Addressing inequalities is not a choice – it’s a moral and practical necessity
A moral necessity that speaks directly to our conscience… our sense of fairness and justice… our conviction that all people must have a fair opportunity to live full, healthy lives, no matter where they live, no matter what barriers they face. That is their right and a practical necessity, because a focus on equity in our work saves more lives, is more cost-effective, spurs economic growth and is an important means of ‘getting to zero’ in preventable deaths, malnutrition and denial of basic services.
As 2015 approaches, there is much to celebrate, as the Crown Princess noted: reduced poverty rates… increased school enrolment… more children surviving beyond their fifth birthdays… better access to clean water… and more people lifted by growing economies, powered by innovation and inclusion.
But national statistical successes mask the reality that among and within countries, progress remains uneven… inequitable… and often, deeply unfair.
A 2010 UNICEF analysis showed that in 18 out of 26 countries where the national child mortality rate had declined by 10%, the gap between the rates in the richest and poorest quintiles had either grown or remained unchanged.
When we disaggregate the data… when we zero in on communities and families… we move beyond the tyranny of statistical averages and confront the progress we must make for those being left behind.
For the children in the poorest households, who are nearly three times as likely to be underweight… twice as likely to be stunted… and twice as likely to die before their fifth birthdays as those in the richest households. For people living with disabilities, searching for meaningful work, and finding only the cold shoulder of discrimination. For a girl denied an education. For a woman not getting the emergency obstetric care or the nutrition she needs because she lives in an isolated or neglected community.
For indigenous and minority ethnic groups denied the same access to fertile land and water as their neighbours. For families struggling to stay intact in conflict zones or disaster-prone regions.
How can we secure a better future for all people if we fail to address the needs and rights of these people… those left behind in the march of progress… those still entangled by socially entrenched prejudices about how they live… or who they love?
Or if we continue failing women and girls? Michelle will speak about gender equality in more detail. Let me just say that it is deeply unjust to deny generations of women the chance to reach their potential, and deny societies the opportunity to benefit from their contributions. This we must end.
Or if too many countries and families are not prepared to withstand, and recover from, natural disasters, periods of conflict or economic crises?
Or if economies fail to sustain long-term jobs and decent incomes for all people?
Or if we fail to educate not only girls, but also children with disabilities and children from minority ethnic groups, concentrated among the poorest households, most isolated communities and in urban slums? Not only for the sake of children with disabilities, but for the sake of the other children in their classrooms – and for the sake of the societies to which they can contribute.
Or if we fail to address climate change? The most vulnerable pay the highest price as glaciers melt, seas rise and coasts recede, and as food, energy and water become more scarce and expensive as a result.
Or if we ignore the clear links between inequalities and social and political unrest, and violence?
This is not, of course, only about poor countries. In fact, 70% of the world’s poorest people – up to one billion people – can be found in middle-income countries. And an excellent editorial by Joseph Stiglitz on January 19th in the New York Times reminded Americans and, indeed, all wealthy nations, of the inequities that are holding back economic recovery efforts there.
First, because it is cost-effective to do so in our programmes. In the race to achieve the MDGs, many countries and many development agencies have naturally focused on those children, families and communities that are the easiest to reach – the ‘low-hanging fruit.’
Helping the neglected, excluded and under-served is, by definition, ‘harder’, and may be more expensive, at least in the short term.
But a UNICEF analysis has found that working in the most disadvantaged communities, focusing on the hardest-to-reach children, yields the most cost-effective results. The additional results usually outweigh the additional efforts and costs. An extensive modelling exercise showed that in the poorest countries with the highest burden of under-five mortality, a pro-equity approach could save up to 60% more children per dollar than through our current approach. In other words, when we invest in equity – and equitably in people – we get better, more cost-effective results for our investment.
Scaling-up immunisations is a good example. Two studies by Johns Hopkins Bloomberg School of Public Health show that if we scaled up the use of existing vaccines in 72 of the poorest countries, we could save 6.4 million lives, and avert US$6.2 billion in treatment costs and US$145 billion in productivity losses over the next decade. This, necessarily, would include a focus on getting vaccines to those who are not now covered – almost 20% of the world’s population. The ‘fifth child’… the forgotten children. Indeed, polio is now making its last stand in some of the hardest to reach places in the world, where many of these children live.
Which leads me to the second reason why equity is right in practice – because it spurs long-term, sustainable growth. Highly unequal societies grow more slowly and erratically than more equal ones.
These divisions set in motion a downward spiral. Stagnant growth means lower demand for goods and services – which means fewer jobs to go around – which means lower household income – which means too many people struggling to survive. This weighs down productivity and progress for everyone.
But we can take inspiration from countries that have invested in their social programmes, and are enjoying significant economic growth.
A report by the UN Economic Commission for Latin America and the Caribbean addresses why poverty in that region has fallen dramatically over the last two decades. A major reason is better, more equal education, which leads to higher wages, greater spending and trade.
Investments in disadvantaged families also helped the region withstand the global recession. The ILO and WHO found that those countries which invested in their social protection floors, before the global crisis, weathered it better than those that failed to do so.
About 12% of Bangladesh’s public spending goes towards social programmes like cash transfers, food for work and direct feeding. The result? In the last 20 years, life expectancy has risen by a full decade among men and women, rich and poor alike. Infant, child and maternal mortality are plummeting. All this, and the country’s GDP has grown by more than 5% annually. We see similar gains in Cambodia, China and Brazil, all with the same conclusion – equity and economic growth go hand-in-hand.
What about investing in nutrition? The World Bank estimates that improving basic nutrition can boost a poor country’s GDP by two to 3% annually.
Education? According to the Global Partnership for Education, potential lifetime income can increase by as much as 10% with each additional year of schooling – for girls and boys alike.
Many of us have argued that, on principle, the benefits of economic growth should go towards strengthening the social protection floor. But many countries around the world are showing us that the obverse is also true – that investing in equity spurs economic growth. Recognising this, the Asian Development Bank has announced a renewed focus on tackling inequality by increasing loans for health and education.
In other words – to paraphrase President Kennedy’s inaugural address – we should be asking not only what growth will do for equity… but also what equity will do for growth. Because equity transforms that social protection floor into an escalator of growth… for people… for communities… and for entire economies and societies.
It also promotes truly sustainable development. A 2011 staff study by Andrew Berg and Jonathan Ostry of the IMF found that, globally, a 10% decrease in inequality increases the expected length of an economic growth period by 50%. As the Secretary-General made clear in an editorial last year, sustainable development ‘can offer what economists call a ‘triple bottom line’ – job-rich economic growth coupled with environmental protection and social inclusion.’ A pro-equity approach can help us move towards these interlocking goals.
Which is why addressing inequities must be embedded throughout the post-2015 development agenda. The agenda should inspire every society to look beyond national averages, and commit to the rights of every person, female and male, young and old – no matter where they live – to have the same opportunity to live a healthy, fulfilling life.
To enable their citizens to hold leaders and decision-makers accountable for doing so.
And to reverse the downward spiral of inequality in so much of the world – instead creating an upward spiral of inclusive growth and human development.
Doing so is right in principle – and right in practice. Not just as a choice – but as a pragmatic, global imperative.”
This Article is taken from Anthony Lake’s speech to the Global Consultation on Addressing Inequalities in the Post-2015 Development Agenda in COPENHAGEN, 19 February 2013.