Women carry children as they wait to see a nurse at a pop-up Marie Stopes clinic in Niger's village of Libore.
(photo credit: REUTERS/TIM COCKS)
For some years now, there has been a rough understanding within the international community that security and population health are interrelated. Governments have made significant investments in this area. While US president George W. Bush’s path-breaking PEPFAR initiative to assist those with HIV/AIDS certainly had a humanitarian element, it was also rooted in a desire to help stabilize certain African countries to promote economic development. Foundations including that run by Bill and Melinda Gates have also taken large and meaningful steps to help eliminate debilitating diseases and promote access to health care.
So, while it seems intuitive that sustainable development and security are interdependent with good health, and large institutions have acted on this insight, not all development approaches include the component of health. If a society is not focused on improving health indicators and creating a stable and accessible health care system, development efforts will not last. Sustainable development rests on social development – literacy and education, effective governance and good health. Without these, all the capital investment in the world will not catalyze sustained development.
It’s this “third leg” of the social development triangle – health – that must become an even more important focus of international community efforts. As noted, foundations and governments have poured billions into preventing diseases, seeking cures and strengthening health systems. Through these efforts, incredible historic achievements have eradicated or nearly eradicated scourges that have ravaged humanity for millennia, including smallpox, rinderpest, polio and Guinea worm disease (dracuncaliasis).
These terrible diseases not only cause untold suffering; they also reduce productivity and prosperity. Where there is little access to health care, people both contract and suffer more from illness. With less work comes less opportunity, less income, and entrenched poverty.
Illness and disease can destabilize entire economic and social systems, undermining the security necessary for investment.
Infectious diseases can be particularly devastating in this regard. The world witnessed just how damaging such diseases can be with the 2014 West Africa Ebola outbreak.
While the number of Ebola deaths was terrible, it was much lower than many predicted. On the other hand, the economic damage was much higher than anyone anticipated. The World Bank estimates that Liberia, Sierra Leone and Guinea – the three worst hit countries – lost 12% of their combined GDP. There could also be permanent losses, such as the cancellation of mining projects in Liberia. Because of border closures and quarantines, economic activity was harmed across Africa. It also disrupted, to a much smaller degree, countries outside Africa that reacted to the outbreak with restrictive trade and travel measures.
The evidence is clear: disease and illness undermine economic, social and political security.
The basic elements of decent health care are well known. While efforts on other fronts should continue, development NGOs and others should integrate into their methodologies and promote these basic elements. Implementation is not always easy, especially in areas wracked by conflict and with weak governance structures. But they are within reach with assistance from the international community:
Basic hygiene and infection control: sanitation, hand washing and other basic hygiene are all keys to disease prevention. They, in turn, require access to potable water, effective human waste disposal and treatment and simple education in proper hygiene techniques. This can all be achieved with relatively minimal investment and by relying on community-based programs to implement the interventions.
Traditional Diets: the tragic irony of industrialized food production and distribution is that unimaginable abundance can coexist with lack of nutrition and chronic illness. In Mexico, Guatemala, Kenya and other countries around the world, ready access to relatively cheap processed foods is quickly replicating the obesity found in the US and other developed nations. Cardiovascular illness, diabetes and other chronic – and expensive – diseases quickly follow. The communities experiencing these diet and health problems often have access to fresh produce and other traditional foods. NGOs can work with community groups to rediscover non- or minimally-processed foods and reinforce the nutritional superiority of traditional diets as a basic preventive health measure.
Services: hundreds of millions of people still lack access to the most basic health services, including dental and eye care. It has been demonstrated time and again that such care can be provided at relatively low cost, often with the assistance of volunteer community members. Basic yet comprehensive primary health care is the best way to help prevent debilitating disease, infections and illness. Models of such care in even the most remote areas of the world have been established and demonstrate their return on investment in terms of health outcomes, productivity and higher incomes.
Health, development, security and stability tend to advance and improve together. This is one of the main lessons of post-war success in Europe and elsewhere. In a globalized world in which disease crosses borders on a regular basis and conflict threatens new and frightening levels of destruction and suffering, we all have an interest in the type of development that results in a healthier and more secure and stable world. As always, more resources is part of the answer. So is a heightened focus on the basics of good health and integrating that into development goals and methodologies.The author is president and CEO of World Neighbors, a global development group with offices in Oklahoma City, Oklahoma, and Washington, DC. Prior to joining World Neighbors, she was a senior program officer at American International Health Alliance (AIHA), where for 14 years she managed health partnerships throughout Eurasia and Central and Eastern Europe.