The infant death rate for African Americans in Washington DC is higher than that in the cities of the Indian state of Kerala, the United Nations has warned as part of a damning review of poverty and inequality around the world.Published ahead of next week’s summit in New York to review progress in meeting goals to halve extreme poverty by 2015, the UN’s human development report says: “US health indicators are far below those that might be expected on the basis of national wealth.”The report, published by the United Nations Development Programme, says the outcome is due partly to “persistent” and “extreme” disparities between people from different social and ethnic groups, as shown by recent images of poor black people stranded in New Orleans by Hurricane Katrina.The findings reflect a new focus by the UN upon differences within countries as well as between countries, as policymakers try to think of new ways to achieve the millennium development goals (MDGs), agreed in 2000. “Inequality matters because it is a fundamental issue for human development,” the report asserts. “Deep disparities based on wealth, region, gender and ethnicity are bad for growth, bad for democracy and bad for social cohesion.”“Unless there is a change of gear in human development”, it warns, “almost all of the goals will be missed by most countries . . . some of them by epic margins.”But debate over how best to inject the goals with new impetus has been marred by a squabble with the US over what targets were agreed in 2000.On current trends, the world will achieve a two-thirds reduction in child deaths only by 2045: 30years later than called for in the MDGs. That gap amounts to a huge, unnecessary, loss of life, the UNDP says. “It translates into an additional 4.4 million child deaths in 2015, above those that would occur if the MDG target were achieved.”Even India and China, which have both enjoyed sustained economic growth, face worrying challenges. “There are worrying indications that social progress is starting to lag behind economic performance, with the slowdown in the rate of reduction in child deaths’ a special concern.”The UN notes that China spends 5 per cent of its GDP on health, but public spending now amounts to less than 2 per cent of GDP. “In effect, health financing has been privatised.”The erosion of public funding, it says, has resulted in a “mismatch between need and provision”,with per capita spending in urban areas 3.5 times that in rural areas.Between 70 and 80 per cent of the rural population have no health insurance. Children living in the poorest parts of rural China face far greater health risks, and the gap is widening. The mortality rate for under five year olds ranges from 8 per 1,000 in Beijing (comparable to the US), to 60 in the poorest parts of Guizhou (comparable to Namibia).India also comes in for criticism. “Improvements in child and infant mortality are slowing, and India is now off track for these MDG targets.” Against a backdrop of inadequate public provision of healthcare, the report warns that girls between the ages of one and five are 50 per cent more likely to die than boys.
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