The Third Freedom

Date: Tue, 5 Feb 2002 15:39:09 -0500 (EST)

Dear All,

In a State of the Union address 61 years ago, Franklin D. Roosevelt proclaimed the "four essential human freedoms": the freedoms of speech and expression, of religion, from want, and from fear.
Since September 11, freedom has moved to the front of the national agenda. In his State of the Union address last week, President Bush said, "History has called America and our allies to action, and it is both our responsibility and our privilege to fight freedom's fight." And so it is. But President Roosevelt's third freedom, the freedom from want, seems to have disappeared from the quest for freedom upon which the Administration has embarked. The President declared, "we will see freedom's victory," but with an incomplete vision of freedom, for vast numbers of people, freedom will lose.
As with the so-called war on terrorism, only a global coalition can secure the third freedom. Governments of poor countries, even if committed to their people, will be sharply limited in their ability to lift their people from disease and despair to health and hope without the assistance of financial and other resources from wealthy nations. But even with these resources, change will be slow in coming in countries whose governments are not committed to improving the well-being of their people. Everyone has a role to play. Sadly, our country is failing in its responsibilities.
Freedom will lose if the United States does not dramatically increase its spending on the global HIV/AIDS crisis. A recent study from the London School of Hygiene and Tropical Medicine found that it will cost about $13-15 billion per year above current spending to rapidly scale up national responses to the HIV/AIDS pandemic. This figure does not include funding for a host of activities that should be part of the response to HIV/AIDS -- funding for orphans, for general education, for nutrition, for families impoverished by AIDS, and more. Yet this year, the United States is spending only $435 million on global HIV/AIDS.
The United States has pledged $100 million for the new Global Fund to Fight AIDS, Tuberculosis, and Malaria for fiscal year 2001, $200 million for 2002, and the budget that the President is presenting Congress proposes an additional $200 million for 2003. U.N. Secretary-General Kofi Annan has called for $7-10 billion per year for the Fund. Given the U.S. share of the global economy, we should be contributing $2.5-3.0 billion to the Global Fund.
Freedom will lose if the United States does not dramatically increase its spending on global health more generally. A December 2001 report commissioned for the World Health Organization (available at http://www.cid.harvard.edu/cidcmh/CMHReport.pdf) found that with greater spending on health by both rich and poor countries, millions of lives could be saved every year. If poorer countries increase their health spending within their means -- an additional $35 billion per year by 2007 and $63 billion by 2015 -- and wealthy nations were to contribute an additional $22 billion per year by 2007 and $31 billion per year by 2015 (current annual donor assistance for the health sector is about $6 billion), at least 8 million lives will be saved every year by the end of this decade.
Given the prevalence of easily preventable and treatable diseases, it is not surprisingly that for a sum of money wealthy nations could easily afford -- their yearly economic production is about $25 trillion -- so many lives could be saved. The report asserts that the economic gains from these lives saved would be $186 billion per year, and possibly much more. Yet even when investments in human health and human life actually pay for themselves several times over in even the most basic economic terms, we do not act (nor do governments of most poor countries).
Freedom will lose if the world does not make every effort to achieve its stated commitments to reducing poverty and many of its manifestations. In 1996, the Organization for Economic Cooperation and Development (OECD), which consists of most of the world's industrialized nations, including the United States, set forth six development goals for 2015. These included halving the proportion of people in absolute poverty and achieving universal primary education in all countries by 2015. The United Nations Millennium Declaration endorsed these goals. Yet last week, a declaration issued in advance of a U.N. conference in March found "dramatic shortfalls in resources required to achieve the internationally agreed development goals." (See Monterrey Consensus, http://www.un.org/esa/ffd/aac257-32.htm)
This is no wonder, for wealthy nations do not seem to have allowed these goals to influence their behavior. The OECD counties allocated about the same funds to official development assistance in 1999 as in 1996, despite economic growth. (See http://www.oecd.org/xls/M00002000/M00002883.xls) U.S. development assistance is now at its lowest level, as a proportion of our economy, since World War II. (See NY Times, Jan. 29 2002) Meanwhile, many poor countries continue to spend significant portions of their budgets on servicing their debts to international creditors, and trade barriers continue to discriminate against poor countries.
Kofi Annan and a top British official, Gordon Brown, have called on wealthy nations to increase their official development assistance by $50 billion per year, which could be enough to achieve the 2015 goals. (See Washington Post, Dec. 17, 2001, and NY Times, Jan. 29, 2002) This figure is still significantly below the 0.7% gross national product (GNP) target that the United Nations set in a 1970 General Assembly resolution.
Last week, the United States rejected even the more modest $50 billion increase in official development assistance. (See NY Times, Jan. 29, 2002) The Administration asserted that poor countries should better use the aid they are receiving. No one denies that corruption, poor governance and other impediments often make aid less than optimally effective -- though in the context of international programs, aid for health programs is less affected by these obstacles than other forms of aid. (See http://www.cid.harvard.edu/cidcmh/CMHReport.pdf) Aid can and should focus more on building the capacity of states to govern effectively and reduce corruption, as well as on human development (such as education and health), rather than on large development projects of questionable utility. Monitoring and evaluating the use of aid can help ensure its proper use. Aid can be targeted to countries where good policies and safeguards against corruption make it most likely that it will be well spent. Some countries have achieved considerable successes with aid.
In short, the obstacles are not insurmountable. Yet while the Administration is asking us to invest billions more dollars to develop smart bombs -- which were necessary but not sufficient for freedom in Afghanistan -- they do not seem interested in investing in smart aid, which is necessary, though not sufficient, for the freedom of literally billions of people.
It is particularly unfortunate that this Administration does not make freedom from want a priority. For Americans do. A poll last October found 59 percent of respondents considered reducing AIDS and other infections diseases a top priority for U.S. foreign policy. (Available through http://www.kaisernetwork.org/health_poll/hpoll_search.cfm) Polls generally show that Americans believe we should be spending about 5-10 percent of the federal budget on foreign aid; we spend less than 1 percent. (See http://www.bergen.com/editorials/aid20011219.htm.)
What to do? Let me suggest three activities. First, you can fill the gap at least a tiny bit by contributing to funds available for microcredit. Microcredit consists of small loans to poor people, often women, who could not otherwise access capital because ordinary banks or money-lenders would only lend to them at exorbitant rates or not at all. Microcredit can be an important part of a comprehensive strategy to combat poverty. There is a free donation website at http://www.povertyfighters.com/.
Second, keep the issue alive. I think we can make progress by reminding ourselves and others of the grave importance of issues that do not often make the news. Several months ago, I saw a posting in a public forum asking bluntly, how can our prosperous nation allow people to be homeless? The freedom from want is wanting at home as well as abroad. Direct questions like that one remove us from thinking within the constraints of our current policies, and can help us see things for what they are, expanding the realm of the possible. Talk to people about poverty.
Third, write, fax, call, or e-mail the President or your Congresspeople. (You should probably use e-mail for Congress only as a last resort. A study last year by the New York Times indicated that Congesspeople do not give much weight to e-mail messages, and many go unread. (See NY Times, Dec. 13, 2001)) Contact information for your Senators and Representatives is available at http://www.visi.com/juan/congress/, and for President Bush at http://www.whitehouse.gov/contact/. Ask them to support increasing foreign aid to the U.N. target of 0.7% GNP, or at the least, to support AIDS funding at the levels suggested above, and to join other wealthy nations in increasing development assistance by $50 billion. And remind President Bush, who seems to have made freedom a personal crusade, of President Roosevelt's third freedom, the freedom from want. Remind him that people afflicted with disease and poverty are not free. If he does not recognize this, then his presidency will not be one of freedom's victory, but of freedom's deadly postponement.
Thank you for your time and patience in reading this message.

Peace,

Eric


"I have only dreams: to build a better world, a world of harmony and understanding, a world in which it is a joy to live. This is not asking for too much." -- Yitzhak Rabin

"Don't say the day will come. Bring the day! Because it's not a dream." -- Shir LaShalom, Song for Peace




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