In most parts of the world, people are healthier and living longer, thanks to improved health services and living conditions and the more widespread use of immunization, antibiotics, and better contraceptives. Although this trend is likely to continue, hopes are fading in some regions where progress slowed or stopped in the 1990s, primarily as a result of the AIDS epidemic. Indeed, life expectancy in sub-Saharan Africa declined from 50 to 46 years between 1990 and 2001. Moreover, most regions of the developing world will not, at the current pace, reach the Millennium Development Goals for health by 2015—including reducing child and maternal mortality and combating HIV/AIDS, malaria, and other diseases. Here, we give a snapshot of changes in the world’s health and demographic conditions, and, in the following pages, four articles explore the importance of good health for economic development.
If developing countries face up to the realities of AIDS and act quickly, millions of lives can be saved. The following three articles on AIDS, written in 1998, look at the epidemic from an economic perspective and outline priorities for developing countries in preventing the spread of HIV and helping people already infected.
The AIDS epidemic is straining the limited resources of many developing country governments. How can governments provide support to those affected by AIDS without neglecting others in need or abandoning important development goals?
About 1.1 billion people worldwide smoke, and, with current trends, the number is expected to rise to more than 1.6 billion by 2025. In high-income countries, the number of smokers has, overall, been declining for decades, although it continues to rise in some population groups. In low- and middle-income countries, by contrast, cigarette consumption has been increasing.
Mr. Sanjeev Gupta, Mr. Benedict J. Clements, Maria Teresa Guin-Siu, and Mr. Luc E. Leruth
The Heavily Indebted Poor Countries (HIPC) Initiative, launched in 1996, was the first comprehensive effort by the international community to reduce the external debt of the world’s poorest countries. It went beyond earlier debt-relief initiatives in that it included debt from multilateral creditors like the IMF and the World Bank and placed debt relief within an overall framework of poverty reduction. Enhancements made to this Initiative in 1999 further strengthened the links among debt relief, poverty reduction, and social policies.
For the latest thinking on the international financial system, monetary policy, economic development, poverty reduction, and other critical ^1 issues, subscribe to Finance & Development, a quarterly magazine published by the IMF. Finance & Development brings you in-depth analyses of these and other subjects by the IMF’s own staff as well as by prominent international experts. Articles are written for nonspecialists who want to enrich their understanding of the workings of the global economy and the policies and activities of the IMF. Additional features are book reviews; profiles of prominent economists; and a regular column, “Back to Basics,” that explains key economic concepts. Finance & Development is read by policymakers, academics, economic practitioners, and decision makers around the world.
With just 12 years left to achieve the Millennium Development Goals (MDGs, see Box 1), a greater sense of urgency is needed by all sides if the targets are to be met. Many developing countries are making substantial progress toward the MDGs as a result of improved policies, better governance, and the productive use of development assistance. But they could do more with the right mix of policy reforms and additional help. Scaling up efforts to meet the MDGs by 2015 presents both opportunities and challenges. By acting now, developed countries can hasten progress by providing more and better aid and by allowing greater access to their markets. Developing countries, for their part, will need to continue to improve their policies and the way they are implemented. Without greater impetus, there is a serious risk that many countries will fall far short on many of the goals.
The past century has been marked by rapid advances in human welfare. People in most parts of the world are healthier and are living longer. While this trend is likely to continue, hopes are fading in some regions where progress slowed or stopped in the1990s, primarily as a result of the AIDS epidemic. This compilation of articles published over the past five years in the pages of F&D looks at the important links between health and economic progress. Articles range over a variety of topics, from the Millennium Development Goals and their health-related targets for 2015 to the economics of tobacco control. Several articles examine the impact of AIDS and the global reaction, while others look at debt and the intellectual property aspects of health care.
David E. Bloom, David Canning, and Dean T. Jamison
The last 150 years has witnessed a global transformation in human health that has led to people living longer, healthier, more productive lives. While having profound consequences for population size and structure, better health has also boosted rates of economic growth worldwide. Between the 16th century and the mid-19th century, average life expectancy around the world fluctuated but averaged under 40 years, with no upward trend. Life spans slowly but steadily increased in the second half of the 19th century and then jumped markedly in the 20th century, initially in Europe and then in the rest of the world (see table). Economic historians and demographers still debate the genesis of these changes, but they increasingly point to rising incomes (and resulting improvements in sanitation and food availability) as the major cause of declines in 19th-century mortality rates. For the 20th century, however, they believe technical improvements were the catalysts—particularly the discovery of the germ theory of disease, a better understanding of hygiene, and me development of antibiotics and vaccines.
AIDS is not just a health issue but a development problem that must be addressed at the global level, As countries increasingly recognize the need to incorporate strategies for tacking AIDS in their national policy frameworks, they are discovering important new weapons—notably national poverty reduction plans-that were not available even two years ago.