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close this bookThe HIV Epidemic and Sustainable Human Development (UNDP, 1998, 13 p.)
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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.


1. That development as represented by the experience of the rich countries creates many problems. Foremost amongst these are an intensification of social and economic inequality in many countries in terms of class and gender, often associated with pressures towards a diminished role for the State and a reduced role for other social institutions which may in the past have ameliorated the excesses of market processes. A gradual realisation that social cohesion in many countries and regions is threatened by policies and processes which have given priority to economic growth over other desirable policy objectives. And evidence that the pursuit of private interest, often driven by greed, is far from Pareto efficient - that there are in fact losers and gainers from economic growth and that the welfare losses of the former may exceed those of the latter. Amongst the losers are future generations who will have to deal with environmental costs and other externalities which will reduce future world welfare for all. Amongst the losers almost everywhere are women who are generally denied access to opportunity and power, both economic and political, with the inevitable result that they are both exploited and denied the opportunity to play a full role in society.

2. That the pursuit of development has to concern itself both with the objectives of development and the processes for achieving these. SHD has the benefit of focusing attention on the purposes of development - that the objective of development is to increase human welfare in all of its dimensions and NOT simply those that are economic. It is, therefore, closer to philosophical concepts of what constitutes a "good life" in which it is possible for all citizens to be free of material deprivation so that they are able to actively participate in national and community processes through the exercise of their social and political rights. The denial in many countries of these rights to women is indeed perhaps the greatest challenge facing far too many countries.

3. That the achievement of SHD requires processes which are themselves inclusive and participatory if in fact the outcomes are genuinely to represent what people want rather than what elites prefer. At the centre of such processes are principles of social, political and economic inclusion which are based both on rights and responsibilities. Only if the human factor is seen as central to the processes of development will its targets represent what men and women want and thus be realisable.

4. Useful though SHD is as a concept which helps to redefine the objectives and processes of development it is less clear about operational issues. Even given agreement on objectives, and commitment to inclusive processes, it is far from clear how to create political and economic conditions in all countries in which the general welfare will prevail where this conflicts with sectional interest. Ultimately SHD may fail not in its espousal of social objectives and a concern for sustainability, but rather in the naivety of its political assumptions - a belief that powerful economic and political groups will act contrary to self- and class- interests. Central to these concerns about power relationships are those relating to men and women, which is ultimately about the willingness of men to give up power in favour of women.

It can be concluded that,

· the involvement of an educated and empowered population is critical for setting the agenda of development;

· an empowered population is central to processes for achieving the development agenda so as to ensure equitable and sustainable outcomes;

· human welfare must be the sole objective of development; and

· what is unclear is how one moves from what is - the present - to where one wants to be.