary education.

India has witnessed several important improvements in its education system over the past few decades. School attendance is currently on the rise as more children between the ages of six and 14 across the country are regularly attending class than ever before. Nationwide enrollment in government-run primary schools has increased from approximately 19 million in the 1950s to about 114 million by 2001. The nation’s overall literacy rate has also seen significant improvement, growing from 52 percent in 1991 to 65 percent in 2001. Furthermore, the total number of illiterate Indians is on the decline for the very first time. Despite these improvements, the number of children who remain illiterate or completely out of school is alarming. Approximately 90 million girls remain illiterate despite the recent growth in literacy rates, and 20 percent of children in the six to 14 year age group do not attend school. In Rajasthan, India’s largest state, 45 percent of girls compared to 55 percent of boys are enrolled in primary school. This discrepancy drastically widens when the children reach secondary school, where a mere 36 percent of girls attend class.

Gender discrimination issues are largely responsible for the nation’s discrepancy in educated girls. Societal norms generally instill in girls the notion that marriage is the utmost priority, often in lieu of a substantial educational background. Financial problems contribute to this when poor families cannot afford to send all of their children to school. In most of these cases, parents choose to enroll their sons over their daughters with the belief that doing so will prove to be the most fruitful option for all parties involved: the girls will stay home and learn how to become good homemakers and wives, while the boys will eventually enter the workforce prepared to secure a well-paying job that will ensure their financial stability and allow them to take care of their aging parents.

Issues arising out of India’s social class system further hamper the nation’s ability to provide equal education for its students. Much like gender discrimination separates girls from boys and allows each group disparate opportunities, caste and class differences strip children of equal educational access. Child labor in certain regions further aggravates this problem.

Insufficient funds and a rapidly growing population are additional factors that contribute to India’s persistent education problems. Public funds simply cannot cover education costs for every child, and schools across the nation regularly experience major shortages of school supplies, teachers and essential facilities. Low retention rates are a serious issue in regard to both students and teachers, an issue that most strongly affects the nation’s rural areas. With a single upper-primary school established for every three primary schools, even those children who manage to complete their primary school education cannot necessarily advance to the next level due to a sheer lack of available space. A related contributing factor is a general lack of quality ranging from educational curricula to school management to teacher training, an obstacle that shortages of classrooms, supplies and staff further exacerbate.

Despite improvements in literacy rates and primary school enrollment over the past few decades, India’s education system remains plagued by specific and significant shortcomings that must be met with serious attention. Young girls in marginalized social and economic groups are especially disadvantaged by the current system as the children most likely to leave school permanently at an early age.

– Shenel Ozisik

Sources: Foundation for Sustainable Development, UNICEF
Photo: Flickr

Possible Health Works for World’s Poor

Possible Health is a “for-impact” healthcare organization based in Accham, Nepal. It seeks to provide low-cost, high-quality health care to the world’s poorest people. It addresses the challenge of rebuilding the public sector health system to ultimately benefit the patient. Since starting in 2008, Possible has treated over 222,000 people. In the first quarter of 2014, Possible treated over 16,000 people, spending about an average of $20.22 per patient.

Possible functions as a partnership between the government of Nepal and the nonprofit to create a healthcare that guarantees the highest standard of treatment to the poor who cannot afford to pay for it. They use what they call a “hub and spoke” model, which allows patients to receive treatment in any of these four ways: through government hospitals, clinics, community members or referral care depending on what treatments are necessary.

For instance, Possible operates out of Bayalpata Hospital in Accham. Around the Bayalpata Hospital, they have established several clinics so that patients who live further have access to great clinical treatment closer to their homes. Trained Nepali staff are established as community members and sent out to patients’ homes to provide check-ups and follow-ups. Those whose conditions are more complicated, and who are unable to be treated by Bayalpata and its clinics are referred to other urban hospitals that have the means to do so—and those costs are fully crowdfunded so that finances are not an issue for the sick when it comes to treatment.

Choosing Accham, Nepal to pilot their program was both a strategic choice as well as jumping on an opportunity to take on a challenge. Back in 2008, when Possible was starting, Accham was one of the poorest regions in the world, where each person made less than an adjusted $0.39 USD per day, far below the world poverty line of $1.25.

And yet, despite its war-torn history and low economic performance, the constitution of Nepal held one of the most progressive and impressive health care stances in the world: the right to universal healthcare—even for the poorest among them all. The government of Nepal has invited Possible to partner with them in creating a new model of health care.

As a team, Possible loves the challenge of defying the impossible. In this case, the job was to create a healthcare model that is sustainable and effective even after providing services to the very poor.

Their strategy is groundbreaking: they identify best attributes of each sector and amplify that into their own design, which they call “durable healthcare,” that will reach the poor. For instance, the private sector is usually too expensive while the public sector is often known to provide poor-qualify services. Then there is philanthropy that comes up with innovative solutions, yet rather expensive and difficult to scale.

However, each sector does have its own forte. The government has existing infrastructure such as hospitals that can deliver effective health care. The private sector holds a standard of healthcare that everyone should receive. And philanthropy can help finance the costs!

Because Possible considers itself a for-impact, and not a for-profit, organization, they are not concerned with revenues. The only financial matter that they are concerned with replacing the costs of the services. This is done through donations and partnerships.

Possible’s motto is, “We make healthcare possible in the world’s most impossible places.” As they continue to succeed in Nepal, perhaps they will replicate it in the other impossible places of the world.

– Christina Cho

Sources: Center for Health Market Innovations, Possible: Health
Photo: Quartz

ICRW Fights for Gender Equality

In the developing world, one in three girls is married before age 18, and over 200,000 women die each year from pregnancy-related causes. In Sub-Saharan Africa, women account for approximately 60 percent of HIV infections, despite making up just over half of the population.

The International Center for Research on Women, or ICRW, a Washington, D.C.-based global research institute and registered nonprofit, has been working for nearly 40 years to combat statistics like these.

Founded in 1976, the ICRW conducts empirical studies intended to measure the obstacles that hinder women in the developing world from reaching their full potential. The ICRW then recommends policy priorities and designs “evidence-based plans” for donors, program designers and policy makers that enable needy women to lead happier, healthier lives.

The ICRW focuses its research on several main areas related to women’s empowerment. The first of these areas centers on issues that begin in adolescence.

Specifically, the ICRW conducts research on child marriage, education, work, healthcare and relationships. By identifying ways to make the attitudes and options of adolescent boys and girls more equitable, the ICRW hopes to empower women to take better control of their own futures.

The ICRW also focuses its research on how disparity between men and women affects agricultural productivity and food security in developing nations; women’s economic empowerment, employment opportunities and property rights; reproductive health and fertility control; HIV contraction, stigma and discrimination; and domestic violence issues.

In the four decades since its inception, the ICRW’s research has been instrumental in bringing about meaningful change in the lives of women in need. Its research efforts have, among other accomplishments, guided the passage of a 2005 law in India working to combat domestic violence, increased the availability of microfinance loans available to women in developing nations and helped integrate women’s empowerment and gender equality into the Millennium Development Goals.

With new regional offices in Kenya and India, the ICRW continues to conduct relevant research aimed to produce “a path of action that honors women’s human rights, ensures gender equality and creates the conditions in which all women can thrive.”

– Katrina Beedy

Sources: International Center for Research on Women, Coalition for Adolescent Girls
Photo: Flickr