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.
Questions 1-3 Using information
from Reading Passage 1, complete the diagram below. Use
NO MORE THAN THREE WORDS for each answer. Write your answers in boxes 1-3 on
your Answer Sheet.