Symptom and cause

Putting into practice today's low cost methods of overcoming malnutrition, disease, and illiteracy, will not solve the problems of economic development; it will not remove the burden of debt or restructure inequitable economic relationships; it will not bring an end to oppression and exploitation or eradicate the many causes of unemployment and low incomes; nor will it meet the legitimate aspirations of hundreds of millions of people in the developing world who are not living in absolute poverty but who do not enjoy the amenities of life that are taken for granted in the industrialized nations. It has therefore sometimes been argued that such specific, targeted interventions address only the symptoms of poverty and leave the causes undisturbed.

This is an argument which is no longer deserving of the politeness extended to it in the past. For it is an argument which fails to recognize that frequent illness, malnutrition, poor growth and illiteracy, are some of the most fundamental causes as well as some of the most severe symptoms of poverty. It fails, for example, to take into account that the pulse of economic development is weakened when millions of children suffer from poor mental and physical growth; that the march toward equality of opportunity is slowed when the children of the very poor drop out of school and into a lifetime of illiteracy; that the productivity of communities is enervated by hours spent carrying water from unsafe sources and by the time, energy, and health that is lost to the diseases it brings; that the prospects of finding a job and earning an income are crushed by preventable disabilities such as polio or nutritional blindness; that a family's capacity to save and invest in the future is the less when a child is born mentally retarded by iodine deficiency; and that the contribution of women to economic development cannot be liberated if women remain chained to long years of child-bearing, long days of attendance on illness, and long hours devoted to the fetching and carrying of water and fuel.

In these and many other ways, the worst symptoms of poverty help to crush the potential of the poor, to reduce their control over circumstance, to narrow the choices available to them, and to undermine the long-term process of development.

The struggle for social justice and economic development, both within and between nations, must continue - just as the poor themselves will continue to struggle, as they have always done, to meet most of their own needs by their own efforts. But it is a tragic mistake not to recognize that those efforts can be enhanced by doing what can now be done to reduce disease, disability, malnutrition, illiteracy, and drudgery. Today's advances in knowledge and technology could therefore augment future prospects as surely as they could diminish present suffering. And the argument that making today's advances widely available is dealing only with symptoms is an argument as destructive to the future as it is insensitive to the present.

Finally, the great demographic change taking place in our times also adds its weight to the idea that the time is now right for a determined effort to overcome the worst aspects of poverty.

Fertility rates have fallen in almost every region of the world. In Latin America, the annual number of births has now begun to decline; in Asia, births will reach a peak in the mid-1990s and begin to fall; even in South Asia, a peak will be reached within a decade. Only in Africa will the annual number of births continue to rise until well into the next century. A historic turning-point in the modern era will therefore soon be reached. For once the annual number of births is stable or declining, any further investment in such services as health and education can be used to improve the quality of the services offered and to increase the proportion of people reached. In other words, the task of providing such services will no longer be a case of 'running to stand still', and the goal of meeting basic human needs will no longer be a target that is for ever moving away.