By Jonathan Power
July 28, 2010
We live in exciting times. I am not talking about the advances of medicine, science and engineering. Nor the growth of the internet, the mobile phone and the fact that Africa is the world’s fastest growing market for the latter. Nor…..I could go on.
I’m talking about the dramatic drop in child mortality, the birth rate and the death rate in the poorest countries – a drop that appears to be accelerating. It is expected that more up-to-date figures to be published in a few years, will show an even more dramatic fall. Give thanks to all the energy and sweat that has been poured into the problem by local governments, the Bush administration’s program to fight AIDS and malaria, such organisations as the Bill and Linda Gates foundation, the Global Fund for AIDS, Tuberculosis and Malaria, and countless smaller but effective NGOs.
Today we have a preview of that. Only reported in one of the major Indian newspapers, the Times of India, the Indian census office published this week its latest results on these indicators, based on an India-wide sample of 7 million. These statistics are more up-to-date than the above. There has been a 14% country-wide decline in the annual birth rate. In eight major states it was much more. In the bread basket of Punjab it was almost a quarter. In West Bengal and Kerala, where communist governments have been in office for decades, it was nearly 20%. The drop in death rates was also astonishing – in the desert state of Rajasthan there was almost a quarter drop. And Bihar, the poorest of the large states, had a drop of 22%. West Bengal, Kerala and Rajasthan have the lowest rates.
Contraception is one explanation. So is better sanitation, life saving drugs and, as in West Bengal, an increase in rural incomes. In West Bengal rural incomes are now high enough to severely cut down migration into Kolkata. In Kerala high education levels are another instrument of success, especially that of young girls- a policy that produces dramatic results wherever it is tried.
The infant mortality rate is one of half a dozen indicators that give a picture of a society’s well-being and one more accurate than GNP alone. Kerala has the best rate. The southern state of Tamil Nadu has slashed its infant mortality rate by an incredible 42%; West Bengal by 34% and Maharashtra (in which the city of Mumbai dwarfs everything else in the state) by 33%.
In a recent report UNICEF noted that the Millennium Goals, which most countries have signed up to, commits the UN membership to cut the rate of infant mortality in Third World countries by two thirds by 2015. The progress over the last decade suggests this is an achievable target except in sub-Saharan Africa where progress is slow, but accelerating too, as many economies are achieving GNP growth rates of 7% or more and would have done even better of it hadn’t been for the Great Recession.
Measles infections falling by 60% has been one of the Third World’s successes. So has the effort to resist the advertising and clever marketing of companies like Nestle to get mothers to use “sophisticated” bottle feeding instead of breast feeding.
The Dominican Republic, Vietnam and Morocco are the world pace setters and have cut infant mortality rates by one third. This beats the Indian average but is on a par with the leading Indian states. Madagascar shows what can be done with a bit of extra effort. It has cut its rate of infant mortality by 41%. India, for one, with much more knowhow and medical infrastructure at hand, should seek to emulate this.
To keep up the pace, all countries need more mosquito nets, more Vitamin A drops, more breast feeding, more inoculations, more testing for malaria and an increased use of vaccines. When the last citizens of Nigeria were vaccinated against polio two years ago the World Health Organisation announced that the world was polio free, just as happened with an earlier campaign against smallpox.
The Great Recession didn’t do as much damage to Third World countries as had been feared. This is because most of its banks hadn’t overextended themselves as Western banks did. So in principle all these countries and regions could do much better if priorities were re-ordered – for example smaller defence budgets, and more rural and poor urban area health clinics than large city hospitals.
Come to West Bengal – on average the best all round Indian performer – where I am at the moment. If all the words spouted by politicians every day in their often petty arguments were channelled into the energy needed to enhance children’s programs the state would soon have the best infant mortality rate in the Third World. That would make a truly exciting result.
