PHA-Exchange> THE IRAQ+MIDDLE E CONFLICTS AND HLTH+DEV IN AFRICA

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From: <pambazuka-news at pambazuka.org>

THE IRAQ WAR, MIDDLE EAST CONFLICT, HEALTH AND DEVELOPMENT IN AFRICA
Akintola Odutola, Nigeria ( chpss_abo at yahoo.com )
(Excerpt)

Here are some predictions for health  and development in many African
countries as war in the Middle East
progresses and the Iraq post-war period unfolds:

1. Given the present high dependency of most Africa countries on
bilateral and multi-lateral donor funding for population, nutrition and
health (PNH) activities, many may well kiss these activities goodbye
unless they willfully undertake a major paradigm shift and target more
internal resources towards the promotion of their PNH activities. The
alternative saving grace (assuming external dependency is considered
inevitable) would be for the EU, Japan and other non-U.S donors to step
in and fill inevitable funding shortfalls.

2. In the ensuing five or more years, African countries should expect
more pressure to remove subsidies on social goods, devalue national
currencies and promote more privatization of water, power, education
and health. These standard structural adjustment policies recently
repackaged as Poverty Reduction Strategy Programmes (PRSP), have been
shown to worsen rather than uplift health, education and development
indices generally in Africa.

3. Given American anxiety about rising costs of the war and with
massive reconstruction estimates running from $20 billion per year for
the first several years to $600 billion over a decade, it is no
surprise that the World Bank and the IMF have been conveniently charged
with managing war and rebuilding funds. African countries should
(regardless of their economic problems) expect to contribute
willy-nilly in paying for the Iraq war and for post-war reconstruction.

4. Among the many specific consequences of adjustment policies, World
Bank/IMF funds management duties and diversion of humanitarian
assistance funds to rebuild Iraq, Africa should expect:
a) The prevalence of AIDS and AIDS-related diseases to increase as the
poverty index worsens and the external funds which now drive prevention
activities and access to anti-retroviral treatment declines.
b) Subsidy on socially-marketed condoms to be removed at source or its
level reduced and free condom distribution to be constrained, resulting
in condom scarcity and increase in open market pricing beyond the reach
of the "common man". Prior gains in family planning and control of
sexually transmitted diseases including HIV/AIDS would suffer setbacks.
c) Further drop in immunization coverage with worsening infant and
childhood mortality/morbidity as donor funding for free or subsidized
distribution of childhood vaccines reduces.
d) Poverty-induced girl trafficking and prostitution to rise as poverty
worsens locally and the externally-funded micro-credit and other women
empowerment projects get less funding. Mainstreaming women into the
development agenda of most African countries will likely suffer
setbacks.
e) Worsening unemployment rate especially in the pool of
non-governmental organisations in health, development and human rights
activities as most of these organisations and their projects are  largely
dependent on external donor funding.
f) More aggravated drain in health manpower to developed nations with
consequential reduction in the local manpower pool for services
delivery.

The litany of adverse consequences is long, but some challenging
policy-related questions beg to be asked. Must health and development
in Africa be inevitably worse off in the ensuing years as a result of
conflict in the Middle East? Is there a silver-lining for Africa in the
conflict? Necessity is said to be the mother of invention and the war
may well present African countries with a forced opportunity to reform
their high dependency on donor funds from the North. Such funds, rather
than supporting sector-wide reforms, drive health and development
assistance programs project-by-project. These projects are not always
coordinated with national health plans and policies. African countries
would do well to seize the opportunity to re-examine and publicly
redefine their respective national and geo-strategic interests,
restructure their resource mobilization and allocation process and look
more inwards for their health and development solutions.

Don't you think this appiies to other continents as well?
 Send your comments to editor at pambazuka.org