Abstract |
The last quarter century – the years of the re- cent globalisation – was one of epochal changes which impacted favourably on economic growth and health status. The first of these epochal changes was the end of the Cold War, which is estimated to have freed up a ‘peace dividend’ of 2-4 percent of GDP per year since the early 1990s for the NATO and Warsaw Pact countries, as well as their allies in the developing world. Secondly, following the collapse of communism and military juntas, many countries benefited from a democratic dividend’ which led to the spread of participatory political institutions, democratic values and practices, and a free press. Thirdly, resource use likely became more efficient – ceteris paribus – due to the ‘market dividend’ which came with the introduction of market reforms in socialist and dirigiste economies. Fourthly, with the exception of Africa, most developing countries, including Bangladesh, India, China and Egypt, enjoyed a considerable ‘demographic dividend’ due to a sharp deceleration in birth rates and a parallel rapid growth in the labour force. Fifthly, the last quarter century benefited from the spread of the ‘in formation and tele-communication (ITC) revolution’ and steady technical progress in the medical field. The ITC revolution cut information, communication and transport costs, raised the rate of growth of GDP by one percent a year in those countries which invested in it, and facilitated access to health information for mil- lions of people. Finally, the last 10-15 years witnessed a shift in the development discourse towards a reduc- tion of infant and child mortality and a reorientation of the international development strategy towards the achievement of the Millennium Development Goals (MDGs). The last quarter century also witnessed the emergence and spread of an economic paradigm which emphasizes stringent macroeconomic stability, rapid liberalisation of domestic markets, privatization of state-owned enterprises and public utilities, the removal of barriers to international trade and financial flows, and the search for market-based solutions even in the field of ‘public goods’. This paradigm aims at creating a global market in which competition among economic agents occurs with only limited government intervention. Its proponents have long maintained that these measures lead to a reduction in rent-seeking, increased competition, improved export opportunities, and can facilitate the convergence of the incomes and health status of poor countries towards those of the advanced ones.
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