From Poverty to Power Green, Oxfam 2008 - weman

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HIV, AIDS, AND OTHER HEALTH RISKSPrudence Mabele is a party animal. Scrambling onto the stage at aJohannesburg jazz club, her long dreadlocks carve through the air asshe dances. Earlier she’d hustled a table in a crowded restaurant and afree concert ticket for a friend. She never stops networking, but usuallydirects her boundless energy to more lofty ends. She runs PositiveWomen’s Network, a South African NGO that helps women livingwith HIV to lead full and active lives. Prudence has been HIV-positivefor the past 17 years.However, Prudence faces an uphill task in a country where anestimated 1,000 people die every day from AIDS, and HIV infectionrates are still rising due to a combination of poverty, stigma, migration,illiteracy, and mixed messages from a deeply divided government.The health of poor people is subject to daily attrition from dirtywater, malnourishment, and a lack of basic health services. At thehousehold level, illness can be a ‘shock’that sends a family into a spiral ofimpoverishment. Bouts of sickness, especially in childhood, can havelife-long impacts in terms of chronic ill health, stunting, and pooreducational performance. The best guarantor of security against suchharrowing experiences is a functioning health service – a form ofmedical social protection, discussed more fully in Part 2. When healthshocks occur at the societal level, in the form of a disease epidemic,they can set development efforts back decades. From at least the time231
FROM POVERTY TO POWERof the Black Death, such health shocks frequently take the form of newdiseases that lay waste to entire populations.The latest of these is AIDS, which initially seemed to be buckingthe trend, attacking health in the rich countries. But soon the basiclink between poor health and inequality reasserted itself, as thehuman immunodeficiency virus (HIV) spread rapidly across theworld, affecting poor and vulnerable people, particularly in sub-Saharan Africa and particularly women. Other new diseases, such asavian influenza or severe acute respiratory syndrome (SARS), many ofthem ‘zoonotic’ (originating in animals, then passing to humans) alsothreaten to trigger an HIV-style pandemic, while long-standingmaladies such as tuberculosis, malaria, bilharzia, Chaga’s disease, andsleeping sickness continue to take an enormous toll on individuals,families, and societies.In societies where HIV prevalence is high, every aspect ofthe struggle against poverty and inequality, from production toorganisation to daily relations, has been transformed by HIV andAIDS. Taking action now can prevent millions of deaths in the future,as the example of Brazil shows (see page 235). Given that there is notyet a medical cure for AIDS (although there is treatment that stopsshort of a cure), reducing poor people’s vulnerability involves lookingat the social and economic context of their lives to find out whatmakes them vulnerable, and taking steps to remedy these sources ofrisk. ‘It’s not the disease that kills, but the lack of other resources –poverty, dirty water, food’, says a nurse at an HIV centre in SouthAfrica. 52The stigma attached to HIV and AIDS makes the disease far harderto bear. When people living with AIDS in northern Thailand weresurveyed, researchers expected them to say that access to antiretroviraldrugs (ARVs) was their main worry but, instead, ending discriminationagainst HIV-positive people was their number one concern.The first cases of HIV and AIDS were discovered in 1981 in theUSA, the Democratic Republic of the Congo, and East Africa. By 1985cases were reported in every region of the world. In 25 years thedisease has spread to virtually every country, with 65 million peopleinfected with HIV and 25 million deaths from AIDS. In 2005, therewere 38.6 million people worldwide living with HIV and AIDS:232
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OXFAM INTERNATIONALOxfam Internatio
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First published by Oxfam Internatio
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PART 4 RISK AND VULNERABILITY 197Li
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LIST OF ACRONYMSAIDSARTARVASEANAUCA
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ACKNOWLEDGEMENTSThe word ‘editor
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FOREWORDGeorge Bernard Shaw argued
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FOREWORDThis book, which I hope wil
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PART ONE
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1 INTRODUCTION THE UNEQUAL WORLDEnd
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1 INTRODUCTION THE UNEQUAL WORLDExt
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1 INTRODUCTION THE UNEQUAL WORLDPOV
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1 INTRODUCTION THE UNEQUAL WORLDSuc
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1 INTRODUCTION THE UNEQUAL WORLDACT
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1 INTRODUCTION THE UNEQUAL WORLDpeo
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1 INTRODUCTION THE UNEQUAL WORLDcom
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PART TWOThe political roots of deve
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2 POWER AND POLITICS THE POLITICAL
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2 POWER AND POLITICS THE POLITICAL
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I HAVE RIGHTS, THEREFORE I AMThe hi
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2 POWER AND POLITICS I HAVE RIGHTS,
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FROM POVERTY TO POWERThe attitudes
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FROM POVERTY TO POWERJain: ‘A man
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FROM POVERTY TO POWERI READ, THEREF
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FROM POVERTY TO POWEREven where pub
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FROM POVERTY TO POWERplayed a pivot
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FROM POVERTY TO POWERDespite some p
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FROM POVERTY TO POWERof sub-Saharan
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FROM POVERTY TO POWERIn water servi
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FROM POVERTY TO POWERI SURF, THEREF
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FROM POVERTY TO POWERDespite the hy
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FROM POVERTY TO POWERresearch effor
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FROM POVERTY TO POWERWE ORGANISE, T
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FROM POVERTY TO POWERreinforce disc
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FROM POVERTY TO POWERThe bedrock of
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FROM POVERTY TO POWERwith imperviou
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FROM POVERTY TO POWERgovernments an
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FROM POVERTY TO POWERCASE STUDYand
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FROM POVERTY TO POWERI OWN, THEREFO
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FROM POVERTY TO POWER‘breathe lif
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FROM POVERTY TO POWERLAND REFORM‘
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FROM POVERTY TO POWERled to the cou
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FROM POVERTY TO POWERthese things.
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FROM POVERTY TO POWERwhile Benin an
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FROM POVERTY TO POWERWhere flawed d
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FROM POVERTY TO POWERstarted to att
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FROM POVERTY TO POWERI STEAL, THERE
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FROM POVERTY TO POWERTHE CURSE OF W
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FROM POVERTY TO POWERI RULE, THEREF
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FROM POVERTY TO POWERthe turn of th
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FROM POVERTY TO POWERBOX 2.2ARE EFF
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FROM POVERTY TO POWER‘embedded au
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FROM POVERTY TO POWERIn the face of
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FROM POVERTY TO POWERcost incurred
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FROM POVERTY TO POWERIn the Horn of
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FROM POVERTY TO POWERFROM POVERTY T
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FROM POVERTY TO POWER106
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FROM POVERTY TO POWERAN ECONOMICS F
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FROM POVERTY TO POWERpicture it off
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FROM POVERTY TO POWERthe work of wo
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FROM POVERTY TO POWERWhile the envi
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FROM POVERTY TO POWERcan be broaden
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FROM POVERTY TO POWERbut are largel
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FROM POVERTY TO POWERaltogether. Ru
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FROM POVERTY TO POWERFIGURE 3.2: MO
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FROM POVERTY TO POWERin their relat
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FROM POVERTY TO POWERliving from lo
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FROM POVERTY TO POWERenvironments.
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FROM POVERTY TO POWERthem farming o
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FROM POVERTY TO POWERThe jury is al
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FROM POVERTY TO POWERor credit to i
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FROM POVERTY TO POWERplanned mill.
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FROM POVERTY TO POWERto begin with.
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FROM POVERTY TO POWERprogrammes (SA
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FROM POVERTY TO POWERfertilisers to
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FROM POVERTY TO POWERDomestic and r
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FROM POVERTY TO POWERHOW CHANGE HAP
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FROM POVERTY TO POWERTHE CHANGING W
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FROM POVERTY TO POWERThe nature of
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FROM POVERTY TO POWERNOBODY’S FOR
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FROM POVERTY TO POWERFordist mass p
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FROM POVERTY TO POWERand Palau have
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FROM POVERTY TO POWERA similar situ
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FROM POVERTY TO POWERMany unions ha
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FROM POVERTY TO POWERBOX 3.5INDIA
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FROM POVERTY TO POWERrather than di
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FROM POVERTY TO POWEROne trade agre
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FROM POVERTY TO POWERPRIVATE SECTOR
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FROM POVERTY TO POWERothers see the
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FROM POVERTY TO POWERlocal producer
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FROM POVERTY TO POWERWhile China’
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FROM POVERTY TO POWERcountries rock
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FROM POVERTY TO POWERLocal NGOs and
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Page 217 and 218: FROM POVERTY TO POWERInsecurity and
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Page 237 and 238: FROM POVERTY TO POWERFINANCE AND VU
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Page 243 and 244: FROM POVERTY TO POWERfirewood for s
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Page 257 and 258: FROM POVERTY TO POWERTherefore when
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Page 261 and 262: FROM POVERTY TO POWERgovernment to
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Page 265 and 266: FROM POVERTY TO POWERIn regions pro
Page 267 and 268: FROM POVERTY TO POWERThe key to suc
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Page 271 and 272: FROM POVERTY TO POWERdisaster-drive
Page 273 and 274: FROM POVERTY TO POWERIn enhancing h
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Page 277 and 278: FROM POVERTY TO POWERIn Africa’s
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Page 281 and 282: FROM POVERTY TO POWERcommunity and
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FROM POVERTY TO POWERreplaced the t
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FROM POVERTY TO POWERCourt, for exa
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FROM POVERTY TO POWERSHOCKS AND CHA
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FROM POVERTY TO POWERMajor changes
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FROM POVERTY TO POWERpassed from be
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FROM POVERTY TO POWERWHO RULES THE
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FROM POVERTY TO POWERPowerful state
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FROM POVERTY TO POWERThroughout the
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FROM POVERTY TO POWERinflationary p
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FROM POVERTY TO POWERWhen critics r
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FROM POVERTY TO POWERFund now both
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FROM POVERTY TO POWERbecome more pr
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FROM POVERTY TO POWERcrisis consist
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FROM POVERTY TO POWER- rather than
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FROM POVERTY TO POWERhis call the f
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FROM POVERTY TO POWER• Sudden inf
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FROM POVERTY TO POWERthe USA is cur
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FROM POVERTY TO POWERto reduce the
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THE INTERNATIONAL TRADING SYSTEMTRA
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FROM POVERTY TO POWERPatents: Intel
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FROM POVERTY TO POWERdumping on wor
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FROM POVERTY TO POWERMost alarming
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FROM POVERTY TO POWERprotectionism
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FROM POVERTY TO POWERThe vast major
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FROM POVERTY TO POWERPrices for som
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FROM POVERTY TO POWER• Establish
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FROM POVERTY TO POWERborder, or at
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FROM POVERTY TO POWERBOX 5.1MIGRANT
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FROM POVERTY TO POWERnumber of‘fr
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FROM POVERTY TO POWERFor example, q
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FROM POVERTY TO POWERMotivated by a
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FROM POVERTY TO POWERIn the Uruguay
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FROM POVERTY TO POWERlong-term deve
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FROM POVERTY TO POWERimportance in
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FROM POVERTY TO POWERUN Global Comp
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FROM POVERTY TO POWERThe drivers of
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FROM POVERTY TO POWERMore broadly,
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FROM POVERTY TO POWERWhatever the m
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FROM POVERTY TO POWERThe heightened
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FROM POVERTY TO POWERThe aid optimi
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FROM POVERTY TO POWERThe aid optimi
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FROM POVERTY TO POWERand 2006/07, f
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FROM POVERTY TO POWERgovernment dow
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FROM POVERTY TO POWERpractice, but
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FROM POVERTY TO POWERWithholding ai
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FROM POVERTY TO POWER1950s and 1960
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FROM POVERTY TO POWERchanged. Simil
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FROM POVERTY TO POWERremain in the
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FROM POVERTY TO POWERand the UN pro
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FROM POVERTY TO POWERA decade on, t
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FROM POVERTY TO POWERCASE STUDYFebr
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FROM POVERTY TO POWERTHE INTERNATIO
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FROM POVERTY TO POWERThe humanitari
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FROM POVERTY TO POWERThe wrong kind
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FROM POVERTY TO POWERlead agencies
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FROM POVERTY TO POWERgovernment in
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FROM POVERTY TO POWERThe only probl
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FROM POVERTY TO POWERopportunity is
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FROM POVERTY TO POWERREFUGEESPeople
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FROM POVERTY TO POWERWest African S
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FROM POVERTY TO POWERdrivers of con
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FROM POVERTY TO POWERCASE STUDYgrou
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FROM POVERTY TO POWERCLIMATE CHANGE
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FROM POVERTY TO POWERwithout heavy
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FROM POVERTY TO POWERunless the wor
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FROM POVERTY TO POWERcap the aspira
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FROM POVERTY TO POWERreduce the qua
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FROM POVERTY TO POWERThe CDM is bes
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FROM POVERTY TO POWERAccused variou
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FROM POVERTY TO POWERemissions by 8
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FROM POVERTY TO POWERBangladesh and
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FROM POVERTY TO POWERGLOBAL GOVERNA
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FROM POVERTY TO POWERNew Zealand wa
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FROM POVERTY TO POWERA NEW DEAL FOR
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FROM POVERTY TO POWER430
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FROM POVERTY TO POWERHOW CHANGE HAP
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FROM POVERTY TO POWERHow change hap
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FROM POVERTY TO POWER• Family str
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FROM POVERTY TO POWERTHE DYNAMICS O
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FROM POVERTY TO POWERseeking change
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FROM POVERTY TO POWERWithin many de
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FROM POVERTY TO POWERSecond, becaus
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FROM POVERTY TO POWER15 For a more
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FROM POVERTY TO POWER41 WaterAid (2
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FROM POVERTY TO POWER121 UNDP (2007
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FROM POVERTY TO POWER46 R. Offenhei
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FROM POVERTY TO POWER106 M. Rama (2
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FROM POVERTY TO POWER172 P. Chaudhr
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FROM POVERTY TO POWER37 FAO (2007).
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FROM POVERTY TO POWER94 IPCC (2007)
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FROM POVERTY TO POWER155 UN OCHA (2
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FROM POVERTY TO POWER34 UN (2006)
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FROM POVERTY TO POWER101 M. Chen (2
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FROM POVERTY TO POWER168 D. Rodrik
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FROM POVERTY TO POWER215 UN Framewo
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FROM POVERTY TO POWERBIBLIOGRAPHYAc
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FROM POVERTY TO POWERBoko, M., I. N
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FROM POVERTY TO POWERCiconello, A.
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FROM POVERTY TO POWERDFID (2005)
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FROM POVERTY TO POWERGaleano, E. (1
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FROM POVERTY TO POWERHopkins Leishe
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FROM POVERTY TO POWERKeynes, J.M. (
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FROM POVERTY TO POWERMoran, T. (200
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FROM POVERTY TO POWEROxfam Intermó
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FROM POVERTY TO POWERRama, M. (2003
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FROM POVERTY TO POWERStockbridge, M
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FROM POVERTY TO POWERUNESCO (2007)
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FROM POVERTY TO POWERWorld Bank (20
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FROM POVERTY TO POWEROxfam Australi
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FROM POVERTY TO POWERGLOSSARYAccoun
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FROM POVERTY TO POWEREffective stat
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FROM POVERTY TO POWERNeoclassicalec
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FROM POVERTY TO POWERINDEXPage numb
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FROM POVERTY TO POWERfinancial inst
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FROM POVERTY TO POWER303, 304, 305,
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FROM POVERTY TO POWERgrowth 114, 18
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FROM POVERTY TO POWERIndia:access t
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FROM POVERTY TO POWERJapan:climate
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FROM POVERTY TO POWERPacific region
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FROM POVERTY TO POWERtransnational
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FROM POVERTY TO POWER241; human sec
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