Cover Image
close this bookThe HIV Epidemic and Sustainable Human Development (UNDP, 1998, 13 p.)
View the document(introduction...)


There is no agreement among development practitioners as to what SHD is or is not - indeed whether this represents something new, as UNDP seems to believe, or is simply a reformulation of development objectives which have long been at the core of development policy. This is not to argue that the concept has no value - this is not my position at all - but rather to suggest that SHD, whatever its rhetorical significance, may in fact contain little which is new, and may in practice offer little OPERATIONAL guidance to those who have responsibility for policy and programme development.

There is a long history of debate on development going back at least to the discussions relating to Soviet industrialisation in the 1920s. While it may not be necessary to go back that far it is worth reviewing thinking about development since 1945 - which is roughly speaking when economists and other social and natural scientists began extensively to theorise about development. The core questions have always been why some countries were rich and others poor, and how to change socio-economic, cultural and political conditions so that a larger % of the world's population had the real and supposed benefits of development. What was central to such theorising was the assumption that development, which was tacitly assumed as amounting to the values and material benefits common to the rich countries (but not available to ALL who lived in such countries), was what poor countries who lacked these things needed to acquire through development. It was self-evident, so it was argued, that poor countries would be better-off with more material possessions than without, and that these were attainable if only they would adopt the values and the institutions which had led to general abundance in the rich countries.

So development was both a set of targets and a process. Implicit in the process was the assumption that there existed models or routes towards development such that countries who followed these would in time achieve its fruits. Of course the emphasis on different elements of the development model changed over time, and different theorists and practitioners emphasised different factors as being central to the process. Some argued that raising investment rates was the way forward (seeing capital formation as central to the process - building on the research of economists like Kuznets and on the theories of Harrod and Domar - sometimes enshrined in both theory and practice as by Mahlanobis in India, as also in many centrally planned economies). Others emphasised the role of human factors in the development process - so that education and skill creation were seen as crucial for development. Yet others focussed on institutional and cultural elements which were said to hinder development. And yet others argued in favour of market processes - and especially those processes associated with opening countries to the benefits of trade, international investment and the international transfer of technology - usually based on a belief in trade and mobility of capital/technology as the engine of growth and transformation. With capital mobility the mechanism for both technology and management transfer so that production was relocated worldwide in accordance with dynamic changes in comparative advantage.

Central to most of these models of development are different conceptions of the role of the State - to a degree it seemed possible to pick and choose, as is manifest in the recent rethinking on this issue by the World Bank. It is instructive to observe how the Bank has see-sawed in its perceptions of the role of the State in the development process. Until the late 1970s the Bank lent extensively to governments in the developing world for all kinds of infrastructure projects - from roads, to water to agriculture - reflecting its beliefs at the time that the State could be an instrument of development. But at the time of the introduction of SAPs (the 1980s) the Bank shifted to a belief in the minimalist State and pursued policies and programmes to achieve this in many countries. Yet overnight in the World Development Report 1997, The State in a Changing World, the Bank proved capable of completely reversing its position so that the State is again resurrected as an essential instrument of development. Such is the power of theory unrelated to historical experience of development.

The lessons of history on the essential role of the State as critical for providing essential structures that the market cannot efficiently supply are only too clear for those that have eyes to see. Who else but the State can ensure the general health of the population, provide the requisite skills and education, build and maintain a communications and transport infrastructure, establish and fairly implement a framework of laws, and support those elements of social capital essential for a free society? Who else but the State has responsibility for setting the macroeconomic framework within which micro decisions need to be taken? Indeed it is the failures of the State in determining parameter conditions relating to the exchange rate, taxation structures and the rate of inflation which have generated such large scale misallocation of resources in many poor countries. But if the State does not perform these roles efficiently and realistically then who will? Ultimately it is the State which has the responsibility of ensuring that the outcomes of development reflect widely held social objectives, and that the benefits of development are equitably distributed.

In the past 50 years or so during which development has been consciously pursued as an objective by all poor countries the means by which it is to be achieved have changed with intellectual fashion and to a lesser degree with experience. What was rarely if ever challenged in debates about development and what remained more or less implicit in development policy and programming, were the assumed targets of development. DEVELOPMENT WAS SEEN INTRINSICALLY AS A GOOD THING. What the discussion about SHD has done is to raise fundamental questions both about process and to a lesser degree about the purposes of development.

On what grounds would it be possible to argue that development was in fact questionable both in terms of HOW it is achieved and also in terms of WHAT it is that development is supposed to achieve?

What has become apparent is that development as represented by the experience of the rich countries is a mixed blessing - that development while it may make it possible to provide for the material needs of most people in rich countries does not do so for all; that development seems to be associated with destruction of social capital in many countries - with losses of core values such as trust and community - and the enhancement of other values such as anomie and forms of social, economic and political exclusion. Even more central is the fact that market processes which have increasingly come to dominate the form of development in the rich countries cannot, and does not, address EXTERNALITIES. These are in part social (a widening of the gap between rich and poor in almost all dimensions - and not just in income terms) and in part environmental (factors such as global warming that are internal to the market processes of economic growth and which are already undermining sustainable development in both rich and poor countries).

Furthermore, there are no ways that market systems can create outcomes that are gendered, other than those which continue to leave women discriminated against in labour and credit markets and in access to political and economic decision making - this in spite of the rhetoric of many decades about the need to rectify the situation. Here the gap between supposed public intent and outcomes is even wider in developing countries than in rich ones, with consequences for the HIV epidemic which are evident for all to see.