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EQUINET NEWSLETTER 62 profiles new information on STOPPING THE DRAIN OF AFRICA'S WEALTH: A BOTTOM LINE FOR AFRICA'S HEALTH
The April 2007 EQUINET newsletter on World Health Day highlights a new EQUINET report with Centre for Economic Justice in Southern Africa authored by Patrick Bond on the wealth flows out of Africa that can be found at http://www.equinetafrica.org/bibl/equinetpub.php
The newsletter editorial on the report is shown below.
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STOPPING THE DRAIN OF AFRICA'S WEALTH: A BOTTOM LINE FOR AFRICA'S HEALTH
EQUINET Steering Committee, April 2007
At this year's World Health Day the WHO will be launching its annual report which focuses on human resources for health. In Africa, as we have raised in previous editorials in this newsletter, we are experiencing a 'global conveyor belt' of health workers flowing from rural, primary health care level in the public sector to urban, private care; from poor to rich areas and countries in the region and from the continent, with its high health needs and under-resourced health services to developed, high income countries such as USA, Canada, UK and Australia. The loss of public investment and social resources in this outflow is significant and outweighs any returns in remittances or aid for education.
However health workers will certainly continue to go to where they can work in adequately resourced health services, in decent jobs and where they can secure their own family needs. This draws attention to the much wider question of how in Africa we secure the resources to retain and value our health workers, and more widely to meet our population health needs. The latest EQUINET discussion paper, written by Patrick Bond and produced jointly by EQUINET with the Centre for Economic Justice in southern Africa points to a South-North drain of African wealth that undermines the resources for health and development, and that increases our dependency on the global North, and our loss of health workers.
The 2005 Commission for Africa report leaves the impression of a continent receiving a vast inflow of aid, with rising foreign investment, sustainable debt payments and adequate remittances from the African diaspora to fund development. Our discussion paper tells a different story: of significant and dramatically rising flows of resources out of Africa northwards, draining the continent of the important resources needed to address its own development, including in health. The paper synthesizes data about the outflow of Africa's wealth, to reveal factors behind the continent's ongoing underdevelopment, as the basis for proposing policy measures to reverse these flows.
The statistics speak loudly of a continent being progressively dispossessed of its wealth, and thus the resources it needs to improve health and human development:
* A debt crisis with repayments in the 1980s and 1990s that were 4.2 times the original 1980 debt levels, and annual debt repayments equivalent to three times the inflow in loans and, in most African countries, far exceeding export earnings, leaving a net flow deficit of by 2000 of $6.2 billion. * Unequal exchange in trade and trade liberalisation policies that have lowered rather than increased Africa's industrial potential and exacted an estimated toll in sub-Saharan Africa of $272 billion over the past 20 years. * Flows of private African finance that have shifted from a net inflow during the 1970s, to gradual outflows during the 1980s, to substantial outflows during the 1990s. * Falling foreign direct investment (FDI) from roughly one third of FDI to third world countries in the 1970s to less than 5% by the 1990s, and a shift to highly risky speculative investment in stock and currency markets - with erratic and overall negative effects on African currencies and economies.
Africa is commonly and mistakenly represented as the (unworthy) recipient of a vast aid inflow. Aid flows in fact dropped 40% during the 1990s, and the phantom aid that flows back to the source countries in technical and administrative costs was estimated in one study to be $42 billion of the 2003 total official aid of $69 billion, leaving just $27 billion in 'real' aid to poor people.
There is also a perverse subsidy in the extent to which industrialised countries exploit the global stock of non renewable natural resources . This takes place through the extraction of minerals and natural resources from Africa by Northern investors with little investment in return and few royalties provided. It also takes place through use of global goods like the earth's clean air. Forests in the South absorbing carbon from the atmosphere are estimated for example to provide Northern polluters an annual subsidy of $75 billion. A method for measuring resource depletion used by the World Bank suggests that a country's potential GDP falls by 9% for every percentage point increase in a country's dependency on resource extraction. This implies, for example, that Gabon's people lost $2,241 each in 2000, based on oil company extraction of oil resources,
These outflows deplete the resources available for productive and human development. They are felt most heavily by women and poor communities, and undermine progress towards the achievement of human security for the majority of African people.
They imply that the first step to effect genuine growth and to deliver welfare and basic infrastructure is for African societies and policymakers to identify and prevent the vast and ongoing outflows of the continent's existing and potential wealth.
Current global reform agendas do not address these outflows. While they point to debt and unfair trade, they do not seek to reverse the outflow of African wealth.
Campaigns to reverse resource flows and challenge perverse subsidies are emerging from grassroots struggles and progressive social movements, such as those in Africa that are resisting privatisation and commodification of basic services, pressuring for rights to generic anti-retroviral medicines and resisting encroachments on human development through trade and macroeconomic policies that intensify inequities.
These grassroots struggles can be consolidated by national governments and regional co-operation to improve disclosure of financial flows and apply policies within Africa to prevent the outflows and encourage the 'stay' of domestic investment resources. The paper points to some options - systemic default on debt repayments, strategies to enforce domestic reinvestment of pension, insurance and other institutional funds; national-scale regulation of financial transfers from offshore tax havens; clearer identification and renegotiation of tied or phantom aid; and improved calculation and negotiation around of the costs of FDI (not simply the benefits), including natural resource depletion, transfer pricing and profit/dividend outflows.
EQUINET welcomes the focus on this year's World Health Day on one area through which Africa is bleeding- its loss of human resources. We would however urge that to deal with this effectively in the continent, and address the inequity globally in the resources needed for health and human development goals, we need to deepen the debate. In 1998 EQUINET highlighted that a critical dimension of equity is the power and ability people have to make choices over health inputs and their capacity to use these choices towards health. For Africa this must surely include bringing control over the resources for health and development back within the continent.
Please send feedback or queries on the issues raised in this briefing to the EQUINET secretariat at TARSC, email admin at equinetafrica.org . EQUINET work on economic policy and health is available at the EQUINET website at www.equinetafrica.org
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