Month: November 2003

World Bank Report Warns of Impending Central & Eastern European AIDS Crises

The World Bank released a report in September highlighting the increasing rate of HIV infection in Central and Eastern Europe, and warned that if governments there do not do more to deal with the problem, it could turn into a catastrophe for that part of the world.

The World Bank estimates that 1.2 million people in Central and Eastern Europe are currently infected with HIV, and that number is growing by as much as 25 percent annually. About a quarter million people in the region, for example, were infected with HIV in 2002. The total number of people infected with HIV in Central and Eastern Europe is expected to rise to 8 million by the end of the decade.

The World Bank warned that if that infection rate is not curtailed, it could have serious widespread effects. In a press release, the World Bank said,

An uncontrolled HIV/AIDS epidemic could have devastating consequences on health and development in ECA, the report warns. If the HIV epidemic becomes widespread among the working age groups in the region, annual economic growth rates could decline by 0.5 to 1.0 percent. The effects of this drop will be compounded by rising health expenditures, which could increase by 1-3 percent, with substantial impacts on the health budgets of poorer countries in the region. Furthermore, the dependency ratio (the ratio of non-economically active to economically active people) could rise, which would severely strain social protection systems.

Despite such warnings, some country’s in the region aren’t doing much to combat the AIDS epidemic. For example, Russia’s total spending on AIDS is less than 1 percent that of Great Britain, even though Russia has 20 times as many HIV infected individuals than Great Britain. Five hundred people a month die from AIDS-related causes in Russia, with that number projected to increase to as much as 20,000 per month by 2020.

Sources:

Europe’s looming Aids ‘catastrophe’. David Bamford, The BBC, September 16, 2003.

HIV / AIDS Epidemic in the ECA Region. World Bank, September 2003.

Averting AIDS Crises in Europe and Central Asia. Press Release, World Bank, September 16, 2003.

Russia Enacts Limit on Abortion

In September, Russia enacted its first restriction on abortion in almost 50 years.

The new law limits the circumstances under which women can have an abortion between the 12th and 22nd week of gestation. Prior the law, there were a wide variety of circumstances under which women could legitimately seek abortions during that period, but now there are only four. According to the BBC they are,

  • rape
  • imprisonment
  • death or severe disability of husband
  • court ruling stripping woman of parental rights

According to official Russian statistics, only about 7 percent of women who have abortions in that country have them between the 12th and 22nd week of pregnancy but some abortion supporters claim that official statistics only record about half the abortions that take place.

Official statistics show a sharp decline in the number of abortions since the collapse of the Soviet Union. From a high of 4.6 million abortions in 1988, the total fell to 1.78 million in 2002.

Abortion supporters in Russia fear that this is simply the first step in policies that will become ever more restrictive of abortions in that country. Russian Family Planning Association director Ingra Grebesheva told the BBC, “The resolution is the first steps toward an attack on the rights of women.”

Some Russian health officials, however, characterize the move as an effort to reduce health problems related to the extraordinarily high rate of abortion that occurred during the Soviet era. A spokesman for the Russian Health Ministry told the Christian Science Monitor,

Artificial termination of pregnancy after week 12 is fraught with grave consequences for a woman’s health. Abortions account for 30 percent of maternal mortality in Russia. It has been decided to reduce these dangers.

Source:

Russia turns spotlight on abortion. The BBC, September 16, 2003

Russia begins to reconsider wide use of abortion. Fred Weir, Christian Science Monitor, August 28, 2003.

Ethiopia and the International Monetary Fund at Loggerheads Over Privatization

Ethiopian officials complained in September about International Monetary Fund requirements that it privatize several industries in order to receive further IMF aid. Ethiopia formally rejected IMF requirements that it privatize state-run telecommunications, power and water utilities.

The IMF agreed on a $190 million loan to Ethiopia in 2002 to reduce poverty in that country, and provided it with an emergency loan of $14.3 million in August 2003 to combat the effects of drought.

In a press release announcing the August loan, IMF Deputy Managing Director and Acting Chairman Shigemitsu Sugisaki said of Ethiopia’s economic performance,

Recent economic performance has been seriously affected by a severe drought in 2002, the worst in many years. As a result of the drought and a sharp drop in cereal production, real GDP declined in 2002/03, and food prices rose markedly. An estimated 12.6 million people are in need of food assistance.

Despite this shock, Ethiopia’s performance during the second annual program was broadly satisfactory. All the quantitative performance criteria and benchmarks through December 2002, as well as the indicative targets for end-March 2003, were observed. In particular, the introduction of the value-added tax was carried out in January 2003, a performance contract was signed with the Commercial Bank of Ethiopia (CBE) in June 2002, and an audit of the CBE by independent auditors was completed in May 2003, after a delay of four months. The ongoing decentralization of fiscal powers to woredas (local districts), however, contributed to delays in the implementation of structural benchmarks (and HIPC Initiative completion point triggers) related to the improvement of public expenditure management.

Ethiopia apparently wants to retain a controlling interest in any utilities that it privatizes, even though at the moment the state industries represent a drain on Ethiopia’s budget.

Meanwhile, the World Bank and IMF plan to send representatives to Ethiopia by the end of November to evaluate Ethiopia’s progress in making structural changes that it agreed to in order to receive the 2002 loan.

Sources:

Ethiopia hits out at IMF. The BBC, September 1, 2003.

Ethiopia rejects IMF proposal to privatize loss-making state firms. Agence-France Press, August 31, 2003.

IMF to send experts to review EthiopiaÂ’s achievements. Tamiru Geda, CapitalEthiopia.Com, September 29, 2003.

IMF Completes Review Under Ethiopia’s PRGF Arrangement and Approves US$14.3 Million Disbursement. Press Release, International Monetary Fund, August 28, 2003.

Does UNFPA Indirectly Support Coerced Abortions?

Last July the U.S. House of Representatives voted 216-211 to deny funding to the United Nations Pouplation Fund on the grounds that its activities indirectly support China’s coercive one child policy.

In September the pro-abortion Catholices for a Free Choice sent nine investigators to China to investigate such charges. In its report, Cathlics for a Free Choice argues that coercive policies in China have declined in recent years and, in any event, the UNFPA criticizes such policies and does not actively assist them.

Yet the report also concedes that, at a minimum, China continues its highly coercive tax on those who violate its population goals. Specifiically, couples who have more than their allotted quota of children may be assessed a special tax equivalent to as much as three years’ worth of income.

Catholics for a Free Choice says that this tax is “mischaracterized” by anti-abortion groups and, besides, sometimes it isn’t even enforced!

The bottom line here is quite simple — China engages in coercive reproductive policies. Sending money to support family planning efforts there makes about as much sense as sending money to support physics programs in North Korea. By sending funds for non-coercive family planning, the United Nations Population Fund indirectly subsidizes China’s coerceive family planning efforts.

China should not receive a single cent of U.S. taxpayers money until it has renounced and abandoned coercive family planning methods.

Source:

Religious leaders visit China to investigate claims against UNFPA. U.N. Wire, September 4, 2003.

Survival Rates in the British NHS vs. U.S. Hospitals

There is some support in the United States for “solving” America’s health care problems with a state-run health system like Canada and European countries have. Fortunately, although there might be a lot of support for a generic health care system like this, such support tends to vanish when people start seeing the details (e.g. HillaryCare).

British paper The Telegraph had a story back in September about a study comparing the performance of the UK’s National Health Service with that of the United State’s mishmash of private, semi-private and public system of hospitals. The difference was quite striking,

Patients who have major operations on the National Health Service are four times more likely to die than Americans undergoing such surgery, according to a new study.

. . .

The results showed that just under 10 per cent of the British patients [in the study] died in hospital after major surgery, compared with 2.5 per cent of the American patients.

What would explain such a high difference in mortality? Are British surgeons and nurses less competent than Americans? Do Americans use technologies that the British don’t have access to?

Part of the difference in mortality rates is explained by a feature of most nationalized health care systems — the increased waiting period from diagnosis to surgery.

The joint study, carried out by University College London and a team from Columbia University in New York, found that patients in Britain who were most at risk of complications after major surgery were not being seen by specialists and were not reaching intensive care units in time too save them.

The other part is due to cost-cutting measures in Great Britain when it comes to post-op care. Quite simply, in the United States someone undergoing such an operation would be treated in post-op by another surgeon and an anesthesiologist, typically in a critical care unit.

Prof [Monty] Mythen . . . said: “In The Manhattan hospital, the care after surgery is delivered largely by a consultant surgeon and an anesthetist. We know from other research that more than one third of those who die after a major operation in Britain are not seen by a similar consultant.

“In America, everyone would go into a critical care bed — they go into a highly monitored environment. That doesn’t happen routinely in the UK.”

Which brings up my other pet peeve about nationalized health plans proposed for the United States. Advocates of such plans frequently blast HMOs for interfering with the doctor-patient relationship by dictating what doctors can and cannot offer their patients. But a nationalized health system would simply substitute a single entity — the federal health agency — for the various HMOs. Call it the mother of all HMOs.

The trend in countries that have nationalized health care is not some utopian health care system where doctors get to treat patients regardless of cost. Rather it is a system where health care is explicitly rationed by state and/or national health care agencies and health care decisions are completely subsumed to the need to control costs.

Source:

US surgery safer than under NHS. Thair Shaikh, Telegraph (UK), September 7, 2003.

Swaziland Government Demonstrates Its Support of Free Speech

About 2,000 protesters turned out to highlight the lack of democracy in Swaziland in August. Swaziland was being visited at the time by heads of state as part of an international conference on sustainable development.

Swaziland made the protesters’ point for them by using what the BBC described as “heavily armed paramilitary police and soldiers [who] fired tear gas canisters and rubber bullets to disperse” the crowd.

Of course the sustainable development conference included such stalwart supporters of democracy as Zimbabwe’s Robert Mugabe — perhaps Mugabe was taking notes on Swaziland’s technique for later application back home.

Source:

Swazi protesters and police clash. The BBC, August 13, 2003.