A Little Good News Concerning the World’s Poor

Stephen DeAngelis

October 12, 2010

With the effects of the Great Recession continuing to cling unmercifully to many economies around the world, it might surprise you to learn that there is some good news to be found about the improving lot of the world’s poor. The first bit of good news is that the percentage of people suffering from hunger around the world is forecast to drop for the first time in 15 years [“U.N.: World Hunger to Fall 9.6% in 2010,” by Scott Kilman, Wall Street Journal, 13 September 2010]. Kilman reports:

“The United Nations’ Food and Agriculture Organization in Rome estimated Tuesday that the number of hungry people in the world will drop 9.6% this year to 925 million, the first decline in 15 years. The FAO, which annually gauges the level of global hunger, said an improving economic climate in many developing countries is allowing millions of poor people to afford to eat better than they did last year. In 2009, the global recession and shock waves from the 2007-2008 grain-price boom combined to push up the number of hungry to 1.023 billion, the FAO calculates.”

There is one caveat to the this report, “the FAO’s estimate doesn’t take into account the resurgence in grain prices since early July, when a stubborn drought began to destroy Russian wheat fields and other crops throughout the Black Sea region.” Kilman reports that the price of U.S. wheat grown has more than doubled over the past year. Corn prices have also risen dramatically. Fortunately, “FAO officials and many economists doubt that the rise in grain prices this summer is enough to trigger another food crisis of the sort seen two years ago, when many nations limited their exports as food riots and street protests erupted in dozens of countries.” Kilman continues:

“World wheat supplies are far higher today, thanks to record global harvests in 2008 and 2009. At the same time, prices of most major crops are far lower than their 2008 peaks. Still, grain traders expect crop prices to remain volatile for months, partly because a budding weather pattern might threaten crops in parts of South America. Hedge funds have taken huge positions in futures contracts for commodities such as corn, betting prices will rise.”

Although a falling percentage of hungry people is something to celebrate, the fact remains that a huge number of people still suffer from malnutrition. Kilman explains:

“While the number of hungry people across the globe is falling, the number is still so big that 16% of the population in developing countries is malnourished. A child dies of a hunger-related malady every six seconds, the FAO said. While Asia has the highest number of hungry people this year at 578 million, the region with the highest prevalence of hunger is sub-Saharan Africa, where the 239 million people counted as malnourished this year represents 30% of its population. Economists say it is highly unlikely that the world powers can accomplish their Millennium Development Goal of cutting the proportion of the population in developing countries who are undernourished to 10% by 2015, from 20% in the early 1990s. A study released by the U.S. Agriculture Department in July predicted that the number of malnourished people in 70 of the hungriest countries will decline 1% over the next decade. The department expects food security gains in Asia and Latin America to be offset by worsening hunger in sub-Saharan Africa. According to the USDA forecast, the number of food-insecure people in sub-Saharan Africa by 2020 could climb to 500 million, or half of the region’s projected population. The USDA defines a food-insecure person as someone eating less than 2,100 calories a day.”

Although the rate of improvement in reducing hunger around the world may be slower than desired, the United Nations predicts that more dramatic improvements should occur in poverty rates [“U.N. foresees dramatic cuts in poverty,” by Mary Beth Sheridan, Washington Post, 21 September 2010]. Sheridan reports:

“A decade ago, world leaders at the United Nations signed off on eight goals aimed at transforming the lives of the world’s least fortunate – including cutting extreme poverty in half by 2015. Many Americans were skeptical; in a poll, only 8 percent thought that was possible. This week, as nations gather to assess the goals, the United Nations countered the skeptics with an announcement: The world is actually on track to halve the percentage of people on the lowest rung of the economic ladder. Even with the brutal global recession, the ranks of the world’s desperately poor are likely to shrink to 15 percent of the population by 2015, less than half of the original 42 percent, said a recent U.N. report. The World Bank, in a separate analysis, said the objective appears ‘well within reach.'”

As with the hunger rate, however, the UN has issued a word of caution. Sheridan explains:

“Despite the achievement, not everyone is celebrating. Because of the economic crisis and jumps in food and fuel prices, ‘the momentum has been derailed’ toward even deeper cuts in poverty, Dominique Strauss-Kahn, of the International Monetary Fund, said … at the opening session of a summit on the Millennium Development Goals, as the U.N. benchmarks are known. Several of the original eight goals will probably not be met, including slashing the maternal and child mortality rate worldwide. Moreover, the progress on poverty comes with caveats: The absolute number of poor will shrink less than the percentage figure, because of population growth. Many note that the decline in poverty is due in large part to changes in a few big countries – in particular, China. Still, development experts say that there are numerous underreported success stories in other countries, even in Africa. While the economic growth drove the reductions in poverty, the ambitious U.N. goals prompted a greater flow of international aid, and got some poor countries to adopt better policies, experts say.”

The fact that real progress has been made is still significant. “Nine African nations have already succeeded in halving their rate of extreme poverty since 1990, the baseline for the U.N. targets.” This progress is important because we are talking about those living in extreme poverty. Sheridan continues:

“The U.N. goals are aimed at the dirt-poor … people living on less than $1 a day (later raised to $1.25 to reflect inflation). Many of them live in mud huts and shanty towns, with little access to flush toilets, medicine or high school.”

Sheridan then asks the big question: “How have so many people managed to get out of poverty?” She continues:

“China, with 1.3 billion people, has had the biggest impact. About 60 percent of its massive population lived in extreme poverty in 1990; because of pro-market overhauls, that figure had plummeted to 16 percent by 2005, according to U.N. figures. Excluding China, the percentage of people worldwide in extreme poverty is still projected to drop from about 35 percent to 18 percent in 2015, according to the World Bank. ‘There are a lot of very large countries in terms of population that have had dramatic reductions in poverty,’ said Benjamin Leo, a researcher at the Center for Global Development. He cited Brazil, Pakistan, Vietnam and Bangladesh as examples. While growth is the most critical ingredient in lowering poverty, other factors have mattered too – like remittances, improved governance, international aid and social spending.”

Unfortunately, Sheridan notes, “The relatively bright picture on poverty reduction doesn’t extend to sub-Saharan Africa, which fared the worst of all regions.” She continues:

“Analysts say development there has been stalled by conflicts in big countries like Sudan and the Democratic Republic of the Congo, as well as environmental devastation. Africa’s poverty rate fell from 58 percent in 1996 to 50 percent in 2005, according to the World Bank. But because of population growth, the absolute number of poor grew from 296 million to 388 million. In other words, the poor were a smaller slice of the pie, but the pie got bigger. Still, analysts say, there are notable examples of improvement in the continent. Consider Ethiopia, which became the symbol of African suffering during the 1984 famine. The level of extreme poverty there has dropped from 60 percent to 39 percent.”

Closely tied to hunger and poverty is poor health. My colleague Tom Barnett and his wife recently adopted two sisters from Ethiopia. He reports “when we got them they had: 1) bronchitis 2) ear infections 3) giardia 4) hepatitis A, and 4) tapeworms. And people wonder why your average kid in Africa might not summon up all the mental strength required to score as high as their northern brethren on IQ tests. Well, if you spent that much of your body’s energy every day fighting that array of stuff, you’d have less power to your brain too. It’s as simple as that. I have to tell you, these are two tough little kids.” Fortunately, there are strides being made on the health front as well. For example, Sheridan noted that one of the Millennium Development Goals was “slashing the maternal and child mortality rate worldwide.” Significant progress in that area has been made [“Maternal Deaths Decline Sharply Across the Globe,” by Denise Grady, New York Times, 13 April 2010]. Grady reports:

“For the first time in decades, researchers are reporting a significant drop worldwide in the number of women dying each year from pregnancy and childbirth, to about 342,900 in 2008 from 526,300 in 1980. The findings, published in the medical journal The Lancet, challenge the prevailing view of maternal mortality as an intractable problem that has defied every effort to solve it. ‘The overall message, for the first time in a generation, is one of persistent and welcome progress,’ the journal’s editor, Dr. Richard Horton, wrote in a comment accompanying the article. … The study cited a number of reasons for the improvement: lower pregnancy rates in some countries; higher income, which improves nutrition and access to health care; more education for women; and the increasing availability of ‘skilled attendants’ — people with some medical training — to help women give birth. Improvements in large countries like India and China helped to drive down the overall death rates.”

Interestingly, “some advocates for women’s health tried to pressure The Lancet into delaying publication of the new findings, fearing that good news would detract from the urgency of their cause.” Obviously those advocates don’t believe that success breeds more success. Grady continues:

“Dr. Horton said the advocates, whom he declined to name, wanted the new information held and released only after certain meetings about maternal and child health had already taken place. … ‘People who have spent many years committed to the issue of maternal health were understandably worried that these figures could divert attention from an issue that they care passionately about,’ Dr. Horton said. ‘But my feeling is that they are misguided in their view that this would be damaging. My view is that actually these numbers help their cause, not hinder it.’ He said the new study was based on more and better data, and more sophisticated statistical methods than were used in a previous analysis by a different research team that estimated more deaths, 535,900 in 2005.”

Grady reports that progress has unfortunately been uneven around the globe. She explains:

“Among poor countries with longstanding high death rates, progress varied considerably. For instance, from 1990 to 2008, the maternal death rate dropped 8.8 percent a year in the Maldives, but rose 5.5 percent in Zimbabwe. Sub-Saharan Africa has the highest maternal death rates. Brazil improved more than Mexico, Egypt more than Turkey. Six countries accounted for more than half of all the maternal deaths in 2008: India, Nigeria, Pakistan, Afghanistan, Ethiopia and the Democratic Republic of Congo. But India has made steady progress, and because its population is so large, its improvements have helped considerably to decrease the worldwide rate of maternal deaths. China has also made considerable progress. In India, there were 408 to 1,080 maternal deaths per 100,000 live births in 1980, and by 2008, there were 154 to 395, the new study found. In China, there were 144 to 187 deaths per 100,000 live births in 1980, and 35 to 46 in 2008. Dr. Murray said the findings came as a surprise. What also surprised him and his colleagues, he said, was the number of pregnant women who died from AIDS: about 60,000. ‘Really to a large extent that’s why maternal mortality is rising in eastern and southern Africa,’ Dr. Murray said. ‘It means, to us, that if you want to tackle maternal mortality in those regions, you need to pay attention to the management of H.I.V. in pregnant women. It’s not about emergency obstetrical care, but about access to antiretrovirals.’ Dr. Horton contended that the new data should encourage politicians to spend more on pregnancy-related health matters. The data dispelled the belief that the statistics had been stuck in one dismal place for decades, he said. So money allocated to women’s health is actually accomplishing something, he said, and governments are not throwing good money after bad.”

Another area where progress in the area of health has been made is the fight against malaria. The concern has been that progress could be wiped out as drugs that have been used to treat the disease become ineffective. The good news is that a new drug may have been found [“New Malaria Drug Candidate Holds Promise,” by Gautam Naik, Wall Street Journal, 3 September 2010]. Naik reports:

“An international team of scientists has identified a promising drug candidate that represents an entirely new class of medicines to treat malaria, one of the biggest killers in the developing world. The new drug was shown to be effective when tested in a small number of mice, according to a study appearing in the journal Science. Human trials, backed by Swiss pharmaceutical giant Novartis AG, could begin later this year. The discovery comes amid two key developments in the fight against the mosquito-borne illness. Several parts of Africa are showing a decline in malaria deaths, thanks to wider use of insecticides and bed nets to ward off mosquitoes that carry the disease, as well as use of artemisinin, a potent drug. At the same time, there are worrying signs that the malaria parasite in parts of Southeast Asia is becoming resistant to artemisinin, which is the mainstay of combination therapy for as many as 100 million patients world-wide. Resistance has already rendered some older therapies less effective.”

To read more about efforts to fight malaria, read my posts entitled Malaria Fighting Mosquitoes, New Malaria Initiative Launched, The Rise of “Creative Capitalism”: Tackling Malaria, Some Updates on Global Healthcare, and Healthcare in the Developing World. Naik continues:

“‘We welcome a new class of drug because it could help us stay one step ahead of the parasite,’ said Robert Newman, director of the global malaria program at the World Health Organization, who wasn’t involved in the Science study. However, he cautioned, ‘it’s a long route to making the drug marketable … many drugs fall by the wayside.’ The malaria parasite can cause fever, joint pain and death. Last year, there were an estimated 240 million cases of malaria. Of total deaths, 91% occurred in Africa and 85% were children under the age of five, according to the WHO. But the battle against malaria is making progress, and a potent new drug could help sustain the momentum. In 2009, malaria deaths world-wide fell to 836,000 from more than one million a few years earlier, including declines in Eritrea, Rwanda, Zambia and Zanzibar. Over the past decade, malaria cases have fallen in nine countries in Africa and in 29 elsewhere.”

Naik explains more about how the new class of drug differs from those used in the past.

“Most anti-malaria compounds being tested today are derivatives of existing drugs. Many common medicines treat malaria by essentially making the parasite’s blood meal toxic. For other medicines, the mechanism is more of a mystery, said Thierry Diagana, co-author of the Science study and malaria program head at the Novartis Institute of Tropical Diseases in Singapore. Finding a drug that can kill malaria in a new way is hard. When malarial parasites infect people, they spend part of their life cycle in the blood and part of it in the liver. In 2007, Elizabeth Winzeler of the Scripps Research Institute in La Jolla, Calif., who also works for Novartis, used robots to screen 12,000 naturally occurring chemicals against plasmodium falciparum, the deadliest malaria parasite. The chemicals were supplied by Novartis, which leads a big effort to develop drugs for tropical diseases. Dr. Winzeler and colleagues at Novartis and elsewhere came up with NITD609, a compound that killed two species of parasites in their blood stage and also proved effective against drug-resistant strains. The drug, a class of compounds known as spiroindolones, was then tested in mice. A mouse with malaria usually dies within a week. But when NITD609 was orally given to five infected mice, they were cured with no side effects. Other mouse tests also showed promising results. ‘The next step would be to go into humans’ for early-stage safety testing, said Dr. Winzeler. ‘As far as I can tell, there are no red flags.’ … What makes the discovery unusual is that it harks back to an older way of finding novel drugs. The modern, ‘molecular’ approach is to first identify a protein vital to the survival of the malaria parasite, and then screen various drugs until one is found that targets the protein. In the past few years, this approach has been tried on millions of compounds against malaria, with modest success. The more traditional way is to bombard the entire parasite with various chemical compounds, and see what happens. The hitch is that even if a particular compound is effective, no one knows exactly how it worked. That uncertainty can make it harder to develop the drug for people. Still, Dr. Winzeler opted for the traditional approach, which yielded a pre-clinical candidate in three years—quick by industry standards. She and her co-authors then figured out that the compound acted on a protein called PfATP4, which allows substances to cross cell membranes. No other malaria drug acts on this protein, though its exact mechanism has yet to be pinned down.”

Clearly, the good news reported above must be tempered by the enormous challenges that remain ahead. Progress, however, is progress. If you are not moving forward, you are probably falling behind. With the world’s population continuing to grow, falling behind in the fight against poverty would only exacerbate the situation. Undoubtedly, the world is facing donor fatigue — especially with the results of the recession tenaciously lingering on. Now, however, is not the time to either give up the fight or fail to press forward. Progress may slow as donations falter, but if progress can be maintained the fight against poverty will proceed much more rapidly when flush times return. The posts the remainder of this week will continue to look at the situation in Africa and the goals to help reduce poverty, eliminate hunger, and improve health around the globe.