In 1989, no less than 44 per cent of sex workers in Chiang Mai, Thailand,were HIV positive.
Instead of denying the problem of prostitution, the Thai government focused on reducing the number of male visits to brothels. At the same time, it promoted the use of condoms among prostitutes.
Beginning in 1991, 31 million condoms were distributed to high-risk groups. Clinics gave out another 600 million prophylactics a year.
The results of this initiative have been startling. Between 1989 and 1992, condom use in brothels rose from 14 per cent to 80 per cent, and the average visits by men to each prostitute fell from 4 a day to 1.2 day. As a result, the prevalence of HIV among prostitutes fell from 50 per cent in 1991 to 10 per cent in 2001.What a result. This tells us that something can be done.
By contrast, in southern Africa, young women are four to six times more likely to be HIV positive than men in the same age group. They are dying at a staggering rate.
Last year, 3.1 million people worldwide died of Aids.The vast majority of these people were in Africa. Another 43 million contracted HIV. Most of them don’t even know it yet.
Thespread ofAidsisonly one alarming indicator of a profoundly disturbing trend which can best be summed up by the observation that, in the 1990s, most of Africa fell off the radar screen. In that continent, infant mortality, one of the acid tests of medical and humanitarian progress, has risen.
For example, in Sierra Leone,18 per cent of children will not make it to their first birthday.Today, 30,000 kids will die of diseases that are preventable. Because their children die, desperate women try to have more kids, and because they try to have more kids in deplorable circumstances, 500,000 of them die inchildbirthevery year. That’s one every minute.
Over the past few days, I’ve been fretting about the teething problems of my own one-year-old boy, and the fact that he wakes the household in the middle of the night. For me, that’s a big deal.
But just consider how lucky he is. Due to an accident of birth, he will, hopefully, live a full life, like the vast majority of Irish kids. He will go to school, and will be raised in a peaceful society with basic amenities such as clean running water, sanitation and a balanced diet. He will be given every chance to fulfil his human potential.
And so will his sister. She will never have to deal with the nutrition deficiency or the malaria that will kill 400,000 under-10s this year. Nor will she have to look after her brother because her parents died of Aids before they were 40. She will get a full education and probably use it to her own advantage.
Unfortunately, these basic assumptions do not hold for over 70 per cent of children born as you are reading this article.
Yet the success of theThai example in the fight against Aids suggests that these deteriorating global trends are not inevitable.
We can do something, and in the case of Africa,we have to, not because there is any real proximate threat to our own liberty or lifestyles, but because it is morally right.
Some may argue that we should look after our own before we go off trying to save the world. After all, the United Nations report this week also stated that Ireland was ranked 15 out 16 rich countries in terms of equality. Should our own travails not concern us more?
Well, to be frank, no. Our problems are not even in the same league.There is an enormous difference between a country that spends €9 billion on state healthcare, and a country that cannot even afford to asphalt its roads.
There is a huge difference between a country with unemployment under 5 per cent and 100 per cent literacy among school kids, and one where only 50 per cent of children even get as far as primary school.
There is a world of difference between a country with an average income per head of $30,000, and one where the majority of people live on $1 a day.
In Ireland, almost everyone has a chance; in some parts of Africa, almost nobody has. If people in this country make the right individual choices, there is every opportunity to prosper.
In the broadest sense, the system works and it balances opportunity with an adequate safety net. In many parts of the world, this is not the case. It is incumbent on us to try to alleviate their plight. Put simply, we have never been richer, and they have never been poorer.
The question is: why? Why, in the 1990s, did the gradual progress of the Third World catching up go into reverse and then free-fall?
Obviously, in many cases, despotism, war and corrupt, greedy elites that do not care a jot about their own people are culpable. But there are too many good governments in Africa for these to be the only reasons.
Indeed, blaming bad local governance and the existence of corrupt middlemen is like concluding that our sleeveens and gombeen-men of the 1840s were responsible for the Famine.
Yes, these middlemen may have prospered while their compatriots starved and emigrated, but a natural disaster, a bloated and dependent population and no public services, combined with London’s laissez-faire economics doctrine, turned an 1846 crisis into a disaster.
Africa’s version of the potato blight is Aids, facilitated by a tropical environment riddled with malaria and a variety of acute respiratory infections. The corrupt governments are their gombeen-men, but the population explosion plus the breakdown of public services and our laissez-faire attitude suggest remarkable similarities, and notably similar reactions in the seats of power.
My guess is that the Young Ireland rebellion of 1848 was regarded in London in the same way that many financial commentators regard Africa’s civil wars: clear evidence that these people cannot govern themselves and are not worthy of aid or trade until they learn to do so in a civilised, lawabiding manner.
Yet even the most fervent colonialist now freely admits that the Young Irelanders and the subsequent Fenian rebellions were the symptoms, not the causes, of rural hardship in Ireland.
Another reason for the Third World’s decline in the 1990s could be much more worrying. The economic penalty for not playing by the rules appears to have increased dramatically, just as the benefits for being model students have also increased hugely.
With capital mobile and unfettered, being a good student like Ireland leads to a massive inflow of capital looking for yield.
This causes destabilising booms in `good’ countries and disastrous busts in `bad’ countries. It also means the good countries can operate on tick for years.
For example, the US today absorbs 10 per cent of the world’s total savings to pay for its enormous consumption, yet a country like South Africa experiences capital flight. It is reasonable to argue that the money fleeing theThird World, either legally or illegally, is being used to buy imported sprinkler machines for the lawns of New Jersey.
Thus, with capital freely moving into every potential nook and cranny, countries which have blotted their copybook, or have no copybook at all, are suffering disproportionately.
This is where the free market fails. It does not provide capital for the right things. For example,the so-called efficient markets can waste $2 trillion on the mirage of the telecom and dotcom booms – and yet it would only take $50 billion to eradicate extreme poverty across the globe.
A belief in the free market is one of the central tenets of this column, but blind belief in all circumstance leads us up blind alleys. This is precisely where our increasingly divided world is headed.