Australia and the World: Healthy, Wealthy and Unwise

At 48 I am always happy to hear that 50 is the new 40, and that the dreaded baby boomers, to whom I belong, are refusing not only to grow old gracefully but to grow old at all.

We owe this remarkable increase in our ability to live longer, while looking and feeling younger, to the explosion of medical knowledge that has enhanced the lives of those of us lucky enough to live in the West. And I’m not talking about extremes, like plastic surgery, but simply about our ability to cure and forestall all sorts of diseases that might have killed us in the past.

I owe my own life and that of my daughters to medical science. When 34 weeks pregnant with my first child, my waters began to leak, and I had to spend a week in hospital. An infection developed in the ‘liquor’ as they called it, meaning I had to be induced at 35 weeks. A century previously, if I had developed such a condition, I likely would have developed an infection in the uterus (the leaking waters allowing bacteria to enter the womb) and both my daughter and I would have died – rather nastily, I presume. Indeed, I have often wondered if the supposed increase in cancer amongst people in the developed world is simply because we are not dying of other things. In other words, we are now living long enough to get it.

Unfortunately, as we all know, the same is not true for most of the world’s population. Outside of Europe, Australia, New Zealand, Canada and the US, I daresay women with conditions such as mine, and their unborn babies, are still dying simply for want of the medical treatment I could access so easily.

But we do things about that, don’t we? There was the wave of generosity that followed the tsunami and we are about to give a sizeable sum to the victims of Hurricane Katrina. Many of us give money to overseas aid organizations and do things like sponsor kids in disadvantaged countries. Pop stars run big concerts to feed the hungry, and movie stars make much-publicised jaunts to unpleasant places to publicise their plight. Some of them (Brad Pitt) even return with more than they bargained for, like a nasty dose of meningitis. Even better, in Monday’s Sydney Morning Herald (12/9/05) our government announced that it would be increasing the amount of overseas aid it provides.

However, before we all rush off and celebrate our government’s uncharacteristic generosity, it might be worth unpacking what we actually mean when we talk about overseas aid.

According to a recent editorial in the Medical Journal of Australia (1/8/05) an increase is not before time. Australia’s Overseas Development Assistance (ODA) has been declining steadily since the 1970s. It is now down to 0.28% of GNI (Gross National Income) from a high in 75-76 of 0.45%. Given that our government, and any economic expert you care to name, love to crow long and loud about what a kick-arse economy we’ve got, this seems pretty pathetic. Other developed countries, including many less successful than us, continue to give an average of 0.42%.

Worse, the current paranoia about terrorism seems to have infected our aid budget. According to the editorial ‘a notable trend in Australia’s latest aid budget is the increased focus on governance, which now attracts 36% of ODA, squeezing out other commitments.’ And almost half of that 36% now goes to law and justice, particularly to the Australian Department of Defence and the Australian Federal Police for their activities overseas. Which seems to mean we’re giving a large percentage of our overseas Aid budget to ourselves!

Indonesia, Papua New Guinea and the Solomon Islands get the lion’s share of our ODA, with our commitment to the poorest continent on earth, Africa, down to just 3%. The editorial states that as little as 0.05% of Australia’s GNI now goes to the world’s least developed countries, one of the lowest rates of all OECD countries. And, to the considerable dismay of the authors of the editorial, while 36% is going to law and order only 12% goes to health.

Our commitment to HIV/AIDs has increased, but the money we give to support non-HIV/AIDs services has declined, and in some cases sharply. Laos, Cambodia and Vietnam no longer receive AusAID funds for health at all. If I was a 34-week pregnant woman with leaking waters in a village in Cambodia, I wonder how my child and I might fare? People, particularly pregnant women and children, are dying for want of often simple and inexpensive medical care, but it seems we are too obsessed with the possibility of Islamic terrorism to pay a blind bit of notice.

Yet, this is so short sighted. Generosity by the West, by rich countries like Australia, particularly in the areas of health and education, will do more to help our long-term security than all the Australian Federal Police in the world. Rather than decreasing the aid we give to our poorer neighbours (both near and far) we should be increasing it exponentially. Perhaps Anthony Zwi, Natalie Grove and Maria-Theresa Ho, the authors of the MJA editorial, put it best:

‘Increasing commitment to health and education will reinforce governance and security, but this is not why they should be supported. Health and education should attract funds because we care about other people, because we have a commitment to promoting human security in the region, and because we find it unacceptable that women die in childbirth because of lack of health services, that preventable diseases kill so many children before the age of 5, and that infectious and non-communicable diseases are decimating economies.’

The trouble is, under our current government, I am beginning to wonder whether we really do care about any of these things at all.

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