PART FOUR Human Security Living with risk Social protection How change happens: India’s campaign for a National Rural Employment Guarantee Finance and vulnerability Hunger and famine HIV, AIDS, and other health risks 165 173 180 182 186 191 How change happens: South Africa’s Treatment Action Campaign 200 The risk of natural disaster Climate change: Mitigation, adaptation, organisation Living on the edge: Africa’s pastoralists Violence and conflict Shocks and change 202 212 221 225 236 Living with risk It is hard to imagine a more precarious life than that of the Karimojong in northern Uganda. Semi-nomadic herders, or pastoralists, they live within fierce thorn stockades, scattered across a baked dusty plain. Visitors must crawl through tiny gaps to get through the defences, which have been set up against cattle raiders from other pastoralist groups. Nearby, charred hut circles show where an army attack recently burned a number of elderly villagers to death, along with a woman who was in the middle of giving birth. Drought is a constant threat, although today the earth smells hot and damp from the first rains, bringing out a horde of brilliant red beetles. However, the Karimojong are anything but victims, and constantly seek ways to minimise the risks they face. Sitting on cowhides outside their huts, members of a women’s group describe how they set up a communal grain bank, and how they now buy sorghum when it is cheap at harvest time, store it in large wicker and mud granaries, and sell it back to the villagers during the hungry months. ‘It’s better to work as a group – it gives you strength’, they say. ‘In a group you can never be lazy, you get motivated.’ The benefits extend to controlling their husbands’ alcohol consumption: ‘If you have a family granary, it’s harder to say no to your husband or son when they come and ask for sorghum to make beer.’ Laughing, they add that they still keep a small stock at home just in case their husbands become too insistent. No-one’s life is free of risk. One way or another, we all suffer from, and have to cope with, insecurity – over jobs, health, relationships, raising our children. While more affluent individuals and societies can manage some risks and avoid others altogether, often with the assistance of formal institutions, poor people and poor countries cannot. As a result, the lives of most poor people are built around coping with risk – and, all too frequently, such risks turn into personal or societal catastrophe. The majority of such catastrophes can be avoided through a combination of protection (by the state, or the international community) and empowerment of the individuals concerned, a combination known as ‘human security’. Ending needless suffering of this kind is both a moral imperative and an act of enlightened self-interest in a world where climate change, conflict, and disease show scant respect for borders. This part of the book argues that guaranteeing human security is possible, if governments, citizens, and the international community all take action. Vulnerability to sudden ‘shocks’, the result both of individual or social factors (gender, age, disability, health, class, or caste) and of the relative power 165 FROM POVERTY TO POWER of an individual or community to defend their interests, is one of the defining characteristics of poverty. When World Bank researchers interviewed 64,000 poor people in 24 countries as part of its Voices of the Poor exercise in 2000, it asked them to reflect on how their most pressing problems had changed over the course of the past decade. In their responses, people particularly mentioned far greater insecurity of livelihood than in the past. The only exception to this was in Viet Nam, where all the groups interviewed said that economic opportunities had increased and that poverty had declined substantially in the 1990s. Physical insecurity also emerged as a major concern. With only a few exceptions, notably in some isolated communities, poor people reported feeling less secure and more fearful than they did ten years earlier. The researchers concluded that: ‘Anxiety emerges as the defining characteristic of insecurity, and the anxiety is based not on one but on many risks and fears: anxiety about jobs, anxiety about not getting paid, anxiety about needing to migrate, anxiety about lack of protection and safety, anxiety about floods and drought, anxiety about shelter, anxiety about falling ill, and anxiety about the future of children and settling them well in marriage.’1 Insecurity and risk are not just greater for poor people than for rich, but vary across other faultlines of social and economic inequality. Women and children often face different risks from men because they hold relatively less power in most societies, and so are more vulnerable. For example, they may face domestic violence or have less access to food in ‘normal’ times and have less access to emergency aid after a disaster. In many countries, women face penury after the death of a husband. Similarly, commonly marginalised groups such as ethnic minorities, elderly people, or disabled and sick people often face greater risks. The individual risks that poor people face reinforce and exacerbate one another, ratcheting up inequality and exclusion. If a family’s main breadwinner falls sick or loses his or her job, the family may have to eat less, weakening its resistance to disease, or sell off prized assets such as goats or cows, rendering it less resilient to further shocks. Studies in Malawi show how the famine of 2001–2 drove desperate women and girls to sell sex to survive, greatly increasing their chances of contracting HIV.2 When shocks affect the whole community, help from relatives or neighbours is harder to come by, further undermining resilience. A devastating feedback loop can develop between conflict and ‘natural’ disasters, which drains individual, community, and national resources, weakens institutions, and heightens risk through displacement, the blocking of aid and recovery assistance, and the destruction of physical and natural assets. Conflict can turn low rainfall into famine. More than 50 per cent of Africa’s food crises can be explained by armed conflict and the consequent displacement of millions of people.3 In 2003, thirteen of the seventeen countries with more than 100,000 AIDS orphans were in conflict or on the edge of emergency.4 166 4 HUMAN SECURITY One of the menaces of climate change is its tendency to exacerbate existing sources of risk and vulnerability for poor people. In Kenya and Darfur, for example, drought has heightened conflict over diminishing areas of fertile land or depleted supplies of water. In Zambia, droughts have left people more prone to contracting HIV, since they have forced families to marry off daughters early, often to older men who have had numerous sexual partners. Drought and deprivation also force women and girls into the sex industry and stoke migration to the towns, where HIV is more prevalent. The negative synergy works both ways, with sickness, death, and the need to attend numerous funerals undermining farming families’ abilities to adapt their livelihoods to a changing climate.5 Short-term disruptions and suffering have long-term consequences. Research shows that, even decades after droughts, wars, and floods, those affected earn and consume less, have fewer qualifications, and get sick more often. Moreover, the ways in which poor people cope with such shocks often trade off short-term survival against the possibility of long-term progress. This section explores some of the multiple risks in the lives of poor women and men. It examines the everyday risks that poor people face, as well as the shocks that can buffet whole communities and countries, from ‘slowonset’ disasters such as drought to ‘sudden-onset’ catastrophes such as earthquakes and war. It assesses the changing nature of risks, and sets out ideas for preparing people, mitigating the impact of such risks, and addressing their root causes. It shows that poor people are nearly always more vulnerable, and suggests that reducing their vulnerability is crucial in the fight against poverty and inequality. Who is vulnerable? ‘Vulnerability’ describes the reduced ability of some communities or households to cope with the events and stresses to which they are exposed. Such stresses can equally well be an ‘everyday disaster’ such as a death in the family, sickness, a robbery, an eviction, or the loss of a job or a crop, or a major event such as a drought or a conflict that affects the whole community. Both types of event can tip poor families over the edge into a downward spiral of increasing vulnerability and poverty. The risk that a poor individual or household faces can be understood as the interaction between two factors, the scale of the hazard and the level of vulnerability. Risk can result either from poor people’s extreme vulnerability to comparably minor events, or from a massive shock that creates a hazard large enough to sweep even well-defended families before it. Figure 4.1 shows a sample of the risks that can threaten a poor individual or household, and the key assets with which they can manage and withstand them. The factors are constantly evolving through social, political, and environmental change. For example, urbanisation is placing millions of people 167 FROM POVERTY TO POWER Figure 4.1: How vulnerability affects livelihoods Livelihood assets Human capital: skills, knowledge, ability to work, and good health. Social capital: the social resources upon which people draw, including informal networks, either with individuals or wider institutions, such as political or civic bodies; membership of more formalised groups such as churches; and relationships of trust, reciprocity, and exchange. Natural capital: the natural resource stocks on which people can draw, including common resources, land, water, and so on. Physical capital: the basic infrastructure (shelter, transport, irrigation, energy, etc.) and producer goods needed to support livelihoods. Financial capital: savings, wages, remittances, or government transfers such as pensions. 168 4 HUMAN SECURITY in potential death traps. Almost half of the world’s largest cities are situated along major earthquake faults or are exposed to tropical cyclone tracks, while many large cities are on coasts where they may be vulnerable to rising sea levels, storms, and possibly tsunamis.6 Whether in cities or rural areas, in normal times juggling risk is a large part of what it means to be poor. Families are adept at diversifying their dependence: in rural areas, they send young adults off to work in the city, grow multiple crops in different areas, sell and buy livestock to smooth their income, or collect and sell wild products. In the cities, they hustle a living in the informal economy, working as street vendors, maids, in construction, or recycling rubbish. If these strategies fail, they resort to more drastic measures that in effect mortgage the future, pulling children out of school, eating fewer meals, or selling off vital assets, even when this reduces future earning power. This happens regularly in ‘peacetime’ but is more widespread when a shock hits a whole community, so that households find it harder to borrow from or support each other or otherwise cope, and local authorities are overwhelmed with the demand for help. At some point, vulnerability can tip over into a downward spiral of hunger, weakness, distress sales, destitution, and even death. Although vulnerability is conceptually similar to poverty, it focuses more attention on relationships. It provides an X-ray of the power, connections, and exclusion that run through society. When disaster strikes, you find out who your friends are: social ties and relationships with other families and patrons render even very poor households less vulnerable than, for example, wealthier migrant households with no ties in the community or claims on patronage. The most vulnerable people of all are the marginalised groups who constitute the ‘chronic poor’: ethnic minorities, women heads of households, elderly people, and those who are sick or disabled. Human security The opposite of vulnerability is security. Broadly speaking, rich and powerful people and communities lead more secure lives. As one resident of Ha Tinh, one of Viet Nam’s poorest provinces, explains, ‘The wealthy can recover losses in one year, but the poor, who have no money, will never recover.’7 Correcting that disparity is central to tackling poverty and inequality. To reduce the threat of shocks, individuals and governments must seek to enhance people’s security: not the militarised version of security that has dominated public debate in recent years, but a more comprehensive human version, taking the insecure and anxiety-ridden experience of living in poverty as its starting point. Guaranteeing security in this way strengthens poor people’s ability to withstand shocks and increases their chances of emerging from poverty, and not falling back. 169 FROM POVERTY TO POWER The human security approach, first put forward in the UN’s 1994 Human Development Report,8 unites emergency response and development in a single framework, based on three propositions: • People vulnerable to shocks are agents of their own destiny, with a series of rights that need to be fulfilled. • Governments and international bodies are bound to address the full range of risks and vulnerabilities that affect people living in poverty. • Social, political, and economic stability, generally ignored or downplayed in debates on poverty reduction, equity, and growth, is fundamental for reducing risk. Like ‘sustainable development’, many governments have devalued the idea of human security by paying lip service to the concept while ignoring its profound implications. The approach challenges governments and international bodies to build from the bottom up, supporting and complementing citizens’ own efforts to reduce their vulnerability and protect themselves from risk, and to provide protection in accordance with international humanitarian and human rights law. Vulnerable people are far from passive and are constantly seeking ways to prepare for and cope with the daily risks that surround them, including by building assertive organisations that can manage risk directly and press for public policies that reduce risk. Governments can support such empowerment, importantly by ensuring access to health, education, livelihoods, and information, so that more poor women and men have the skills and knowledge required to address risk as active citizens. This theme is explored in more detail in Part 2. Governments and international bodies must also protect poor and vulnerable people by guaranteeing their rights both in normal times and in times of crisis, for example by ensuring that they are not prey to violence, deprivation, or coercion. They should also act to reduce the likelihood of shocks and to mitigate their impact. Human security thus involves the same two core elements as the fight against poverty: active citizens who organise to assert their rights and effective states that work to fulfil those rights. The particular vulnerability of children illustrates the importance of a human security approach. Traditionally, children have been largely ‘invisible’, treated as little more than the property of their parents or guardians. The idea of rights for children, for example not to be beaten, remains contested and uncomfortable for parents both North and South, but the 1989 UN Convention on the Rights of the Child marked a sea change, pressing for improved state protection of children, provision of the essential services needed for children to develop, and for both state and public to acknowledge that children have rights, including the right to be consulted over the decisions that affect their lives.9 170 4 HUMAN SECURITY The primary public responsibility for addressing risk rests at the level of national government, which is the major focus of this section. However, tsunamis, droughts, and conflict show little respect for borders, and many of the most vulnerable communities live in countries where the state is extremely weak, and may well be part of the threat rather than the solution. In such situations, the international community is obliged to act to save lives, be it through development assistance, emergency aid, diplomacy, or international peacekeeping, a role addressed more fully in Part 5. As is true regarding poverty, for issues such as conflict or climate change only simultaneous action at national and international levels will suffice. Unfortunately, security is not currently conceived this way in most international discussions. Figure 4.2 shows the main causes of death – the ultimate manifestation of insecurity – in the world today. It draws into sharp relief the gulf between the political agenda as established in rich countries, where terrorism is often portrayed as the greatest threat to security, and the reality of the lives of poor people, who face far greater daily insecurity from more mundane but far more lethal threats of disease and ‘low-tech’ violence. 171 FROM POVERTY TO POWER Figure 4.2: Causes of premature death worldwide, circa 200910 Note: these figures are approximate and often disputed, and in some cases may overlap (for example, some deaths may be double-counted in categories such as child mortality and child undernutrition). However, they serve to give a sense of relative scale. 172 Social protection It may seem surprising that giving pensions to the elderly should help to keep children in school. However, in South Africa and Brazil monthly cheques enable elderly people both to look after themselves and support their grandchildren, conferring dignity in old age and preparing the citizens of tomorrow to play an active and productive role. In the case of South Africa, grandparents have become all the more important since so many parents have succumbed to AIDS. Pensions are just one example of what is called ‘social protection’. Social protection describes all public and private initiatives that: • Provide income or consumption transfers to poor people; • Protect vulnerable people against livelihood risks; and • Enhance the social status and rights of those who are marginalised. Its overall objective is to reduce the economic and social vulnerability of poor and marginalised groups.11 Taken for granted in many developed countries, where welfare states routinely transfer income and support to the most vulnerable (although delivery methods remain controversial), social protection is rapidly gaining support in some of the poorest countries of the world, and challenging many of the assumptions of the aid industry. In 2005, the Ethiopian government introduced a ‘productive safety net programme’ to support over seven million of its poorest citizens through a combination of public employment schemes and grants to elderly people and expecting and nursing mothers. In Brazil, the Bolsa Familia (Family Stipend) scheme provides financial aid to some 11 million poor Brazilian families, on condition that their children attend school and are vaccinated. Narrowly defined, social protection consists of two components. Social assistance transfers resources to vulnerable groups in the form of direct resource transfers (cash or food) to poor people, indirect transfers such as food subsidies, and pensions and benefits (both contributory and non-contributory), while social insurance allows individuals and households to protect themselves against risks by pooling resources with others. However, social protection goes much deeper than this. It tackles head-on a central aspect of poverty, arguing that the state in particular has a duty to seek to reduce vulnerability by guaranteeing the basic rights set out in the Universal Declaration of Human Rights. Such rights constitute a fundamental part of citizenship. Approached in this way, social protection spills over into 173 FROM POVERTY TO POWER issues of social services and social equity raised elsewhere in this book – providing decent education, health care, water and sanitation; redistributing land to vulnerable farmers; helping them adapt to climate change; guaranteeing property rights for women or for squatters in the cities; combating gender-based violence; or guaranteeing labour rights for workers in formal and informal economies alike. Instead of treating poor people as ‘beneficiaries’, such a conception of social protection focuses on the rights and voices of poor people themselves, building an enduring constituency and demand for state action, and so promoting the combination of active citizens and effective states that is crucial to development. When done well, social protection can have an extraordinary impact. In 2007, a combination of child support, disability payments, and pensions was reaching approximately 13 million South Africans, out of a total population of 48 million. Total spending in 2007 amounted to $9bn – 3.4 per cent of GDP.12 The programme resulted from a combination of high-level political support and an active civil society continually pushing the government to go further. Emerging from the dark days of apartheid, South Africa’s new Constitution promises that ‘everyone has the right to have access to social security, including, if they are unable to support themselves and their dependants, appropriate social assistance’.13 Evaluations show that households that receive social grants are more likely to send young children to school, provide better nutrition for children, and look for work more intensively, extensively, and successfully than do workers in comparable households that do not receive social grants.14 As part of its Soviet legacy, Kyrgyzstan has formal systems of social protection which, in principle, cover all its citizens. Kyrgyzstan’s social protection system now comprises a social insurance fund from which old age and disability pensions are paid; a health insurance fund, which covers the costs of health treatment for the working population and for children and older people; and a social assistance system, which provides small amounts of cash assistance on a means-tested basis to people living below the poverty line. Although far from perfect, it shows that even a very poor country (in 2010 Kyrgyzstan’s annual per capita GDP was US$86015) can run a social protection system that helps protect the most vulnerable. World Bank analysis suggests that, without the system, the extreme poverty headcount would have increased by 24 per cent, the poverty gap by 42 per cent, and the severity of poverty by 57 per cent. Furthermore, these levels of social protection do not represent an unsustainable drain on public resources: in 2002, they cost 3 per cent of GDP.16 Nor is social protection confined to the state alone. A huge amount of such activity takes place ‘below the radar’ at community level, through family support networks or religious organisations. NGOs such as India’s Self Employed Women’s Association (SEWA) organise a range of health, maternity 174 4 HUMAN SECURITY benefit, and other insurance and credit schemes for thousands of women in the informal economy, exemplifying how social protection can target gender inequality.17 International NGOs such as Oxfam are also increasingly introducing elements of social protection into their programmes. The burgeoning interest in social protection springs both from an improving grasp of the nature of poverty and inequality and from past failure, notably the poor record of the ‘safety nets’ introduced to soften the impact of structural adjustment programmes and other shocks in the 1980s and 1990s. These typically reached only a portion of their target groups, and could not be introduced fast enough to deal with unexpected crises such as the Asian financial crash of 1998, or the global financial crisis a decade later. At the same time, it became increasingly clear that emergency relief such as food aid, designed to deal with short-term shortfalls in food supply, was obscuring the real nature of chronic (i.e. near-permanent) hunger and vulnerability in many countries. Between 1994 and 2003, for example, an average of five million Ethiopians were declared ‘at risk’ and in need of emergency assistance every year, and since 1998 the numbers of food aid beneficiaries in Ethiopia have fluctuated between 5 and 14 million. Hunger is the norm, not an ‘emergency’. The Food and Agriculture Organization of the United Nations (FAO) estimates that chronic hunger lies at the root of 90 per cent of food insecurity worldwide, leaving just 10 per cent attributable to shocks or humanitarian crises.18 Avoidable deaths associated with malnutrition in six countries in southern Africa are estimated at between 100,000 and 200,000 every year, compared with the estimated 50–100,000 who died in the five months of the East African drought and conflict-induced food crisis of 2011.19 Chronic malnutrition is a far bigger problem than acute malnutrition, and yet it receives far less attention. A maturing understanding of the nature of poverty, with its growing attention to issues of rights, dignity, and empowerment, and the recognition that inequality and social exclusion are not just damaging in themselves but hold back economic progress, have also played a part in this process. Progressive political leaders in countries such as South Africa and Brazil have seen how popular such policies can be, addressing directly the need for the state and others to guarantee basic human rights and to include less active groups, such as elderly or disabled people, who are often sidelined in development policies that focus solely on economic growth. Cash transfers What do hungry people need? Food would seem to be the obvious answer, but poor people often prefer cash, because it allows them to make their own choices about how best to improve their own situation: what and when to 175 FROM POVERTY TO POWER invest and consume. It is also more consistent with a rights-based approach to social protection. Increasingly, cash transfers are supplanting in-kind transfers – for example, cash for work is replacing food-for-work programmes, and school subsidies are starting to displace school feeding programmes. In response to predictions of acute food insecurity across parts of Southern Africa in 2005–6, Oxfam decided to implement cash transfer programmes as an alternative to emergency food aid in Malawi and Zambia, covering a total of about 20,000 households. Subsequent evaluations showed that neither project encountered any major security problems: the cash was delivered and spent safely. In both countries, the vast majority of the cash transfers were spent on food, mainly maize. People also made small but sometimes crucial non-food expenditures. In Malawi, the cash enabled people to purchase the subsidised inputs provided through a government agricultural input voucher scheme. In Zambia, where spending on health and education was important, NGOs’ efforts complemented the Zambian government’s social protection programme, which pays the poorest 10 per cent of communities in one district of Southern Province $6 per person per month, a minimal safety net against the worst forms of deprivation.20 In Viet Nam, Oxfam went one step further, deciding to give substantial cash lump sums to some 500 poor households in eight deprived villages, and monitoring how the villagers spent the money. The top six uses were clearing debts (thereby freeing up future income from the burden of debt repayments), buying livestock, repairing and building houses, paying for school fees and books, buying seeds and fertilisers for agriculture, and paying for health care. These results demonstrate how, given the chance, poor people invest in the future, and how varied and unpredictable their needs are: a dozen elderly people opted to spend the money on buying coffins, thereby ensuring that they could live out their days in the knowledge that they would have a dignified funeral.21 Cash transfers put poor people in the driving seat, spending resources on the things that matter most to them. Cash transfers have been judged successful in many countries, particularly when made conditional on keeping children vaccinated or in school, as in Brazil’s Bolsa Familia or Mexico’s Oportunidades programmes. These have reduced present vulnerability and have also increased school attendance, thereby improving long-term security for the next generation. Pioneer countries such as South Africa or Kyrgyzstan show that social protection can be provided for as little as 3 per cent of GDP. This is serious money, but much of it would be recouped by avoiding emergency spending when things go wrong. In 2005, the UK government’s high-level Africa Commission concluded that the costs of pre-emptive social protection are less than the costs of responding after a crisis and argued that, for an annual $5bn–6bn, ‘Five million of the most vulnerable children and another 40 176 4 HUMAN SECURITY million chronically poor households caring for orphans and other vulnerable children would be supported through community programmes and cash grants, perhaps conditional on school and health clinic attendance. The interlocking cycles of poverty and exclusion trapping millions would be interrupted, preventing the transfer of poverty from parent to child and mitigating the far-reaching impacts of AIDS and conflict.’22 Nevertheless, cost is often raised as an objection, not least by the International Monetary Fund in its role as custodian of financial prudence. In 2004, the government of Lesotho introduced a non-contributory pension for all over-70s (against advice from aid donors that it was unaffordable), becoming the fourth country in southern Africa to do so, after South Africa, Namibia, and Botswana. An additional $5.5bn in aid, as the Africa Commission recommends, would cost less than $5 per person in donor countries, and would equal just three weeks’ spending by the US government on the war in Iraq at the height of that conflict.23 Social protection holds the potential to transform the lives of poor people across the world, North and South, and it is evolving rapidly. For aid donors and NGOs, it addresses the divide in their thinking between ‘emergencies’ and ‘development’. Oxfam, like most other aid organisations, deals separately with sudden disasters (where it specialises in providing water and sanitation, restoring food security, usually by transferring cash rather than giving out food, and providing emergency shelter) and with long-term development issues. The two parts of the organisation have different staff, budgets, and mindsets: a can-do engineers’ attitude to saving lives in emergencies, contrasting with a more long-term focus on rights, processes, and politics among development types. However, recognising that vulnerability is chronic, and that, for example, food ‘emergencies’ in a number of African countries are becoming the norm rather than exceptional events, means rethinking this division. Social protection offers a way to move from an inevitably chaotic emergency response to long-term protection based on the rights of poor people. If social protection systems are in place before an emergency hits, they also provide a ready-made delivery channel, for example by allowing pensions or child support to be stepped up to help families cope. This can be a huge benefit when delays in creating payment systems can cost lives, as became clear in the global financial crisis of 2008–9.24 However, blurring the boundary between humanitarian relief and long-term development also carries the risk of politicising humanitarian work in the eyes of governments, which sometimes prove more willing to countenance outsiders providing food aid for the hungry than supporting the organisations of poor people demanding land so that they can reduce their long-term vulnerability. Joining up humanitarian relief and long-term development work is far easier to advocate than to actually do, but the renowned Bangladeshi NGO BRAC 177 FROM POVERTY TO POWER (Bangladesh Rural Advancement Committee) has shown the way. Its Income Generation for Vulnerable Group Development (IGVGD) programme builds the productive capacity of chronically poor households and simultaneously provides them with a protective base. Through collaboration with the World Food Programme and local government, families receive a monthly wheat ration for two years, plus training and credit provision by BRAC. Microcredit has helped to set up income-generating activities, such as poultry, livestock, and silkworm farming. IGVGD targets in particular widowed or abandoned female heads of household, households owning less than 0.5 acres of land, and those earning less than Tk.300 ($4.40) per month. Standard bearers for social protection, such as Brazil and South Africa, are now showing increasing interest in moving from targeted interventions such as pensions or child support grants to establishing a national ‘basic income guarantee’ for all citizens, an idea that has long been debated as a means of addressing poverty in developed countries but has never been implemented. The growth in social protection has also raised old debates about universalism versus targeting. Is it either more efficient or more equitable to target benefits to identified groups of vulnerable communities or individuals, or is it better to give universal benefits, as was the fashion in developed countries in the 1960s and 1970s? Targeting is very difficult to implement, especially for cash-strapped and debilitated state machineries, as resources are frequently ‘captured’ by the more powerful members of a community. In India, data from 5,000 households in 12 villages showed that, although subsidised food schemes were ostensibly focused on the poor, the beneficiaries were mainly middleincome families; the situation for pensions was even worse.27 A wider World Bank study of 111 social protection projects found that targeting worked in three-quarters of them, but benefited poor people proportionately less in the remaining quarter.28 In general it seems that targeting categories of easily identified people (elderly people, pregnant women, children) is more successful than means-testing populations to establish who is poor. While more expensive, giving benefits universally carries other advantages: helping to build a political and social consensus for the benefit (since everyone gains), avoiding the stigma that goes with means-testing, and enhancing cohesion by clearly establishing social protection as a universal right, rather than a form of charity to the deprived. In Malawi, farmers rejected the targeting of subsidised farm inputs on the grounds that they were all poor, and it would be divisive. Social protection epitomises the human security approach, offering a practical and effective way to reduce chronic vulnerability, tackle poverty and inequality, bridge the gap between ‘emergencies’ and ‘development’, and nourish the relationship of rights and responsibilities between citizens and states that lies at the heart of successful development. 178 4 HUMAN SECURITY Box 4.1 The Basic Income Guarantee: The next BIG idea? Too many of our people live in gruelling, demeaning, dehumanising poverty. We are sitting on a powder keg. … We should discuss as a nation whether a basic income grant is not really a viable way forward. We should not be browbeaten by pontificating decrees from on high. We cannot, glibly, on full stomachs, speak about handouts to those who often go to bed hungry. It is cynical in the extreme to speak about handouts when people can become very rich at the stroke of a pen. (Archbishop Desmond Tutu, Nelson Mandela Lecture, Johannesburg, November 2004) As different social protection programmes have multiplied, interest has grown in a much simpler idea. Why not guarantee all members of society a basic income? Typically, advocates argue for this to be linked to national poverty lines, for example set at 20 per cent of GDP per capita, and made universal, so that all citizens receive it. An income tax would fund the scheme, so that richer people contribute more, potentially helping to reduce inequality. In Brazil, President Luis Ignacio Lula da Silva in 2004 became the first president to sign a law setting out a universal income guarantee.25 The Brazilian parliament subsequently approved a Citizen’s Basic Income, to be implemented gradually, starting with the poorest families. The Bolsa Familia programme is the first step towards the universal benefit, although it is not yet clear when and how the full programme will be implemented. In addition to such national, universal programmes, a global one is possible. In 2010, supplementing the income of each poor person in the world to bring their daily income up to $1.25 would have cost $66 billion, or slightly more than half of all official aid.26 One possibility is to design a scheme along the lines of the global education Fast Track Initiative, in which donor countries agree to fund any credible plan presented to them by a developing country. Alternatively, an existing agreement, the Food Aid Convention, could be transformed into a form of global safety-net that would secure predictable funding for national social assistance schemes aimed at alleviating chronic poverty and vulnerability. Source: International Journal of Basic Income Research, www.bepress.com/bis 179 FROM POVERTY TO POWER How change happens: India’s campaign for a National Rural Employment Guarantee For the first time in history, citizens of rural India are now guaranteed a job. Within 15 days of a valid application, the government is legally obliged to provide 100 days of unskilled work per year on public works programmes. Activists, politicians, and academics have hailed the National Rural Employment Guarantee Act (NREGA), passed in August 2005, as vital for improving the lot of rural workers. The Act was born of drought and rural distress in the state of Rajasthan, where civil society networks denounced the failure of public food distribution and employment programmes to prevent starvation. Activists submitted a petition to the Supreme Court in 2001 on the ‘Right to Food’, which received favourable interim directives. Encouraged, they drafted a Rajasthan State Employment Guarantee Act in 2003, though this was not implemented. However, the activists’ success in rallying civil society reflected the growth of rights-based approaches in India, favouring a demand-based system over the passive beneficiary employment programmes of the past. From 2001, Congress Party leaders, including party president Sonia Gandhi, raised the issue in the national party, but most people believed that it had no chance in the 2004 national election. Luckily for NREGA activists, impending political defeat weakened the resistance of fiscal conservatives in the Congress leadership to a potentially costly employment guarantee, and also gave impetus to those who argued that Congress needed a strong, positive policy programme to revive its fortunes. These factors led to an employment guarantee being included in the 2004 Congress national manifesto. Although unrelated to its presence in the manifesto, the Congress alliance’s surprise victory in the 2004 general election, and its formation of a majority government with the support of two left-wing parties that had achieved unprecedented success, marked a watershed for the proposal. Electoral success reinforced the political arguments for action in the minds of Congress leaders. Taken by surprise by its own victory, the party’s leadership needed to rapidly cobble together a policy programme. The employment guarantee policy was not only ready to go, but the presence of the left-wing parties would in any case have made it difficult to remove from the programme. A newly formed National Advisory Council, chaired by Sonia Gandhi and including influential figures closely associated with the NREGA, such as professor and activist Jean Drèze, activist Aruna Roy, and Congress leader Jairam Ramesh, drew up a draft Act based on the civil society draft from Rajasthan. CASE STUDY 180 4 HUMAN SECURITY By the time the National Rural Employment Guarantee Bill was submitted to Parliament in December 2004, however, the Ministry of Finance had introduced a number of clauses to limit the government’s potential financial liability, sparking a row with activists and leftwing leaders. A determined campaign, involving a 50-day march across the country’s poorest districts to spread awareness of the concept of the right to employment, sit-in protests, direct contacts with politicians, and public hearings – all of which won substantial media coverage – increased risks for politicians who openly supported the Ministry of Finance restrictions, because they would be seen as ‘anti-poor’. Passed unanimously, the final text was a compromise – but one with great potential, thanks to civil society’s effective combination of public campaigning and a determined political lobby. By the end of 2009, the scheme was reaching 46 million households across India, providing them with an average of 49 days’ work a year. Sources: I. MacAuslan (2007) ‘India’s National Rural Employment Guarantee Act: A Case Study for How Change Happens’, paper for Oxfam International; www.righttofoodindia.org; www.nrega.nic.in; N. Dey, J. Drèze, and R. Khera (2006) Employment Guarantee Act: A Primer, New Delhi: National Book Trust; C. Gonsalves, P.R. Kumar, and A.R. Srivastava (eds) (2005) ‘Right to Food’, New Delhi: Human Rights Law Network; I. MacAuslan and A. Mehtta (2010), ‘The National Rural Employment Guarantee Act: A Case Study’. CASE STUDY 181 Finance and vulnerability Saving for a rainy day and borrowing when hard times strike have always been strategies used by people living in poverty to reduce their vulnerability to shocks. In recent years, the failure of national and global financial systems to meet the needs of poor communities in many countries has led to the creation of a new phenomenon, microfinance, which was driven first by civil society organisations and ‘social entrepreneurs’ and is increasingly being picked up by mainstream financial institutions and the state. Access to credit is critical to any business, however small, while being able to save and borrow enables poor people to smooth out the sudden peaks and troughs in their income and expenditure that can inflict shortterm hardship on a family, such as job loss, sickness, funerals, or weddings. However, conventional financial markets systematically exclude many poor people. Banks rarely have branches where poor people live, they require onerous collateral or deposits, or they will not deal in small loan amounts. Gender or ethnic bias frequently has a large part to play. This financial exclusion was exacerbated by the structural adjustment programmes in the 1980s and 1990s, which shut down or privatised state-owned banks, including so-called ‘development banks’ which had offered subsidised loans to farmers and others. Poor people’s needs are often tiny in financial terms, but are critical to their well-being. A shoe-shiner who cannot afford to buy his brushes will be forced to rent them at extortionate rates. The same goes for a rickshaw driver without his own rickshaw or a seamstress without her own sewing machine. A family without a secure place to hold savings may store its wealth in much riskier investments such as livestock. Discussion of access to finance often revolves around formal channels such as banks, insurance companies and increasingly, microfinance institutions (MFIs). But when researchers used ‘financial diaries’ to track the finances of 250 households in Bangladesh, India and South Africa, they uncovered a rich ecosystem of informal financial arrangements that barely register on the official developmental radar. Every one of the 250 households had both savings and debt of some sort, and no household used fewer than four types of financial instrument over the course of the year. Even people living on $1–2 a day typically save about 25 per cent of their income. This constant activity is needed because people living in poverty need financial skills more than the better off. They must manage the erratic cash flow of poor homes to make sure there is food on the table every day and deal 182 4 HUMAN SECURITY with the health and other emergencies that can derail families with little in reserve. In South Africa, funerals (frequent because of HIV and AIDS) cost between 5 and 10 months’ household income – a huge sum for people living on the edge. Finally they need to raise lump sums to seize opportunities (typically to buy land) or pay for big ticket expenses like weddings (which in India took up over half the yearly income of a typical household).29 Since the early 1970s a number of non-profit microfinance organisations have stepped into this gap, led by the most famous, Bangladesh’s Grameen Bank, whose founder Muhammad Yunus was awarded the Nobel Peace Prize in 2006. The growth of microfinance institutions has been spectacular, and the total number of very poor families with a microloan has grown more than 18-fold from 7.6 million in 1997 to 137.5 million in 2010. Over 80 per cent (113.1 million) of these were women. The vast majority of these people (over 90 per cent) live in Asia, where over two-thirds of poor families have access to microfinance.30 More than four out of every five microfinance customers are women, often female heads of households, or elderly women, and usually grouped together into groups of three to six, who collectively guarantee loans. With loans, the result has been astonishingly high repayment rates – Grameen claims that over 98 per cent of its loans are repaid – making microfinance both selfsustaining and profitable. Although typically loans are in the order of $100, some are much smaller: Grameen Bank’s interest-free loans for urban beggars average $9, and include credit lines with local shops that allow items to be bought for resale, allowing beggars to upgrade to become street-sellers. The growing commercial interest in such ‘bottom-of-the-pyramid’31 markets has seen the entrance of a number of large commercial banks, often in partnership with existing microfinance organisations, and this has greatly increased the numbers of poor women with access to credit and savings. The first private multinational microfinance bank is Procredit, founded in 1996 and backed by investment from the International Finance Corporation (IFC), the commercial arm of the World Bank.32 Procredit has set up banks in 22 countries and has taken over institutions in four others. By 2008 it had 17,000 employees, €4.1bn ($6bn) in assets, and an investment grade rating that allows it to raise money in the German bond market. Long-established commercial banks, such as Citigroup and Standard Chartered, are also getting in on the act, as are domestic banks such as Indonesia’s Bank Rakyat Indonesia (BRI). The much-emulated BRI converted itself in the 1970s from a failing state bank into a microfinance institution and became one of the most profitable banks in the country, with 32 million depositors and three million borrowers. Still 70 per cent state-owned, BRI shows what effective state action can achieve in reducing vulnerability. Since as many as three billion people worldwide, especially those living in rural areas, still do not have access to financial services, there is plenty of room 183 FROM POVERTY TO POWER for expansion. In Latin America, the entry of commercial banks appears to have freed up microfinance NGOs to go in search of even poorer people, and their average loan sizes have shrunk.33 New trends in microfinance include exploring the links with remittances sent home by migrants and using new technologies such as ATMs and mobile phones. In 2007, in what was described as a world first, Kenya’s biggest mobile operator began allowing subscribers to send cash to other phone users via SMS messaging, obviating the need for a bank account and potentially giving whole new groups of customers access to microfinance providers.34 Although Kofi Annan called microcredit ‘one of the success stories of the last decade’, and the award of the Nobel Peace Prize to Muhammad Yunus boosted the hype still further, it is far from being a ‘magic bullet’ for reducing poverty. In 2010 a spate of debtor suicides in Andhra Pradesh, India, prompted accusations that commercial microfinance institutions were tantamount to loan sharks with habits of predatory lending.35 A wider backlash argued that loans generally go to the moderately poor, missing out the most deprived individuals and communities, who continue to rely on informal mechanisms or social protection from the state, such as pensions and work schemes.36 The vast majority of microloans do not create jobs, but are used for consumption. Those that are used for business purposes usually create more sellers in an already overcrowded informal sector, with few chances of long-term progress, and do not deal with the underlying structural problems of under-development.37 In East Africa, commercial microfinance lending at 2–3 per cent a month still leaves villagers with heavy debts, and risks microfinance banks becoming little more than kinder, gentler loan sharks. The flipside of high repayment ratios is that, however heavy the burden of repayments, women are often too fearful of social opprobrium to default (as loans are generally guaranteed collectively). In other cases, men have forced their wives to apply for loans and then taken the money themselves, showing that simply lending to women may not be enough unless unequal gender relations in the home are also dealt with. The likelihood is that the euphoria and backlash will both fade, leaving a more realistic understanding that microfinance is but one more tool in the development toolkit, and can have both good and bad impacts depending on how it is governed and designed. Although microfinance is generally equated with microcredit (small loans), in many cases the availability of well-designed, safe, and accessible savings products for poor people is just as important – if not more so – in reducing poverty. Indeed, despite the explosion of microcredit institutions worldwide, it is estimated that more than 60 per cent of rural people globally still have no access to any kind of formal financial institution, microcredit or not. Even microcredit institutions typically do not reach the more remote or more sparsely populated areas of a country. 184 4 HUMAN SECURITY Even if they do, the very poorest people are often unwilling to take the risk of a microcredit loan. Yet they are keen to save small amounts to reduce future vulnerability. Savings groups of 20 or so individuals provide one effective approach. People save monthly at an interest rate determined by the group, and then in turn lend the savings to members of the group who need cash for petty trade, emergency purchases, or school fees. The interest goes back to the group fund as well as the savings account of each member when the group cashes out, which is typically once a year. A revolving savings and loan scheme of this type can earn members 20–40 per cent a year on their savings, as well as providing the benefits of a microcredit scheme to those who take out loans. One such scheme is Oxfam America’s Saving for Change programme, which has 552,000 members spread across more than 6,000 villages in Mali, Senegal, Burkina Faso, El Salvador, and Cambodia. Collectively, these groups have saved over $11 million, and the participants on average earn 20 per cent annually on their deposits.38 Women find that joining the groups can reduce vulnerability to various kinds of future shocks because of the solidarity built up within the group for mutual self-help. They have also found that the groups help them carve out greater political space for women in the village. These groups are so attractive that over two-thirds of the working savings groups in Mali actually have been formed by women on their own initiative (rather than at the instigation of outsiders). And this is being done in an environment in which over 90 per cent of the women are illiterate. Other providers are developing ‘microinsurance’ along the lines of microcredit, charging from as little as 50 cents to insure anything from television sets to burial costs. In India, the largest comprehensive contributory social security scheme for informal economy workers is the Integrated Social Security Programme set up by the Self Employed Women’s Association (SEWA) (see Part 3). SEWA’s programme insures more than 100,000 women workers and covers health insurance (including a maternity component), life insurance, and asset insurance.39 Dhan Foundation in Madurai, India has more than a million people signed up for its life insurance scheme.40  Microinsurance providers often forgo traditional documentation requirements, sometimes selling life insurance to people who do not know their date of birth. As with microcredit, microinsurance is increasingly moving into the mainstream, attracting big players such as the insurance multinational AIG. Insurance markets are saturated in many rich countries and growth prospects are limited, so insurance companies are looking for long-term growth in emerging markets. 185 Hunger and famine Hunger exists in a world of plenty. Worldwide, improvements in crop yields have run ahead of population growth, meaning that there is enough food to go around.41 In principle, there is no reason why a single child or adult should go hungry. In fact, the world has a growing number of obese people, currently standing at 500 million. Of the 43 million children overweight in 2010, close to 35 million lived in developing countries.42 Levels of obesity in Mexico, Egypt, and South Africa are on a par with those in the USA, bringing with them soaring rates of diabetes and other ‘diseases of plenty’. Yet one in seven of the world’s people go to bed with empty bellies, perhaps the starkest proof of the deep inequality and injustice that blights the global economy, both within and between countries. Up until the mid-1990s, the numbers of hungry people fell slowly but steadily, despite rising global population. But since the late 90s, hunger has started to rise, leaping to over a billion people in 2008 for the first time in human history. The driver has been high global food prices, with fierce debates over whether this is a long-term setback or a short-term hiccup in human progress. Somewhere around the middle of the last decade, a major change hit the global food system. After 25 years of steady decline, the price of the main global food crops – rice, wheat, and maize – rocketed. The impact of this food price spike is discussed in Part 6. Famine, where hunger tips over into social breakdown and mass starvation, is less common and less devastating than it once was. Asia and the Soviet Union were home to the twentieth century’s worst famines, led by the estimated 30 million people who died in China in 1958 and the nine million dead in the Soviet Union in 1921. By comparison, the worst famine of recent decades, in Ethiopia in 1984, claimed an estimated one million lives.43 At the time of writing it is not yet clear if the new famine in Somalia, the first in 30 years, will reach those grim heights, but in 2011, more than 13 million people across the Horn of Africa were facing terrible food shortages after the worst drought in 60 years. Undernourishment cripples individuals and society. At its most extreme it kills, with young children and babies often the first to die. More commonly, it weakens people, draining them of the energy that they need to work, and making them more prone to disease. Severe malnutrition in children increases the likelihood of future illness and death, reduces school performance, causes long-term brain damage, and reduces future potential and incomes. The UN calculates that the loss of productivity due to malnutrition costs the developing world between 5 per cent and 10 per cent of its GDP every year.44 186 4 HUMAN SECURITY Box 4.2 Coping with hunger ‘[T]o understand the demise of [the town of] Furawiya [in Darfur, Sudan], we must go back to the last humanitarian disaster to strike the area, the drought and famine of 1984–1985. When that famine was drawing to a close, I spoke with a young woman in Furawiya called Amina. The widowed mother of three children, she harvested barely a basketful of millet in September 1984, when the third successive year of drought was devastating crops. Rather than eating her pitiful supply of food, she buried it in her yard, mixing the grains with sand and gravel to stop her hungry children from digging it up and eating it. Then she began an epic eight-month migration, not atypical of the journeys that ordinary Zaghawa rural people make. Amina started by scouring the open wildernesses of the Zaghawa plateau for wild grasses, whose tiny grains can be pounded into flour. Together with her mother (who was, like most older rural women, something of a specialist in wild foods), she spent almost two months living off wild grass and the berries of a small tree, known locally as mukheit and to botanists as boscia senegaliensis. Mukheit is toxic and needs to be soaked in water for three days before it is edible; although it has a sour taste, it contains about a third of the calories of grain. ‘Having lived solely on wild foods for eight weeks, and having stored enough provisions for a week’s journey, Amina left her eldest daughter in the care of her mother and walked southward. She found work on farms in better-watered areas, collected firewood for sale in towns, and sold a couple of her goats (for a meagre return, since the market was flooded with distressed rural people selling animals). She finally made it to a relief camp in June, just before the rains were due, and collected one set of rations. With a couple of kilos of sorghum on her back, Amina and her two other children promptly left the camp and walked home (it took one week), dug up the seed Amina had buried the previous fall, planted it, and watched it grow for another three hungry months (again living off wild foods plus the milk from the herds of camels and goats that the Furawiya residents were bringing back from southern Darfur). Finally she harvested her first post-famine crop, which she was threshing the day I arrived. ‘A remarkable story of sheer toughness and survival skill, Amina’s story brought home to me just how marginal we outsider agents of relief are to the survival of ordinary Darfurian villagers. We provide little help and even littler understanding. A Zaghawa refugee in Chad today, looking across the border to the small town of Tine, with its gracious mosque, sees not a desert but a land in which she can survive, if only given the chance.’ Source: Alex de Waal, ‘Tragedy in Darfur, On understanding and ending the horror’, http://bostonreview.net/BR29.5/dewaal.html 187 FROM POVERTY TO POWER Citizens and states Reducing hunger, like mitigating the impact of natural disasters, requires action by the state and self-help by hungry people.45 The state can intervene to improve livelihoods or head off a crisis, can put in early warning systems to spot signals such as spiralling food prices, can maintain strategic food reserves and, if necessary, can provide food or other forms of social protection. Poor people themselves are best placed to anticipate problems in feeding their families, and to urge authorities to act. The Nobel prize-winning Indian economist Amartya Sen wrote: ‘No famine has ever taken place in the history of the world in a functioning democracy.’46 Sen pointed out that, since achieving independence in 1947, India has not had a single famine, even in the face of severe crop failures. When food production was hit hard during the 1973 drought in Maharashtra, elected politicians responded with public works programmes for five million people and averted a famine. Sen concluded that ‘famines are, in fact, so easy to prevent, that is it is amazing that they are allowed to occur at all’. Famines may be the fruit of autocracy rather than democracy (or of violence, rather than peace, as in Somalia in 2011), but, as Sen acknowledges, democracy has a much less impressive record in dealing with endemic hunger and malnutrition. More than 6,000 Indian children die every day because of malnourishment or a lack of basic micronutrients.47 Beyond the political changes required to narrow the distance between governors and governed, Sen sets out a number of proposals for preventing hunger and famine: • The focus has to be on the economic power and freedom of individuals and families to buy enough food, not just on ensuring that the country has sufficient food stocks. Government-run temporary job creation schemes (as employed by India) are one of the best ways to help people earn enough to buy food. • A good deal of the mortality associated with famines actually results from diseases that can be brought under control by decent public health systems. • A free press and an active political opposition constitute the best earlywarning system. • Since famines seldom affect more than 10 per cent of the population, governments usually have the resources to deal with them. Sen also points to the importance of economic growth and the diversification of rural incomes. Growth generates jobs and tax revenues, allowing governments to fund social protection and relief schemes, while diversification allows poor families to manage risks by reducing their reliance on any one source of income. 188 4 HUMAN SECURITY In recent years, there have been promising signs in India of progress at national level, as citizens’ campaigns around hunger have changed laws and lives. In 2005, the Indian government passed the National Rural Employment Guarantee Bill. The bill provides 100 days of unskilled manual work for every rural household that wants it, and much of the work itself will help to reduce vulnerability, for example by reforesting land or building irrigation canals to poor and marginalised villages. The bill represents a triumph of public action, and is discussed in more detail in the case study ‘How change happens: India’s campaign for a National Rural Employment Guarantee’. Some African governments are following India’s example in funding job and social protection programmes. Governments have also recognised the benefits of involving civil society and international agencies in anticipating and dealing with food emergencies. Vulnerability Assessment Committees (VACs) in Southern Africa, made up of governments, UN agencies, and NGOs, monitor harvests, markets, and incomes to provide early warnings of impending problems. The assessment from the Malawi VAC for the 2005 food crisis resulted in timely donor and government intervention. When hunger strikes, the reflex response in rich countries is often to send food. But as Part 5 explains, food aid often arrives too late, in the wrong form, or stifles the recovery of local agriculture. As noted above, except where markets are not functioning, sending cash for the purchase of locally produced food is a much better option. People’s capabilities can be strengthened during and immediately after food emergencies, for example by supporting seed fairs to encourage the planting of traditional crops best suited to the environment, in order to kickstart local food production. Oxfam has found that giving farmers vouchers to buy seeds at fairs offers them greater choice than simply handing out seed packages. Oxfam held 37 seed fairs in partnership with local organisations in Masvingo and Midlands provinces in Zimbabwe in 2004–5, bringing together producers, seed merchants, extension agents, and local people, who were given vouchers to pay for their own choice of seed. At each fair, hundreds of local farmers crowded in to see what was on offer. The rich diversity of 21 crops and 51 varieties included groundnuts, sorghum, cowpeas, maize, soybeans, sesame, rice, sunflower, and pearl millet, as well as a range of vegetable seeds, some of which were previously threatened with extinction. Many of these traditional crops are cheaper and more tolerant of marginal conditions than high-yielding varieties. Some 23,000 households benefited directly through buying seeds. When people are in danger of starving, talk of rights and citizenship may seem like a luxury. Nothing could be further from the truth. A human security approach, guaranteeing people’s rights and building systems of social protection, can reduce their vulnerability when a food crisis hits, and so 189 FROM POVERTY TO POWER prevent a hazard turning into a disaster. Poor people and communities who can exercise their rights when food is in short supply are better able to cope and rebuild their lives rapidly once the crisis is over. In all these stages, they need active support from states that are both effective in delivering services and accountable to the needs of their people. 190 HIV, AIDS, and other health risks Prudence Mabele is a party animal. Scrambling onto the stage at a Johannesburg jazz club, her long dreadlocks carve through the air as she dances. Earlier she’d hustled a table in a crowded restaurant and a free concert ticket for a friend. She never stops networking, but usually directs her boundless energy to more lofty ends. She runs Positive Women’s Network, a South African NGO that helps women living with HIV to lead full and active lives. Prudence has been HIV-positive for the past 20 years. However, Prudence faces an uphill task in a country where an estimated 1,000 people die every day from AIDS, and HIV infection rates are still rising due to a combination of poverty, stigma, migration, illiteracy, and mixed messages from a deeply divided government. The health of poor people is subject to daily attrition from dirty water, malnourishment, and a lack of basic health services. At the household level, illness can be a ‘shock’ that sends a family into a spiral of impoverishment. Bouts of sickness, especially in childhood, can have life-long impacts in terms of chronic ill health, stunting, and poor educational performance. The best guarantor of security against such harrowing experiences is a functioning health service – a form of medical social protection, discussed more fully in Part 2. When health shocks occur at the societal level, in the form of a disease epidemic, they can set development efforts back decades. From at least the time of the Black Death, such health shocks frequently take the form of new diseases that lay waste to entire populations. One of these is AIDS, which initially seemed to be bucking the trend, attacking health in the rich countries. But soon the basic link between poor health and inequality reasserted itself, as the human immunodeficiency virus (HIV) spread rapidly across the world, affecting poor and vulnerable people, particularly in sub-Saharan Africa and particularly women. Other new diseases, such as swine fever, avian influenza or severe acute respiratory syndrome (SARS), many of them ‘zoonotic’ (originating in animals, then passing to humans) also threaten to trigger an HIV-style pandemic, while longstanding maladies such as tuberculosis, malaria, bilharzia, Chaga’s disease, and sleeping sickness continue to take an enormous toll on individuals, families, and societies. In societies where HIV prevalence is high, every aspect of the struggle against poverty and inequality, from production to organisation to gender relations, has been transformed by HIV and AIDS. Taking action now can prevent millions of deaths in the future, as the example of Brazil in the 191 FROM POVERTY TO POWER next section shows. Given that there is not yet a medical cure for AIDS (although there is treatment that stops short of a cure), reducing poor people’s vulnerability involves looking at the social and economic context of their lives to find out what makes them vulnerable, and taking steps to remedy these sources of risk. ‘It’s not the disease that kills, but the lack of other resources – poverty, dirty water, food’, says a nurse at an HIV centre in South Africa.48 The stigma attached to HIV and AIDS makes the disease far harder to bear. When people living with AIDS in northern Thailand were surveyed, researchers expected them to say that access to antiretroviral drugs (ARVs) was their main worry but, instead, ending discrimination against HIV-positive people was their number one concern. Groups such as sex workers and men who have sex with men suffer particular discrimination and a lack of information and treatment, as well as punitive laws. The first cases of HIV and AIDS were discovered in 1981 in the USA, the Democratic Republic of the Congo, and East Africa. By 1985 cases were reported in every region of the world. In 30 years the disease has spread to virtually every country, with 33 million people living with HIV and AIDS in 2009.49 Nearly 30 million have lost their lives in those three decades.50 2.6 million were newly infected with HIV in 2009, more than one fifth (21 per cent) fewer than the estimated 3.2 million in 1997, the year in which annual new infections peaked, while 1.8 million people died from AIDS, down from a peak of 2.1 million in 2004. Sub-Saharan Africa remains the global epicentre of the pandemic, with 22.5 million people living with HIV and AIDS – twothirds of the global total. Women are more at risk, both due to the physiology of disease transmission and because they are less able to refuse sex or insist on condoms, since discrimination and consequent economic vulnerability drive them into a high level of dependence on men. Their demands for treatment or for technologies that prevent transmission, such as microbicides, are less likely to be heard by the authorities. Part 2 of this book notes that women’s lack of property rights allows widows (whether due to AIDS or other causes) to be driven from their land, leaving them destitute and vulnerable. Three in every five HIV-positive Africans are women. Such bare statistics utterly fail to convey the depth of the catastrophe that is unfolding in Africa. Stephen Lewis, the UN’s former special envoy for HIV and AIDS in Africa, conjures up an apocalyptic vision: The pandemic of HIV/AIDS feels as though it will go on forever. The adult medical wards of the urban hospitals are filled with AIDSrelated illnesses, men, women, wasted and dying; aluminium coffins wheeling in and out in Kafkaesque rotation; in the pediatric wards, nurses tenderly removing the bodies of infants; funerals occupying the weekends, cemeteries running out of grave sites; in the villages, hut 192 4 HUMAN SECURITY after hut yields a picture of a mother, usually a young woman, in the final throes of life. No one is untouched. Everyone has a heartbreaking story to tell. Virtually every country in East and southern Africa is a nation of mourners.51 Advances in drug treatments have meant that AIDS has long since ceased to be a death sentence in rich countries, but for many years the high price of medicines and the lack of effective health services turned it into a killer of poor people, especially women. Now though, the picture is changing for the better, thanks to an international effort by the Global Fund, UN and other bodies, as well as national governments and organisations of people living with HIV. More than 5 million of the estimated 15 million people who are eligible are receiving treatment and new infection and death rates are slowly declining, allowing the head of UNAIDs to declare ‘We have halted and begun to reverse the epidemic’. However, progress is slow and could easily be reversed if funding dries up or aid donors and governments declare victory prematurely and turn their attention elsewhere. Citizens and states against AIDS Because there is no vaccine for HIV or cure for AIDS, and because HIV spreads mainly through sexual contact, this health shock cannot be effectively mitigated by state action alone. In this way AIDS is not unlike diseases spread by poor hygiene. Stopping it requires changes in people’s behaviour and societal attitudes. The state must take the lead but all of society needs to become engaged: women to demand their rights; men to resist social pressures to have unsafe sex; groups of people living with HIV to organise systems of self-help and demand services from governments; all to understand how HIV is spread and how it can be prevented. Active, empowered citizens, especially those living with HIV and AIDs or from at-risk marginalised groups, are an essential part of stemming the spread of HIV and AIDS and reducing the devastation it wreaks: their ‘agency’ cannot be neglected. The pandemic has thrown up some inspiring examples of grassroots activism. The experience of perhaps the best known is discussed in the case study ‘How change happens: South Africa’s Treatment Action Campaign’. In the Ukraine, what went on to become an award-winning movement began when seven HIV-positive activists met in 1999 and set up the All Ukraine Network of People Living with HIV and AIDS. Its combination of self-help, public education, and high-level lobbying has helped to get HIV and AIDS designated as national health care priorities, trebled the national budget for treatment, and persuaded the government to cancel the results of what are delicately called ‘non-transparent tenders’ for purchases of ARV drugs. The Network has helped to inspire similar exercises across the countries of the former Soviet Union. 193 FROM POVERTY TO POWER In parallel with citizen action, governments both North and South must deliver protection, whether in the shape of properly funded, effective health services and prevention programmes or trade rules that facilitate (rather than obstruct) the provision of affordable medicines. The pharmaceutical industry, for its part, must understand that access to medicines is a fundamental human right, enshrined in international law, and that this places a particular responsibility on drugs companies.52 Delivering a social good such as access to medicines through market mechanisms is always going to pose challenges: if pharmaceutical companies do not see themselves as bearing the duty to save lives even when it is not profitable, governments must use their regulatory powers to ensure that treatment is available to all. The attitudes and initiative of political leaders are crucial. South Africa’s President Thabo Mbeki questioned the safety and value of life-saving antiretroviral treatment for HIV and AIDS and even publicly doubted that HIV causes AIDS, setting back the national treatment and prevention effort in the worst-affected country in the world. In contrast, Brazil’s Jose Sarney threw the state’s weight behind the national HIV and AIDS campaign early on, while Botswana’s President Festus Mogae spoke publicly about the threat in an effort to reduce the stigma that deterred people from being tested for HIV: ‘We are threatened with extinction. People are dying in chillingly high numbers. It is a crisis of the first magnitude.’53 Botswana was the first African country to commit itself to providing ARVs to all citizens who required them. Brazil shows what can be achieved by a combination of citizen action and state support. Its simultaneous programmes of prevention and treatment have halved AIDS deaths and infectious diseases related to HIV and AIDS.54 Strong and effective civil society participation: A key element in Brazil’s success has been its combination of an open attitude to sex and a vibrant tradition of civil society activism. AIDS carries less stigma than in other countries, a factor that was pivotal in increasing the visibility of the problem. Gay-rights groups were the first to speak out publicly, and activist groups remain the keystone to the prevention strategy, distributing millions of free condoms and ensuring a supportive environment for people living with HIV and AIDS. Activists also influence the health budget through vocal lobbying and public demonstrations. The media play an active role, with continual advertising through television stations, radio networks, and print media outlets, promoting safe sex and increasing awareness of the epidemic. Effective state action: In 1986 the government, pressured by activists, established a national programme that guaranteed every AIDS patient state-of-theart treatment, free of charge. Anti-discrimination laws were passed to protect citizens living with HIV and AIDS. Co-operation agreements between political parties safeguarded these laws and the health budget, providing continuity of the programme despite changes in governments. 194 4 HUMAN SECURITY Brazil took to the world stage to surmount a huge barrier that keeps poor countries from providing free, universal access to ARVs: their cost, which is kept artificially high by overly strict patent rules. Brazil led the way at the World Trade Organisation ministerial meeting in Doha, Qatar, arguing successfully for allowing developing countries to break drug patents for compelling reasons of public health. Brazil had already passed legislation permitting the manufacture of generic versions of patented medicines and now produces eight out of seventeen of its AIDS medicines itself, reducing costs by 82 per cent. It also uses the threat of issuing compulsory licences to its generic companies for other patented drugs to bargain down prices. The Brazilian government has established an impressive network of clinics, built on the existing public health system, and has provided additional training to health workers on helping patients on antiretroviral treatments to take their medicines correctly. A computerised national system allows authorities to exert rigorous control over the supply and distribution of medicines. This makes it possible for health officials to track each individual case of AIDS in the country, to access medical notes and histories from a bar-coded card held by the patient, and to monitor and update the drug regimen for each case from any of the 111 treatment centres across the country. Other state, private sector, and civil society institutions help out by providing free bus passes to AIDS patients, and have also donated food. AIDS and aid Aid donors have made a belated, but welcome, commitment to assist poor countries in the fight against pandemics by setting up the Global Fund to Fight AIDS, tuberculosis and malaria. Proposed by the former UN SecretaryGeneral Kofi Annan in 2001, the Global Fund was quickly embraced by the leaders of the G8 and African Union. It seeks to strengthen countries’ health systems and pays for medicines and other health products, and supports civil society organisations combating the three diseases. This unique international public–private collaboration, dedicated to attracting and disbursing funds to fight the three diseases, is discussed in more detail in Part 5. AIDS is unlikely to remain the only major pandemic of our lifetimes. Already, tuberculosis is a neglected disease that killed 1.7 million people in 2009,55 195,000 of them people living with HIV.56 With the advent of multidrug-resistant TB, tackling the disease has become harder than it was 60 years ago. Zoonotic diseases, which originate in animals and then pass to humans, are also seen as a potential source of new epidemics, leading to global scares over avian flu, which emerged in South-East Asia in 2003, and swine flu. Viruses respect no borders, and tackling pandemics requires co-ordinated international action. In health, this has achieved some spectacular successes, such as the eradication of smallpox and the control of the SARS outbreak 195 FROM POVERTY TO POWER Box 4.3 SARS: What global collaboration can achieve There is a startling contrast between the prompt and effective global response to severe acute respiratory syndrome (SARS) and the years of neglect over HIV and AIDS. The World Health Organization’s Global Alert Response system is a surveillance system that continually tracks the outbreak of emerging potential health epidemics around the world. SARS was one such threat, first identified on 12 March 2003. Unprecedented global collaboration was the key to the containment of this deadly new disease. Initially, international and national teams on the ground provided information on it, which was quickly disseminated globally, allowing rapid identification of imported cases and thus the containment of the outbreak. The WHO went onto something approaching a war footing, receiving daily updates on the situation in countries with outbreaks and demanding the immediate reporting of cases detected in all other countries. Operational teams provided 24-hour advice to countries on SARS surveillance, preparedness, and response measures. As a direct result of this global collaboration, the cause of SARS was identified and the disease was rapidly isolated and treated. By the beginning of July 2003, just four months after the first case was identified, the human-to-human transmission of SARS appeared to have been broken everywhere in the world. Although some 800 people had died, a global pandemic had been contained. Source: World Health Organisation (2003) ‘The Operational Response to SARS’, www. who.int/csr/sars/goarn2003_4_16/en/print.html of 2003 (see Box 4.3). Malaria, an infection caused by the malaria parasite entering the bloodstream – usually through the bite of an infected mosquito – is another major killer, and climate change is contributing to its spread in countries like Kenya, as mosquitoes move into warming areas.57 Chronic vulnerability and health Poor health is both a disaster in itself and has damaging knock-on effects. It reduces people’s earnings potential, often forcing them into debt, increases the burden on other family members, including children, and transmits deprivation down the generations. The sudden illness of a family member is one of the most common reasons why a family tips over the edge into a cycle of poverty and debt. Chronic illnesses such as HIV or diabetes constitute a 196 4 HUMAN SECURITY continuing drain on the household, increasing the workload of women and sometimes pushing them into activities that increase the risk of further illness, whether through sex work or the physical toll of excessive hours working in unsafe or unhygienic conditions. Because of their socialised role as care-givers, women are both more likely to bear the burden of looking after the sick (particularly heavy where treatment is unavailable or too expensive) and most active in struggles for better health care. Women are also more likely to contract diseases such as malaria, TB, and HIV.58 They are usually the last in the family to access health care, especially if it has to be paid for – a sign both of their lack of economic power and of prevalent attitudes towards women in many cultures. There is no starker condemnation of the failure to guarantee women’s right to health than the lack of progress in reducing ‘maternal mortality’ – the anodyne term for women who die in pregnancy or childbirth. Worldwide, over 350,000 women die each year from pregnancy-related causes – a thousand women every day. However, that figure conceals extreme inequalities: 99 per cent of the deaths take place in developing countries.59 A woman’s lifetime risk of maternal death ranges from one in eleven in Afghanistan to 1 in 4300 in the developed world.60 Children who have lost their mothers are up to ten times more likely to die prematurely than those who have not.61 Maternal mortality reflects ethnic as well as economic inequalities. In Mexico, the risk of dying of causes related to pregnancy, childbirth, or postpartum is three times higher in indigenous communities than in the rest of the country.62 The vicious cycle of ill health, ignorance, and poverty starts in the womb. A quarter of children in the developing world have a birth weight below the critical minimum of 2.5kg because their mothers are undernourished.63 Evidence from countries where girls are taken out of school and married off in their early teens shows the link between early motherhood and babies who are more likely to be underweight and have a lower chance of survival.64 Malnourished children are more likely to fall ill, less likely to perform well in school, and so less likely to earn a decent income in adulthood. The record on providing health services to poor people around the world is one of some success in targeted interventions, against a background of disintegrating systems and increasing inequality. Most health-care services are provided by national systems that have been under-funded for decades. Global efforts to boost health-care coverage have provided essential support, but founder on this legacy of neglect. Slow progress in bringing down maternal mortality rates contrasts with solid progress in other areas. For example, immunisation coverage has greatly increased since the WHO launched its Expanded Programme on Immunisation in 1974. In 2010, global coverage for DTP3 (three doses of the diphtheria– tetanus–pertussis combination vaccine) was 85 per cent – up from 20 per 197 FROM POVERTY TO POWER cent in 1980.65 Unfortunately this was done in a way that did not provide the necessary investment in underlying health services. Therefore when donors lost interest and their funding for vaccine programmes decreased, there was a collapse of many vaccination programmes and a falling vaccination rate in the following years. The rapid scale-up in global immunisation since 2001 through the Global Alliance for Vaccines and Immunization (GAVI), a public–private partnership, has reinvigorated vaccination programmes and brought down the death toll, saving an estimated five million lives.66 But the high prices charged by drug companies for new vaccines threaten the universal coverage it seeks. People with less political clout, such as those living in remote locations, urban slums, and border areas, as well as indigenous groups and displaced populations, are most likely to miss out on vaccination – an indicator of their lack of access to other essential health services. An estimated 2.1 million people around the world died in 2002 of diseases preventable by widely used vaccines. This toll included 1.4 million children under the age of five.67 On top of continuing epidemics of preventable diseases such as chest infections, malaria, and TB, and of treatable ones such as AIDS, developing countries now also face a rise of ‘first world’ ailments such as heart disease, diabetes, and cancer, creating a ‘triple burden’ of old, new, and chronic disease that threatens to overwhelm under-funded health services. In 2008, 36.1  million people died from conditions such as heart disease, strokes, chronic lung diseases, cancers and diabetes. Nearly 80 per cent of these deaths occurred in low- and middle-income countries. Many could be avoided by introducing stronger anti-tobacco controls and promoting healthier diets, physical activity, and reducing harmful use of alcohol; along with improving people’s access to essential health care. Another healthrelated topic that is imposing an increasing burden but is often overlooked is road traffic accidents. Of the world’s 1.3 million road deaths each year, a fatality rate comparable to malaria or tuberculosis, nine in ten road deaths and injuries are in developing countries. Simple measures like seatbelts and enforcing traffic regulations could massively reduce the carnage.68 An additional global problem is the extraordinarily unequal geographic distribution of health spending and health workers. The Americas, with 10 per cent of the global burden of disease, have 37 per cent of the world’s health workers and absorb more than 50 per cent of the world’s health financing. Africa, on the other hand, has 24 per cent of the disease burden but only 3 per cent of health workers, and commands less than 1 per cent of world health expenditure. Moreover, Africa’s attempts to increase provision are constantly undermined by the exodus of its nurses and doctors in search of higher wages in richer countries.69 The African Union estimates that low-income countries subsidise high-income countries to the tune of $500m every year through the loss of their health workers.70 198 4 HUMAN SECURITY A human security approach to reducing vulnerability to ill health requires action to empower poor people and communities, enabling them where possible to prevent ill health striking, to cope with it if they are unsuccessful, and to recover as quickly as possible thereafter. Communities must be given much greater say in how services are delivered. Human security also requires effective state protection, in the shape of a health system that provides universal access. Tackling inequality means a shift to primary and rural health care and making services work for women, by promoting and retaining female staff and supporting women as users of health-care services. But primary health care should not be seen as ‘health care on the cheap’ and must be supported by a health system that includes hospitals, not least because an ageing population increasingly aware of its health rights will demand it. This will require governments to pay decent salaries, recruit more staff, and invest in decent health planning systems. They must also invigorate the public service ethos, which has taken a battering from the anti-state message of governments and aid donors alike in recent decades. Governments need to invest in free primary care, abolishing any remaining user fees, and to focus on preventive as well as curative services. Rich countries can help by not luring away qualified nurses and doctors, a point discussed in Part 5. People will always fall ill, but whether sickness then destroys lives is largely determined by social, political, and economic conditions. HIV, while still a personal trauma, need no longer be a death sentence. Without access to treatment, however, health shocks such as HIV all too often are a cataclysmic addition to the daily toll of ill health, which weakens and undermines poor people, communities, and countries in their struggle for development. The chances of enjoying good health are unforgivably skewed between rich and poor people and countries. Sickness and poverty feed off each other, and the best way to address them involves bringing together states and citizens, backed by the resources and global collaboration of the international community. 199 FROM POVERTY TO POWER How change happens: South Africa’s Treatment Action Campaign When nearly three dozen international pharmaceutical corporations sued in 2001 to overturn a South African law allowing the importation of cheaper generic medicines, an upsurge of activism gave them such a public battering that they were forced to drop the case. At the heart of the protests was the Treatment Action Campaign (TAC), an organisation of HIV-positive people in South Africa, a country with one of the highest prevalence rates in the world. Close to 20 per cent of its population carry the virus. Formed on International AIDS Day in 1998, TAC’s 15,000 members are a fair cross-section of South Africa’s people: 80 per cent of them are unemployed, 70 per cent are women, 70 per cent are in the 14–24 age group, and 90 per cent are black. But TAC’s clout is far greater than its numbers or demographics suggest. After it had forced big pharma to climb down and then drastically cut the prices of antiretroviral (ARV) medicines, TAC took on the ANC government. Despite the court victory, some in the government, in particular the President, Thabo Mbeki, continued to question the link between HIV and AIDS. Confusing political statements, combined with slow delivery on the ground, undermined what appeared to be good plans to distribute ARVs to public health clinics. While post-apartheid democracy made violent repression unlikely, TAC’s campaign to change government policy was still long and difficult. TAC used legal challenges regularly and to great effect, winning a series of court victories on access to treatment based on the 1994 constitution, which enshrined the human right to health care. Official participatory structures of the postapartheid order, such as district health committees, offered TAC opportunities to build public support. However, South Africa’s majority rule also produced what is in effect a oneparty state, in which criticism of the ANC is easily portrayed as an attack on democracy. Whatever their private views, few influential voices were willing to publicly disagree with government policy. TAC was obliged to go beyond the courts and use confrontational tactics. Its members broke patent rules by importing cheaper Brazilian generic medicines in 2002 and held repeated loud and angry demonstrations. TAC was astute in building broad alliances both within and outside government, and at local, national, and international levels. The campaign showed a remarkable tolerance for difference, even working with the Catholic Church despite disagreement over the use of condoms. By not denouncing the ANC government (unlike many other social movements), TAC managed to find and cultivate allies within the party who eventually became instrumental in changing government policy. CASE STUDY 200 4 HUMAN SECURITY Since its campaign did not threaten major political or economic interests (other than the foreign drug companies), it was probably more suited to an insider–outsider-type strategy than issues such as land reform or the fall of apartheid itself. As an organisation of HIV-positive people, TAC also empowered its members to become their own most effective advocates, running ‘treatment literacy’ campaigns that provided the basis for both self-help and social mobilisation. Despite TAC’s enormous success in influencing public opinion, however, President Mbeki remained defiant, giving full support to Health Minister Manto Tshabalala-Msimang, who had earned the nickname ‘Dr Beetroot’ for her repeated assertions that garlic, beetroot, and better nutrition offered better prospects for treating AIDS than ARVs. Only in 2006, when the battle over who would succeed Mbeki began in earnest, did the façade of party unity begin to crack. Mbeki’s position on HIV and AIDS became a lightning rod in the leadership contest. TAC’s protests at the 16th International AIDS Conference in Toronto in August that year helped escalate the international public humiliation of the ANC at the hands of UN officials and the media. By late 2006, a change of policy on ARVs was essential for the ANC leadership to regain its authority. As it looked for a face-saving exit, the Health Minister’s (non HIV-related) sickness and temporary departure from office allowed the government to back down with good grace, finally acknowledging the scale of the problem and agreeing to do more, working with civil society and restructuring the South African National Aids Council. Deputy Health Minister Nozizwe Madlala-Routledge, a sharp critic of the government’s policies, acknowledged the role that TAC played. ‘Activism’, she said, ‘did change policy and force government to alter course – partly by strengthening different voices in government.’ And one study concluded: ‘The AIDS campaign, which has been far more concerned to use the instruments offered by constitutional democracy than any other attempt to win change in post-apartheid South Africa, has also been far more successful than its counterparts in winning change.’ Sources: Steven Friedman, ‘The Extraordinary “Ordinary”: The Campaign for Comprehensive AIDS Treatment in South Africa’ (undated); author interview with Mark Heywood, TAC, July 2007. CASE STUDY 201 The risk of natural disaster January 2001 was a bad month for earthquakes, with major tremors striking in India, El Salvador, and the northwest USA around Seattle. On the face of it, nothing could more resemble ‘acts of God’ than earthquakes, which in ages past were seen as instruments of divine wrath. However, the human impact was anything but preordained. These three earthquakes were of similar orders of magnitude, but killed 20,000 people in India, 600 in El Salvador, and none in Seattle. Even allowing for geological differences, the explanation for such a huge disparity lay not in nature, but in poverty and power. Nature is neutral, but disasters discriminate. In India, poor enforcement of building codes added to the toll, as high-rise buildings collapsed. In El Salvador, mudslides swept away the shanty homes of families who had fled rural poverty and who had nowhere else to live but the steep, deforested slopes of ravines. A decade later, up to 300,000 Haitians died from the earthquake that struck in January 2010. In comparison, around 16,000 died from the vastly more powerful earthquake (one of the most powerful ever recorded), and consequent tsunami that struck northern Japan in March 2011. Like other sources of vulnerability, disasters shine a spotlight on inequality. Rich countries and communities have resources and systems that can cope (much of Europe and North America have a natural disaster that strikes every year – it is called winter). Poor countries and communities lack the resources to cope with shocks. The hazard may be natural but the risk (created by the combination of both hazard and vulnerability) is generated by social, economic, and political inequality and injustice. Far more attention needs to be paid to reducing the vulnerability aspect of risk by redistributing voice and power to poor people, whether in the process of preparing for disasters, or in the subsequent response and recovery process. Such an effort must combine empowering poor people and communities to become active protagonists in preparing for, and coping with, disasters with building effective and accountable state machineries for disaster management. Disasters strike in many forms, but (with the exception of the 2004 Indian Ocean tsunami) the most deadly is drought and subsequent famine, which accounted for nearly half of all disaster-related deaths from 1994–2003. Floods, earthquakes, and hurricanes and other ‘windstorms’ accounted for the majority of the remainder. Every day in 2010, an average of over 800 people died as a result of natural disasters (mainly due to the earthquake in Haiti and heat wave in Russia), making 2010 the deadliest year in the last two decades,71 but that number 202 4 HUMAN SECURITY has halved over the past 30 years, thanks to a combination of more effective early warning systems and better disaster preparedness at the community level.72 However, the total number of people affected by disasters is rising.73 Clearly, while public capacity to prevent deaths is improving, the vulnerability of people living in poverty remains, and is exacerbated by issues such as increasing population in vulnerable areas and the deterioration of the environment, including climate change.74 At a national level, poor countries and weak governments are less able to protect vulnerable people. On average, the number of people affected by disasters in developing countries is 150 times higher than in rich countries, whereas the population is only five times greater. The corresponding economic losses are 20 times larger, when expressed as a percentage of respective gross national products. Poor people in wealthy countries also suffer when their governments fail to invest in disaster preparedness or to maintain essential infrastructure, as became evident in the United States in the wake of Hurricane Katrina in 2005. Within all countries, marginalised people and communities are more likely to be hurt than the powerful, with factors such as age, gender, disability, political affiliation, or ethnicity weighing heavily. Disasters also have a disproportionate effect on women. In the wake of a disaster, women and children tend to have less access to health, social, and information services than men, and therefore are less able to deal with further stresses. However, women also possess skills and knowledge that are vital to ensuring a successful recovery. In January 2001 more than 20,000 people died and thousands went missing in the northwest Indian state of Gujarat, after the worst earthquake in over 50 years. Oxfam saw at first hand how the work of one of its partners, the Self Employed Women’s Assocation (SEWA) was faster, better targeted, more efficient, and better linked to longer-term development than that of others – arguably because of SEWA’s membership structure and because it worked with (and was more accountable to) poor women. In particular, SEWA put much greater emphasis on the importance of income in sustaining women’s livelihoods after a shock, developing insurance schemes and other ways to reduce women’s vulnerability.75 Vulnerability is also partly about where poor people are obliged to live, whether on the islands of the highly hazard-prone Ganges delta in Bangladesh, in refugee camps or squatter settlements awash with small arms and a culture of impunity in Sierra Leone and Liberia (in the 1990s), or on the steep slopes of Central America vulnerable to drought, flooding, and landslides. Around urban centres, poor people are often forced to build on highrisk land, without building codes or infrastructure and at risk from flooding, mudslides, or earthquakes. The nature of ‘development’ itself can add to vulnerability, when it ignores the voices and needs of poor people. In Afghanistan, the Shiberghan highway 203 FROM POVERTY TO POWER linking Faisabad to Mazar-e-Sharif – completed in the winter of 2005 and supposed to be one of the best roads in the country – is an ecological nightmare for local farmers as it blocks natural drainage, increasing the risk of floods and threatening to wash away their crops and mud homes.76 Preservation of the natural ecosystem saves lives. The Maldives islands suffered less from the 2004 Asian tsunami than other countries because their up-market tourism industry had preserved the virgin mangroves and coral reefs surrounding the coastline.77 Coral reefs act as a natural breakwater and mangroves are a natural shock absorber.78 In the Indian state of Tamil Nadu, the villages of Pichavaram and Muthupet, which have dense mangroves, suffered few casualties and minimal economic damage, whereas Sri Lanka paid the price for its depleted protective layer.79 In regions prone to disasters, a downward spiral comes into play, as one event drives poor people further into poverty and places them even more at risk to future shocks. In part due to climate change, the total number of natural disasters has quadrupled since the mid-1980s – most of them floods, cyclones, and storms.80 Small- and medium-scale disasters are occurring more frequently than the kind of large-scale disaster that hits the headlines. As the gap between such events shortens, even if each is fairly small, poor people and communities find it harder to recover before the next blow hits, pushing them into a downward spiral of destitution and further vulnerability from which they struggle to recover.81 Reducing risk Previously we just reacted. We’d work together, but now we plan before the flood happens. It’s meant that, for example, we didn’t have to leave this place this year. Before the flood came every family had dried food and a portable oven stored. Cattle were moved and placed in a safe place. When we saw that the tube well was going under water we started to store water in pots. We don’t have to wait for outside help. (Hawa Parvin, Village Disaster Preparedness Committee, Kurigram district, Bangladesh, 2004)82 With disasters, an ounce of prevention is worth a pound of cure. Mozambique’s response to a potentially lethal combination of floods and a cyclone in 2007 showed what good national leadership and planning can achieve, even in one of the world’s poorest countries. The key to success lay in the government’s prior preparations. In October 2006, it adopted a ‘Master Plan’ for dealing with Mozambique’s vulnerability to natural disasters, covering issues ranging from the need for re-forestation and the development of a national irrigation system to the development of crops that can survive prolonged droughts. 204 4 HUMAN SECURITY Box 4.4 The Asian tsunami of 2004 One of the greatest natural disasters of recent times took place on 26 December 2004, when a massive earthquake off the west coast of Northern Sumatra led to movement along a 1,200km section of the sea floor, generating a series of tsunamis that killed people in 14 countries around the Indian Ocean. Indonesia, Sri Lanka, the Maldives, India, and Thailand were the hardest hit. Over 227,000 people lost their lives and some 1.7 million were displaced. A massive, mediafuelled global response resulted, producing an estimated $13.5bn in international aid, including $5.5bn from the public in developed countries. An in-depth evaluation of the relief effort identified a number of areas of good practice by aid agencies, including the widespread use of cash grants to those affected, rapid rebuilding of houses and schools, and greater use of complaints mechanisms and consultation with affected families than in previous disasters. Pointing out that ‘Disaster response was mostly conducted by the affected people themselves’, the evaluation team concluded that ‘The international response was most effective when enabling, facilitating and supporting [local people and national institutions], and when accountable to them.’ However, the evaluation found that this was often not the case. Aid agencies under pressure to spend money visibly opted for high-profile flagship projects, rather than painstaking collaboration with local organisations. National governments were mistakenly written off as ‘failed states’ and ignored. Aid was often supply-driven, rather than in response to the expressed needs of the affected communities. Because aid was often distributed to those who were more articulate or powerful, such as fishermen wanting replacement boats, rather than marginalised women and poor communities, it ended up reinforcing inequalities in society. At a broader level, the evaluation highlighted the irrationality of a mediadriven global system that raised over $7,000 per person affected by the tsunami, but only $3 per person affected by that year’s floods in Bangladesh. It concluded by driving home the human security message of empowerment plus protection, arguing that, for all the successes of the response, ‘A regulatory system is needed to oblige agencies to put the affected population at the centre of measures of agency effectiveness’, and called for ‘a fundamental reorientation from supplying aid to supporting and facilitating communities’ own relief and recovery priorities.’ Source: J. Telford, J. Cosgrave, and R. Houghton (2006) ‘Joint Evaluation of the International Response to the Indian Ocean Tsunami: Synthesis Report’. London: Tsunami Evaluation Coalition. 205 FROM POVERTY TO POWER The Master Plan also argued that Mozambique needs to reduce its dependence on agriculture as the main source of livelihood in rural areas through, for example, the development of its tourist industry, while setting out a clear strategy for emergency management. The plan notes that many people have grown up in conditions of war and disaster, where ‘begging has become almost a way of life’. It argues that the ‘re-establishment of self-esteem, self-confidence and dignity’ is a basic precondition for ‘combating extreme poverty and reducing the country’s vulnerability to natural disasters’. For this reason, the government is determined to avoid ‘running to international donors without first exhausting national capacities’. The strategy was first tested by the floods of 2007. It was an impressive debut, as the government succeeded in evacuating everyone from the flooded areas without loss of life. Emergency preparedness measures undoubtedly reduced the number of deaths and injuries caused by the cyclone that struck around the same time. People whose homes were destroyed were moved to temporary accommodation centres and provided with food, some health care, and basic social services. A subsequent evaluation concluded that, without this assistance, there would have been deaths and widespread suffering, and that ‘the real needs for emergency relief were largely met’ by the operation.83 Throughout this exercise, the Government of Mozambique made a deliberate decision not to issue an emergency appeal for international assistance, demonstrating the impact an effective state can have in dealing with risk and vulnerability. A comprehensive human security approach to reducing the risks posed by natural disasters should include ongoing ‘mitigation’ efforts. Planning systems, building codes, and environmental regulations, for example, can limit damage. Early warning systems and public education programmes are also key: if villagers in Sri Lanka had known that the sudden retreat of the sea was the precursor to a tsunami, they would have fled to higher ground, rather than rush to collect the fish left flapping on the suddenly exposed sea floor. More broadly, risk reduction overlaps with social protection schemes, which can reduce vulnerability to shocks and can also be rapidly expanded after a shock to allow communities to recover as quickly as possible. Poor communities and civil society organisations can also take pre-emptive action to greatly reduce vulnerability. The fruits of such ‘community disaster preparedness’ were seen in April 2007, when flash floods and mudslides due to heavy rains and snowmelts swept across large areas of northern Afghanistan. Unlike many devastated communities, the village of Dari-Souf Payan in Samangan suffered only a single casualty and limited damage to property. The seeds of preparedness had been planted less than six months earlier in a South–South exchange of ideas. In January 2007, the Bangladeshi NGO BRAC (Bangladesh Rural Advancement Committee) had initiated a 206 4 HUMAN SECURITY community-based disaster risk reduction programme (CBDRR) in the village. BRAC trained a total of 30 facilitators from the community (20 women and ten men) to work with groups of 50 families each, establishing Village Disaster Management Units with separate committees for women and men, in keeping with cultural norms and to ensure that women’s concerns were voiced. In April, when the heavy rains commenced, committee members went to each house to discuss the impending floods and the need to move to higher ground. After the floods, with BRAC’s support, the committees mobilised the community to dig out the irrigation channels, to enable floodwaters to drain away and life to return to normal as soon as possible.84 Cuba is perhaps the most renowned exponent of community-based disaster preparedness, as a neighbourhood representative from the Cuban Women’s Federation in Havana explains: ‘I am responsible for this part of the neighbourhood. If a hurricane hits, I know that inside one multi-family unit is an old woman in a wheelchair, who is going to need help to leave. I have 11 single mothers on second and third floors of apartment buildings with children under two, who will need more support to evacuate and special needs in the shelters. I have two pregnant women, one on that block and one on this one, who will need special attention.’85 Disaster risk reduction not only reduces suffering and saves lives, it can also limit the economic damage. The US$3.15 billion that China spent on flood control between 1960 and 2000 is estimated to have averted losses of about US$12 billion – a ratio of roughly 1 to 4. The Rio de Janeiro flood reconstruction and prevention project in Brazil yielded an internal rate of return exceeding 50 per cent and a mangrove-planting project in Vietnam aimed at protecting coastal populations from typhoons and storms yielded an estimated benefit/cost ratio of 52 over the period 1994 to 2001. Often the return on investing in the skills and preparedness of people, rather than infrastructure, can be even higher and more enduring.86 In both economic and humanitarian terms, it may be a no-brainer, but reducing risks before a disaster is uphill work politically, as UN SecretaryGeneral Kofi Annan recognised in 1999: ‘Building a culture of prevention is not easy. While the costs of prevention have to be paid in the present, their benefits lie in a distant future. Moreover, the benefits are not tangible; they are the disasters that did not happen.’87 Governments often find it easier to raise money internationally when disaster has already struck, and TV coverage is raising money in donor countries. According to the Global Humanitarian Assistance report 2011, for every US$100 spent on official humanitarian assistance in the world’s top 20 recipients, only 75 cents – or 0.75 per cent – goes to disaster preparedness and prevention. The key to overcoming such political obstacles is a combination of political leadership, pressure from an informed civil society, and a shift in the international aid system towards prevention. Following the 2004 tsunami, the 207 FROM POVERTY TO POWER Box 4.5 Cuba vs Katrina: lessons in disaster risk reduction Two months after Hurricane Katrina inundated New Orleans in 2005, killing around 1,300 people, Hurricane Wilma, at one point the strongest hurricane ever recorded, struck Cuba. The sea swept 1km inland and flooded the capital Havana, yet there were no deaths or even injuries in the city. Nationwide, 640,000 people were evacuated and only one life was lost. The six major hurricanes that rolled over Cuba between 1996 and 2002 claimed only 16 lives. What did this poor developing country, subject to a longstanding economic embargo by the USA, do that the wealthy superpower next door failed to? Both countries have ‘tangible assets’, including a well-organised civil defence capability, efficient early warning system, well-equipped rescue teams, and emergency stockpiles and other resources. But ‘intangible assets’ present in Cuba and apparently lacking in the USA proved to be just as important. The oil in the Cuban civil defence machine that enables it to function properly includes effective local leadership, community mobilisation, a strong sense of solidarity, and a population that is both well-educated and trained in disaster response. Cuba has developed a ‘culture of safety’, which centralises decision-making in a crisis but decentralises implementation. Many ordinary people play important roles in disaster preparedness and response. Frequent and repeated use of the system has built high levels of trust between communities and civil defence officials. ‘Any child in school can give you an explanation – how you prepare, what you do. Students know what to do, they know the phases [the four emergency phases: information, alert, alarm, and recovery], what to do in each phase … how to gather things in the house and put them away … shut off the water and electricity. All students, workers, and small farmers get this training’, explains José Castro of the civil defence unit in Cienfuegos. Once a year, at the end of May, the entire country participates in a training exercise in risk reduction, including a full day of simulation exercises, and another identifying vulnerable residents, cutting down branches that might fall on houses, checking reservoir walls or dams, cleaning wells, identifying places to evacuate animals, and so forth. Source: Oxfam America: ‘Cuba – Weathering the Storm: Lessons in Risk Reduction from Cuba.’ www.oxfamamerica.org/newsandpublications/publications/research_ reports/art7111.html 208 4 HUMAN SECURITY international community came together to try and create this shift, when 168 countries adopted a ten-year blueprint for disaster risk reduction known as the Hyogo Framework. The Framework sets out the responsibilities of states and international organisations in creating a robust disaster risk reduction system and marks a great step forward, both in recognising the leading role of national governments and in moving from the traditionally disaster-driven international response to a more comprehensive approach to reducing risk and building human security. The Hyogo Framework’s key message is that disaster reduction should be made a central part of the overall development agenda. Only time will tell whether Hyogo makes a real difference, or whether it merely adds to the shelves full of worthy but ultimately ineffectual international declarations. Much will depend on sustained international scrutiny and pressure for change. Recent years have seen a growing recognition that in most countries, the future of humanitarian response lies in the hands of national governments, rather than the UN or INGO system. In Bangladesh, the government provided 52 per cent of the response to Cyclone Aila in 2009, while INGOs contributed 37 per cent and the UN 9 per cent. This welcome trend is only likely to grow as the number of disasters rises, along with the tax and spending power of developing country states.88 Making disaster response accountable Placing more emphasis on ‘downward accountability’ to those people affected by disasters drastically changes the way in which aid organisations respond to an emergency. A culture of consultation and listening, treating people as citizens and holders of rights rather than mere recipients of charity, leads to better aid. When an earthquake struck the Indonesian city of Yogyakarta in 2006, Oxfam’s initial consultations with the residents came up with the surprising result that the most urgent need was for plastic sandals: Yogyakarta is a modern city, with lots of concrete and glass. People forced to flee their homes in an earthquake in the middle of the night often did so without their shoes, leaving them to wander streets strewn with broken glass. The team found a supplier and within hours was handing out flip-flops. By asking survivors of the 2004 tsunami in Aceh one simple question – ‘Do you prefer/traditionally use squat latrines or pour flush latrines?’ – Oxfam was able to get its response right from the outset. Unfortunately, others failed to ask and as a result built thousands of unpopular squat latrines, which remain unused all over the island. Responsiveness and accountability must be joined in any rights-based approach to emergencies. This requires a number of practical mechanisms, including: 209 FROM POVERTY TO POWER • Ensuring the appropriate level of participation by affected communities in all aspects of an aid agency’s response, from initial assessment to final evaluation; • Providing information relevant to communities’ needs in order (in the case of conflict) that they may claim their rights under international humanitarian law; • Providing a means for communities to voice both positive feedback and criticism to those providing humanitarian assistance, and to receive appropriate redress; • Documenting efforts to ensure accountability, and making records available for public scrutiny. Establishing a complaints mechanism in its Malawi food crisis response programme in 2005–6 allowed Oxfam to discover and rectify crimes being committed by ‘middlemen’ in the programme, who were stealing food that should have been going to beneficiaries. The beneficiaries probably would not have had the courage, or known how, to contact Oxfam and the police had they not been involved in discussions in the first days of the programme about their rights and how best to make complaints. Establishing a free telephone hotline in a number of responses (Philippines, Haiti, Pakistan) has led to a substantial increase in the amount of feedback (positive, negative and complaints) Oxfam receives from the communities with whom it and partners work. This has enabled it to adapt quickly to people’s changing needs. Achieving this kind of accountability involves both learning how to do it (bearing in mind that it is it is far from easy to achieve in the middle of a humanitarian catastrophe) and establishing a system for assessing and reporting back on progress, so that organisations can see how well they are doing and generate the pressure to improve. There are various ways in which the effort to improve downward accountability could evolve further. One option is to focus on setting standards and indicators for best practice, as the Sphere initiative has set quality standards for humanitarian assistance more generally. A system of peer review, with published results, could improve levels of transparency and speed up efforts to spread best practice among NGOs. Eventually, it may become necessary to opt for a system of certification by independent auditors. This might help to assuage those critics of NGOs who argue that self-regulation is not enough in an age when the public has moved from a ‘trust me’ to a ‘show me’ culture; however, there are concerns that such formal Northern accounting and auditing models could increase costs and exclude nascent Southern aid agencies that are fast becoming important players. The very word ‘disaster’ comes from the Latin for ‘ill-starred’, but it is inequality and injustice that determine who is at risk from disaster, not the 210 4 HUMAN SECURITY stars. And by hitting poor and marginal groups hardest, disasters ratchet up inequality within and between countries. In enhancing human security, the stereotype of pale-skinned ‘angels of mercy’ rushing to the rescue of hapless, suffering people is thankfully ever less accurate. The reality is very different: human security stems from poor communities coping with risk through their own efforts, supported by effective, accountable states. Most natural disasters are largely predictable, and damage can be minimised by efficient organisation, sound risk analysis, and planning and investment in reducing risk. The key is to enable populations to prepare for disasters before they occur, to cope with them once they strike, and to rebuild as soon as possible thereafter. 211 Climate change: Mitigation, adaptation, organisation We have a word for it – it’s chivala. It means the warming of the earth. And of course people see that changes have come, but they don’t really link them to the global issue. People hear about things on the radio, and they have knowledge of El Niño, but they don’t understand how these things are linked up. (Thomas Bwanali, Shire Highlands Milk Producers, Malawi, June 2007) Every time there is a major ‘weather event’, be it drought in Africa or Russia, floods in Europe or Pakistan, or a hurricane in New Orleans or Haiti, the media immediately launch into a speculative debate about whether climate change is its ‘cause’. Weather systems are so complex, and climate models so new, that specific events can still seldom be pinned on a single cause. However, the fact that the global climate is changing – with enormous ramifications – is beyond doubt. The temperature of the Earth is increasing: so far, 2001–2010 stands as the warmest decade since records began in 1880, replacing 1991–2000, the previous record decade. 2010 tied with 2005 and 1998 as the hottest years on record.89 Climate change has been the subject of decades of global scientific study. Set up in 1988, the Intergovernmental Panel on Climate Change (IPCC) brings together hundreds of the world’s top scientists to periodically assess all relevant, published climate-related research from around the world. Its 2007 report reflected a firm consensus, higher confidence, and more robust findings, based on the availability of more up-to-date studies covering a wider area compared with previous reports. It concluded that human-induced climate change is now ‘unequivocal’, is already well under way, and is occurring faster than expected.90 The IPCC’s grim global prognosis includes more erratic and severe weather patterns and further rises in sea levels. Low-lying island states such as Kiribati, the Maldives and Tuvalu could disappear altogether, while countries such as Viet Nam and Egypt face devastation along their coasts: a one-metre rise in sea levels (an estimate by the World Bank of the possible impact of climate change) would flood the homes of 10 per cent of their populations, inundating major cities, and prompting a massive refugee crisis. The World Bank study concluded, ‘Within this century, hundreds of millions of people are 212 4 HUMAN SECURITY likely to be displaced by sea level rise; accompanying economic and ecological damage will be severe for many. The world has not previously faced a crisis on this scale.’91 The IPCC’s 2007 Assessment Report concluded that, without urgent action to curb greenhouse gas emissions, the world’s average surface temperature is likely to increase by between 2°C and 4.5°C by the year 2100, with a ‘best estimate’ of 3°C.92 At the 2009 G8 Summit, leaders from 15 major economies plus the EU recognised the scientific conclusion that warming ‘ought not to exceed 2 degrees C.’93 Meanwhile, leading scientists have moved steadily towards the conclusion that even this limit is too high – warming beyond 1.5°C could be catastrophic.94 In many countries, poor communities are already facing dangerous impacts. While any estimate of the casualties inflicted by climate change is necessarily approximate, the World Health Organization suggests that the warming and precipitation trends attributable to man-made climate change over the past 30 years already claim more than 150,000 lives a year – most of them in poor countries.95 The deep injustice of climate change is that those with the least responsibility are suffering most from its consequences. Many citizens of developing countries in tropical regions, who have historically produced very low levels of greenhouse gases per capita, are being hardest hit, due to the severity of the environmental changes and to the countries’ lack of resources to cope with them. Poor countries are being hardest hit through a combination of droughts, failing agricultural harvests, more severe storms, flooding, and landslides. They likewise face increased threats to health, for example from water stress leading to diarrhoea and cholera or the spread of malaria-carrying mosquitoes to new areas as temperatures rise further. The increased frequency of such incidents is leaving communities with far less time between shocks in which to rebuild their assets and resilience. Within these communities, gender often determines who is most adversely affected. Women’s roles in rural households – providing food, fuel, water, and care – depend heavily on natural resources being reliably available. When droughts, floods, or unpredictable rainfall make resources scarce, women may be forced to spend more time caring for malnourished children or walking to collect water and fuel. Women’s relative lack of access to assets and credit leaves them more dependent on nature for a living, with all its increasing uncertainties. Research shows that in Ethiopia and Kenya, children under five are 36 per cent and 50 per cent more likely to be malnourished if they were born during a drought.96 When women and men are pushed into extreme measures to cope with severe weather events, the consequences can be devastating. In parts of southern Africa, for example, researchers have found that during a drought the rate of new HIV infections rises. Why this correlation? Because if crops 213 FROM POVERTY TO POWER fail, many men migrate to urban areas to find work as labourers and when they return months later, some bring back the virus with them. Likewise, parents may marry off their daughters at a younger age to men who have had several wives or partners, in order to obtain cash from the dowry and to have fewer family members to feed. And some women, left in the village to cope with a failed harvest, resort to selling sex in exchange for money or food for their children, because they have no other asset to cash in.97 Across continents, climate change is exacerbating the conditions that force people to cope in such extreme ways. Tropical and sub-tropical countries (primarily in sub-Saharan Africa and South Asia), where poor people have few alternatives to farming or pastoralism, are becoming hotter, drier, and more drought-prone, or wetter with more intense rainfall and flood risks. By 2050, yields of maize, sorghum, millet, groundnut, and cassava in subSaharan Africa could fall by 8–22 per cent.98 In Africa’s large river basins, total available water has already decreased by 40–60 per cent.99 If current trends continue, climate models predict that by 2050 much of sub-Saharan Africa will be significantly drier, with 10 per cent less rainfall in the interior and water loss exacerbated by higher evaporation rates. In South-East Asia, climate change is predicted to affect the Indian monsoon, where a 10 per cent fluctuation in average rainfall can cause either severe drought or flooding.100 The increased energy in the climate system is likely to increase the frequency and magnitude of flooding in many regions. More intense downpours will also affect the capture of water by the soil as infiltration rates decline, more water runs off, and soil erosion increases. Increased temperatures and declines in snowfall are accelerating the retreat of glaciers, substantially reducing the volume of melt water on which many higher-altitude countries depend. In Peru, for example, glacier coverage has fallen by 25 per cent in the past 30 years, while in China virtually all glaciers have shown substantial melting. Overall, it is estimated that these changes will increase the number of people suffering water resource stress by half a billion by 2020, with enormous implications for food security and health. Declines in food and water security could result in substantial numbers of environmental refugees and internally displaced persons. One study shows that, in 2008, more than 20 million people were displaced by sudden-onset, climate-related disasters.101 Building resilience to climate change There are two broad routes to reducing people’s risk of harm: reduce the extent of the hazard that they face, or reduce their vulnerability to the hazard that threatens them. In the case of climate change, urgent action is essential on both fronts. The hazards of climate change are floods, droughts, storms, erratic rainfall, and rising sea levels, all the result of human-induced global 214 4 HUMAN SECURITY Box 4.6 Climate change, water, and conflict in Central Asia Climate change is worsening the difficulties faced by the former Soviet states of central Asia, where cotton farming and deforestation have already undermined the ecosystem. Like its neighbours, Tajikistan lives by water-intensive cotton farming, which is based on a dilapidated and hopelessly inefficient irrigation system. A civil war further damaged infrastructure, and nearly a quarter of the population uses irrigation channels – contaminated by farm chemicals – as their main source of drinking water. Far downstream, the Aral Sea continues to shrink, exposing the fertiliser and pesticide dust washed into it in years past, creating a toxic wasteland for people living on its shores. Bad as things already are, climate change could precipitate a ‘tipping point’. Tajikistan’s glaciers, the source of most of the water in the Aral Sea Basin, have shrunk by 35 per cent in the past 50 years, and what is left will shrink even faster as temperatures rise. In mountain valleys, the rapid melting of ice increases the risk of floods and landslides. Downstream, it is likely to increase competition for water. Regional water-sharing systems once closely woven together by Soviet design have unravelled and must now be managed by five fractious and poverty-stricken new countries, each of which wants more water for national development, and all while the overall supply is dwindling – a sure recipe for future tension. warming. Those hazards have to be tackled at their source: overwhelming scientific consensus holds that global greenhouse gas emissions must peak by 2015 and then fall by at least 80 per cent of 1990 levels by 2050, in order to prevent global warming exceeding the high-danger point of 1.5oC (see Part 5). However, even if greenhouse gases are rapidly brought under control, the delayed effects of emissions already released mean that rising sea levels, droughts, floods, hurricanes, and rainfall variability will become more severe throughout this century at least.102 In the jargon, tackling climate change cannot focus only on ‘mitigation’ (reducing emissions) but must also give priority to ‘adaptation’ (building people’s resilience to climate impacts). Adaptation is now essential, and communities need substantial national and international support to do it successfully. Human communities have of course adapted to natural climate variability for millennia by growing diverse crops, using irrigation to manage scarce water, or carefully selecting seeds for the coming season. Still, some of the 215 FROM POVERTY TO POWER poorest communities today are severely set back by natural droughts or floods, taking months or years to re-establish their livelihoods. The speed, scale, and intensity of severe weather events caused by human-induced climate change will push many communities beyond the bounds of their experience. They will be forced to find ways of coping with environmental stress on a scale not seen since the last Ice Age: rainy seasons that do not arrive, rivers that dry up, arable lands that turn to desert, forests and plant species that disappear for ever. In some parts of the world, just how the climate will change is inherently uncertain. In West Africa, for example, it is hotly debated whether rainfall will decrease and cause drought, or increase and cause flash floods, or stay the same on average but become far more unreliable, making farmers’ planting decisions much riskier. In Colombia, which suffered the worst flooding in at least 60 years in 2010–11, many of the areas affected are projected to suffer from drought within 20 years. Where change is this dramatic and unpredictable, people must prepare themselves by acquiring information, resources, infrastructure, influence, and opportunities to diversify their livelihoods. Long-term development is one of the most important routes to building the adaptive capacity of an individual, community, or country, and such adaptive capacity is now in turn becoming a key indicator of longterm development. Development and disaster preparedness may be essential for building resilience to climate change, but climate change in turn forces a rethink of development and disaster planning. It is no good investing in hydroelectric power plants if the river’s flow is falling by 10 per cent each year. Likewise, there is little point in pouring resources into rain-fed agriculture if the rain is about to stop falling. Effective climate adaptation deliberately integrates better awareness of future climate impacts into current planning and actions, whether these are oriented towards minimising risk or maximising opportunity. Where changes in the climate are becoming clear, some communities are already taking action. A study in four villages in South Africa and Mozambique facing increasing droughts and floods and more erratic rainfall confirms that poor people are already finding ways to adapt, by: • Building social institutions: Communities set up numerous associations, communal food projects, co-operatives, and women’s groups to share risk and confront threats together. • Diversifying livelihoods: Communities sought to move into new areas of activity, such as fishing, vegetables, or construction, while some entered the more commercial end of farming, by introducing irrigation and selling rather than consuming their produce. • Looking beyond the village: For example, by building links with nearby towns, sending more male migrants off to work in towns and 216 4 HUMAN SECURITY commercial agriculture, or by building complementary links with other farming areas. Remittances, either to individual families or to public welfare funds, are a major source of income in many scarce-asset or low value-added rural livelihood systems (as discussed in Section 5). At the same time, there are clear limits to how successfully poor communities can adapt if they do not have wider support. Many people lack viable opportunities to diversify their livelihoods or have no money to pay for the technologies they need, such as irrigation systems or insecticide-treated bed nets. Most have very little access to reliable climate information that would help them to plan more effectively, or have no means of learning how other communities in a similar situation have adapted. Research among subsistence farmers in Zimbabwe found that nearly half of those interviewed said that they would want to adjust their farming according to long-term forecasts, but their lack of cash and credit would prevent them from doing so.103 Likewise, a study by ActionAid of climate change in African cities found that the ability of urban slum dwellers to adapt to increased flooding was weak, because they could not easily organise as a community to take the collective action needed to build resilience.104 Adaptation requires citizens and states Glacial melt in the Himalayas is causing more frequent and more severe flooding in the plains below, where millions of people live. The scale of flooding in 2000 certainly came as a shock to riverside communities in India’s West Bengal. ‘There was an announcement over a loudspeaker, warning us that there would be a severe flood’, recalls Dipali Biswas, a resident of Nadia district. ‘But we were still not aware just how severe it would be. When I saw the water rise above the roof of my house, I was stunned.’ Since then, the local NGO Sreema Mahila Samity (SMS) has initiated community-based disaster planning, supporting women as leaders in their communities to set up village task forces, plan and practise disaster response, learn to build quick-assembly boats and flood shelters, raise the foundations of their houses, and establish flood-proof communal grain banks. Dipali is a member of her village’s Early Warning Task Force. ‘These days, we can hear about floods in many ways,’ she explains, ‘from the village committee, from a telephone number that we can call to get the latest information, from the TV and radio, and of course from observing the river ourselves. During the flood season, we never miss a radio or TV weather report.’105 Dipali’s village is as ready as it can be for the floods that climate change will undoubtedly make worse, and the active citizenship of her community has been essential for that preparedness. But all their preparation will succeed only if the local government provides accurate and timely flood warnings, and that in turn depends on the national government investing in India’s 217 FROM POVERTY TO POWER meteorological infrastructure. In short, active citizens can only succeed in adapting to climate change if they have the support of effective states. All countries need to assess their vulnerability to climate change, identify adaptation options and plan responses to protect their populations. Poor countries, especially, need to make this a priority as part of their development strategies. In addition to promoting community risk reduction initiatives and integrating climate risk into development plans, governance at local, regional, and national levels must be strengthened; information systems to accurately forecast and monitor climate impacts must be established; technologies must be developed or adapted for changing local conditions; land use plans and regulations must be reviewed; and infrastructure and ecosystems such as forests must be protected. In planning and implementing climate adaptation, local and national governments must give priority to initiatives involving those people most vulnerable to climate risks. That means taking account of the different impacts of climate change on women and men, and likewise understanding the impacts on and needs of indigenous communities. Rural women and indigenous communities generally face more climate risks because of their intense dependence on natural resources. However, their knowledge of biodiversity and the options for managing it in times of stress will be essential for spurring innovative approaches, and so their involvement must lie at the heart of successful plans to adapt. On Nicaragua’s Atlantic Coast, the traditional authorities of the Miskitu Indians are trying to remedy some of the damage already caused by climate change. The community’s longstanding equilibrium with the forest was based on its ability to forecast the weather and so know when to plant crops, but that predictability has gone. ‘The summer now is winter. April used to be summer, but it rained all month. Now, in May (winter) it doesn’t rain. We listen to the thunder, we see the lightning that should let us know the rain is coming, but it is not’, says Marciano Washington, a farmer on the bank of Coco River. ‘We can’t depend on nature any more. We don’t know when to plant our crops.’ The traditional indigenous authorities, along with a local NGO, Christian Medical Action (CMA), are introducing an early warning system to monitor rainfall and river levels, in order to provide that information in a format useful for the community’s way of life. Such changes are reported by communities around the developing world. Farmers say both the timing of rainy seasons and the pattern of rains within seasons are changing. This is particularly alarming for farmers, who rely on their knowledge of traditional seasonal weather patterns to decide when to sow and harvest. It ultimately contributes to the success or failure of their crops.106 Effective state action on adaptation may also require a reconsideration of wider economic policies, such as on land ownership and use. Economic 218 4 HUMAN SECURITY reforms in Viet Nam, for example, have seen public mangrove forests along the coast replaced by private shrimp farms, which have brought income to some but, at the same time, have curtailed poor people’s livelihood options and destroyed vital natural buffers against storm surges. The resulting increase in income inequality has also undermined the solidarity that previously helped ensure communal maintenance of dykes, thus exposing coastal villages to climate-related rises in sea levels.107 In the absence of publicly planned adaptation based on broad consultation, private responses may well exacerbate the wider community’s vulnerability to climate change. Appropriate technologies – new and old – will also be needed for poor farmers to adapt to climate change, and will require significant national and international agricultural research into drought- or flood-tolerant varieties of seeds. Social organisation and local land policy will also be essential if poor farmers are to succeed in using new seeds. In Mozambique, where climate change is expected to bring both drought and floods, groups of villagers have experimented with drought-resistant varieties of rice, maize, cassava, and sweet potato. By working in groups, combining poor and better-off households and involving both female and male farmers, the villagers were able to share the risks of new practices and learn for themselves through trial, error, and experimentation. These informal associations have started, with some success, to lobby local authorities responsible for land allocation so that farmers obtain parcels of land in several different locations. This diversification of seeds and soil strengthens their resilience to either more drought or more floods. Climate change is the biggest threat to long-term poverty reduction – and yet reducing poverty is essential to equip poor people to deal with unavoidable climate impacts. As the evidence of climate change accumulates, the necessity for urgent action to tackle it becomes undeniable. Climate change is not a linear or reversible process, but it appears to have a number of unpredictable ‘tipping points’ that, once passed, could have catastrophic and irreversible consequences. It is in no country’s long-term interest to wait until millions of people are tipped over the edge into climate disaster. As the Stern Report confirmed in 2006,108 mitigation – rapid cuts in emissions to avoid catastrophic climate change – is essential and urgent. However, time is not on the side of the ‘indecision-makers’ who for years have stalled and delayed international agreement to act. Unless global emissions begin to decline by 2015, there is little chance of avoiding catastrophic climate change beyond 2oC – with devastating consequences for people living in poverty and appalling implications for the stability of global society and its economy. Urgency and leadership are thus central to taking action, while there is still time. Action by citizens in both North and South, allied to business sectors with a longer-term progressive vision, will be crucial to make sure that such leadership is successful. This is examined in detail in Part 5. 219 FROM POVERTY TO POWER For poor people, climate impacts are already outpacing their ability to cope, and for them adaptation is unavoidable. Only significant support will allow them to act on the scale and with the speed of innovation and learning needed to cope with rapid and unprecedented change. Overall, making climate adaptation work requires the same kind of community-based approaches, backed by committed government policies that work for other development issues: building human security through a combination of active, capable citizens and an effective, accountable state. 220 Living on the edge: Africa’s pastoralists Foreign visitors to the Kenyan capital of Nairobi are used to seeing, amid the traffic jams and smog, the distinctively tall, red-cloaked forms of Maasai herdsmen on a visit to the city. The Maasai are the most internationally recognisable of the world’s 100–200m pastoralists – mobile livestock herders living in arid and semi-arid areas that constitute some of the harshest and remotest places on earth.109 In such hostile conditions, it is hardly surprising that pastoralists are subject to higher levels of risk and vulnerability than people living in areas where farming is a viable option. Rain is scarce, infrastructure is almost unknown (or at best dilapidated), and guns abound due to poor security. Nevertheless, there is a considerable body of evidence that pastoral livelihoods are in fact well-designed risk management and adaptation strategies.110 Several studies have even found that economically, pastoralism compares favourably with commercial ranching.111 Pastoralists are not only an important and sizeable group in themselves, but their livelihood epitomises the links between poverty, risk, and vulnerability. Pastoralists are experts at risk management, showing extraordinary resilience, but all too often their efforts are undermined by the prejudice and incomprehension of governments and society at large. Pastoralists are also at the sharp end of climate change, and could provide valuable lessons in how to cope with a dryer, hotter planet. Pastoralism in the arid and semi-arid regions of Africa evolved in response to long-term climate change. When the Sahara entered a period of prolonged desiccation some 7,000 years ago, mobile livestock herding – pastoralism – enabled people to adapt to an increasingly arid and unpredictable environment.112 ‘Shocks’ such as drought are not rare events but part of the natural order, and the reason why pastoral communities live the way that they do. Pastoralists have highly effective coping strategies to make them resilient to such risks. They integrate livestock husbandry with other activities such as farming and the extraction of minerals, dry-land timber, and forest products such as honey and gum. They co-exist with the wild animals so vital to tourism, and provide important ‘environmental services’ such as protecting dry-land forests and water catchments and maintaining wildlife dispersal zones outside of national parks.113 In the Shinyanga region of Tanzania, Sukuma agro-pastoralists who own more than 2m cattle in the region have, with support, reforested an estimated 250,000 hectares of once degraded land.114 221 FROM POVERTY TO POWER Mobility is at the core of pastoral life, and is crucial to managing risk in harsh and unpredictable environments. By moving their cattle, goats, and sheep and negotiating the sharing and maintenance of scarce pasture and water, communities survive off large areas of rangeland that lack permanent water sources. However, while pastoralists have shown their durability, they remain socially and politically marginalised and have experienced increasing disruption, vulnerability, and suffering in recent years. Despite the increasing frequency of drought, the gravity of the current situation for pastoralist communities stems more from years of neglect and misunderstanding by central governments than from the unpredictability of rainfall. Government action in pastoral areas has often been hostile, overtly or otherwise, guided by a paradigm of rangeland management imported from the very different environmental conditions of North America. Officials and ‘experts’ believed that pastoralism was irrational and outdated, that land should be individually, not communally owned, that pastoralists should be settled, and that ‘development’ would follow. They saw pastoralism as environmentally damaging, backward, and unproductive. Like Australia’s Aborigines, or Canada’s Inuit, pastoralists were subject to deliberate attempts to undermine their lifestyle and culture. According to a recent Human Rights Watch report, the Government of Uganda continues to flout the rights of pastoral communities through ‘unlawful killings, torture and ill-treatment, arbitrary detention, and theft and destruction of property’.115 Pastoralists as citizens Making up a small proportion of the national population in any given country, and living in remote areas, pastoralists often lack the power and space to organise themselves effectively. Pastoral voices are not heard; local associations are often weak and frequently are co-opted by powerful elites. However, there are encouraging signs that the tides of political and public opinion are turning. Over the past 15 years the pace of policy reform in West Africa has been considerable. The governments of Burkina Faso, Guinea, Mali, Mauritania and Niger have all passed specific pastoral laws to protect pastoral land and to facilitate livestock mobility both within countries and across international borders. The Pastoral Charter of Mali devotes a whole chapter to the right of pastoral communities to move with their animals both within and between countries. In eastern Africa too there is some progress. The Poverty Reduction Strategies of Ethiopia, Kenya, Uganda and Tanzania all recognise pastoralism as a livelihood system deserving of support.116 An example from Senegal in 2005 illustrates some of the important faultlines in debates over pastoralism and shows what can be achieved through mobilisation. The country’s President Wade announced on radio that he 222 4 HUMAN SECURITY was going to sell off 3,000 hectares of the ‘Doli ranch’ for peanut production. This area was a key dry-season grazing area and drought refuge which, although called a ranch, was actually under the control of resident livestock herders. Following failed meetings between the prime minister and livestock producers, the president issued a decree in November 2003 transferring ownership of 44,000 hectares of the area. Pastoralist groups responded by organising what turned out to be a very effective media campaign. They warned people living in the capital Dakar that, if the government went ahead, they would boycott all livestock markets. They also criticised the underlying rationale behind the land transfer (namely that pastoral production was outmoded and inefficient) and official attitudes towards the livestock production sector in general. The government subsequently withdrew its plans, providing pastoralists with a victory in what has become known as ‘l’affaire du ranche de Doli’.117 While specific campaigns will not necessarily change attitudes toward pastoralism, they illustrate the power of collective action. In East Africa, the UN Office for the Co-ordination of Humanitarian Affairs has been working to develop pastoralists’ voice in Ethiopia and elsewhere. Gatherings have been organised for pastoralist representatives from across the globe to provide a space for them to share their experiences and ideas, and to engage with government and donor representatives on their own terms. At community level, local associations help to reduce vulnerability by providing vitally important veterinary drugs and managing and improving scarce water resources. As they have gained recognition, the associations have engaged with government, advocating for better services and budgets and a greater role in conflict management. In West Africa, membership-based pastoral associations, including AREN and the sub-regional network Bilitaal, have many thousands of subscribing members, combining representative legitimacy with political clout and a degree of economic autonomy. Forward-looking traditionalists Pastoralism, with its strong emphasis on family and clan loyalties, and on common, rather than individual, ownership of land and forests, throws down a profound challenge to many of the assumptions that underlie ‘modern’ governance. Whether such visions can co-exist is a test of the ability of governments and societies to recognise and encourage pluralism, rather than uniformity. Despite widespread stereotypes that pastoralists are static and backward, pastoralists themselves recognise the need to change and adapt. As they are experienced opportunists, used to exploiting every millimetre of rainfall, their adaptability should come as no surprise. In 2007, pastoralist leaders from across Africa wrote: ‘The outside world is changing rapidly, altering 223 FROM POVERTY TO POWER production methods and exchange systems, affecting the very fabric of all societies. Bearing this in mind and the fact that pastoralists are fully capable of adjustment, we are not concerned with protecting pastoralists from these changes. This would be impossible in any case. Our concern lies with the strengthening of the pastoralists’ ability to adapt as well as with the broadening of their choices and opportunities.’118 A positive future would see those pastoralists who are active in mobile livestock production being able to combine the best of past traditions with modern technologies, such as solar-powered radios for education or satellite phones to check on market prices or outbreaks of disease.119 Many households might also have a settled base where children would live for part of their schooling and where elderly family members would stay. Pastoralists could be among the best placed people to adapt to climate change, since they have been adapting to climate variability for millennia.120 In the end, though, the ability to call on the support and resources of government is likely to be fundamental to their ability to cope. Many former pastoralists may end up in towns and cities, enabling families to reduce their vulnerability by diversifying their livelihoods: the point is that such migration would be a positive choice, rather than a desperate flight from drought, hunger, and violence. This vision cannot be achieved without real changes in the relationship between pastoralists and their governments. The reasons why pastoralism is in crisis lie in the action and responses of duty-bearers, not flaws in the livelihood itself which, like any production system, needs to be understood and nurtured. To achieve genuine human security, pastoralists need the right and capacity to decide their own destinies, as well as governments that support them when times are hard. 224 Violence and conflict Humanity will not enjoy security without development, it will not enjoy development without security, and it will not enjoy either without respect for human rights. (Former UN Secretary-General Kofi Annan)121 The gunmen have taken people’s land, their houses, their sons, and forced their daughters to marry them. This is the nation’s blood. (Woman, Mazar-e-Sharif, Afghanistan)122 Half a dozen black vultures darken the sky in Ursula’s drawing of her old house in the Colombian countryside. ‘That’s maize, an apple tree – we had all sorts of fruit’, she explains. ‘That’s a garden. That’s a golero, a bird that eats the dead. There were lots of goleros where we lived.’ A toothy nine-year-old, she wears red stud earrings, an array of cheap plastic bangles, and traces of varnish on her nails. Her dark Indian features grow solemn as she explains why she had to leave her farm. ‘We saw everything when they shot my papa. Everything. They made us go outside when they got there at 6am. When my mother tried to go back in, they said, “Get out or we’ll shoot you”. My brother tried to escape and they shot him, then my Dad went crazy and attacked them with a machete and they shot him too. ‘My mother only cried a month or two after they buried him. She was pregnant with my little sister. She said she was going to come out all sick, but she was fat and big. She’s five now and she’s nearly as big as me! Lots of mothers in my barrio lose their babies.’ Ursula thinks it was the guerrillas who killed her father, but she is not sure. In Colombia, death could come at the hands of the army, the police, drug gangs, paramilitary death squads, common criminals, guerrilla fighters, or street gangs. Colombia’s murder rate is one of the highest in the world, nearly seven times that of the USA.123 The threat of violence is commonplace for people living in poverty. In their homes, women often face the threat of violence at the hands of husbands and fathers, which is often condoned by society; violence against children is even more widely accepted. The notion that children are individuals with rights, enshrined in international law since 1989 under the UN Convention on the Rights of the Child, has still to permeate many communities, leaving 225 FROM POVERTY TO POWER children the most invisible, powerless, and excluded members of society, at the mercy of parents, step-parents, and older siblings. Outside the home, the threat of violence is also ever present, especially for women and for young men, and is often symptomatic of the lack of an effective state. Deadly violent crime is closely associated with poverty and inequality. According to the 2011 World Development Report, poverty is increasingly concentrated in areas of the world affected by conflict, fragility or large-scale criminal violence.124 And this concentration may become even greater in the future as these areas become particularly vulnerable to risks of future violence from the scarcity of energy, food and water.125 At the time of writing, no fragile or conflict-affected country has achieved a single one of the Millennium Development Goals (MDGs).126 People in those countries were more than three times as likely to be unable to send their children to school as those in other developing countries, twice as likely to see their children die before the age of five, and more than twice as likely to lack clean water.127 The reason is not difficult to see. In 2005, violence cost Guatemala 7 per cent of its GDP, more than twice its combined budget for agriculture, health and education.128 Every country with a high annual rate of homicide (more than ten murders per 100,000 people) is either a middle- or low-income country, while most wealthy countries have lower homicide rates than the global average. The European murder rate, of just one per 100,000 in 2010, is a fraction of that for Southern Africa at 30 per 100,000, or Central America at 25.129 While conventional armed conflicts have declined since the Cold War, the scourge of wider violence has become a greater threat to lives and livelihoods in many countries. More people are now murdered in Guatemala each year than the annual death toll from the country’s civil war in the 1980s.130 Violence against women Violence and the threat of violence constrain the hopes and choices of women. They sap women’s energy, compromise their physical and mental health, and erode their self-esteem. The damage carries a cumulative cost to society, since abused and injured women are less able to work, care for their children, or become active citizens. Throughout history, societies across the world have condoned violence to enforce inequality between men and women, and oblige women to conform to expectations of child-bearing and -rearing and household work. It is terrifyingly widespread – enough to make women who have not experienced it personally sufficiently scared not to take risks of their own. The UN estimates that at least one in three women has been physically or sexually abused at some point in her life.131 226 4 HUMAN SECURITY The traditional view of marriage as a contract through which male-led families purchase a woman’s body and her labour power remains current in many places. Far from being a haven in a heartless world, in most settings home remains the place where a woman is most at risk of violence. In parts of Africa, South Asia, and Latin America, wives are still routinely beaten to ‘correct a fault’, an act that many women and men view as normal. In one survey, over three-quarters of Ugandan women agreed with at least one justification for wife-beating, while in Nigeria’s Zamfara state the Sharia Penal Code permits a man to beat his wife, as long as he does not cause her to be hospitalised.132 In both developing and industrialised countries, a man’s right to have sex with his wife whenever and however he wants has only very recently been questioned. Pervasive violence outside the home also severely restricts women’s participation in public life. Simply to attend an evening meeting, never mind speaking out publicly or running for office, entails risks that are too often prohibitive. While violence of this kind does not discriminate between rich and poor, wealthy women can at least reduce the risk by paying for transport or security guards. Over the past three decades, the international women’s movement has made great strides in lobbying states to criminalise violence against women. Domestic violence laws have entered the statute books and the 1979 Convention on All Forms of Discrimination Against Women (CEDAW) is supposed to hold states to account. Rape during conflict is now recognised as a war crime and can, in principle, be prosecuted as such. While very significant, however, these laws often fail to protect women. The attitudes of public officials may be quite hostile, women may lack the education or money to make the justice system work, and many women, particularly in rural areas or among religious minorities, find that ‘customary’ or ‘religious’ law overrules civil law in cases of domestic violence. In a number of countries, women’s legal organisations visit remote areas to raise awareness that violence against women is a crime and to provide legal aid to poor women. Yet even then, women must brave the disapproval of their families or communities for blowing the whistle on these practices. Widespread changes in attitudes and beliefs that condone violence are critical. In South Asia, the ‘We Can’ campaign is supporting a model of change focused on attitudes and beliefs. We Can’s campaign to end violence against women works through people-to-people contact and a massive network of over 1,800 civil society organisations in Bangladesh, Sri Lanka, India, Nepal, Pakistan, and Afghanistan.133 Individual ‘change makers’ sign up to the campaign, promising to change themselves and to influence their family, friends, and neighbours on the need to end domestic violence and change attitudes towards women. They are armed with some basic materials, including 227 FROM POVERTY TO POWER resources suitable for those unable to read, such as posters addressing everyday forms of violent discrimination. In a process reminiscent of viral marketing, those they ‘convert’ become change makers themselves. So far, 3.9 million people have signed on, each of whom will, in turn, reach at least ten others – which the alliance hopes will be enough to achieve a critical mass that can transform power relations in the home and attitudes towards domestic violence across South Asia. To the organisers’ surprise, half the change makers are men, an affirmation of the campaign’s premise that real change is possible, and perhaps that men too find their traditional gender roles oppressive.134 Such deep transformation in entrenched beliefs is neither easy nor rapid, and not everyone supports the changes – some men boycott the meetings and criticise the women’s assertiveness. But the men and women involved report enormous improvements in their family lives and a spillover effect in other areas: men’s groups have started savings schemes, for example, and the number of girls going to school has risen. The success of innovative approaches like the We Can campaign suggests that the state alone cannot solve the attitudes and beliefs side of the development equation. Activism can be a potent force for changing community social institutions that perpetuate violence against women. War Beyond such ‘social violence’ remains another, cataclysmic shock – war. The modern era is bloody on an unprecedented scale. Nearly three times as many people (110 million) were killed in conflict in the twentieth century as in the previous four centuries combined.135 In this century there is now a ‘rump’ of around 30 protracted conflicts, most of them civil wars, which have evaded attempts at resolution. Political violence today is concentrated in developing countries where violence is as deeply entrenched as poverty and inequality. According to the World Bank’s 2011 World Development Report, one in four people on the planet, more than 1.5 billion, live in fragile and conflict-affected states or in countries with very high levels of criminal violence.136 According to the Report, many countries now face cycles of repeated violence and instability. First, conflicts often are not one-off events, but are ongoing and repeated: 90 per cent of the last decade’s civil wars occurred in countries that had already had a civil war in the previous 30 years. Second, new forms of conflict and violence threaten development: many countries that have successfully negotiated political and peace agreements after violent political conflicts, such as El Salvador, Guatemala, and South Africa, now face high levels of violent crime, constraining their development. Third, different forms of violence are linked to each other. Political movements can obtain 228 4 HUMAN SECURITY financing from criminal activities, as in the Democratic Republic of Congo and Northern Ireland. Fourth, grievances can escalate into acute demands for change – and the risks of violent conflict – in countries where political, social, or economic change lags behind expectations, as in the Middle East and North Africa during the unrest that became known as the Arab Spring.137 By the end of 2010, there were 43.7 million forcibly displaced people worldwide, the highest number in 15 years. Of these, 15.4 million were refugees,138 meaning they had crossed an international border. Flight disrupts lives for generations, but the experience varies enormously. Some people flee to neighbouring towns or villages for a period of weeks. Others have fled and returned many times over the course of 20 years. Still others, such as Somalis in Kenya, have been warehoused in refugee camps for up to 15 years, long before more than 200,000 crossed into Kenya in 2011 as conflict-stoked famine struck their own country. The end of the Cold War helped bring down the curtain on a number of wars and allowed major returns of refugees in Angola, Mozambique, Cambodia, Central America, and Afghanistan. At the same time, new conflicts erupted in the former Soviet republics, the Balkans, the Middle East, West Africa, across the Great Lakes region, and in the Horn of Africa. Conflict is contagious, as war-torn countries drag down their neighbours with a combination of refugees, economic collapse, illegal cross-border arms trading, and violence that spills across borders, as has happened between the countries of Central and East Africa in recent years. Seventy five per cent of the world’s refugees are hosted by neighbouring countries.139 By one calculation, the average civil war costs a country and its neighbours a phenomenal $64bn, knocking a startling 30 years of GDP growth off a medium-sized developing country. 140 Conflict both feeds and is fed by inequality. Civil wars are generally more likely to erupt in countries that have severe and growing inequalities between ethnic or regional groups, such as those prevailing between the Hutu and Tutsi peoples prior to the Rwandan genocide of 1994. Violent crime is generally more likely where there are deep gaps between social classes, as in Latin America. In many places, both types of inequality co-exist, with devastating consequences. In turn, conflict drives up inequality because it particularly harms the weakest and most vulnerable members of society – marginalised groups such as ethnic or religious minorities, or vulnerable groups within the rest of society, such as elderly or disabled people, or children. In the cruel calculus of war, civilians rarely remain untouched, especially if they are already poor and vulnerable. Combatants, be they insurgents or governments, routinely view civilians as potential sources of enemy support and therefore legitimate targets, no matter that international law insists on respect for civilian immunity. Even when not deliberately targeting civilians, governments at war often restrict human rights and mechanisms of 229 FROM POVERTY TO POWER democratic accountability, thus undermining incentives to win popular support rather than coerce it through fear. Conflict affects men, women, and children differently. Men make up 96 per cent of detainees and 90 per cent of casualties; women and children are close to 80 per cent of refugees and those internally displaced.141 During armed conflict, violence against women takes on a new and even more sinister dimension when armies use mass rape and sexual enslavement as weapons of war. This sophisticated strategy kills and scars women, and inflicts deep psychological wounds on entire communities. The intent is to destroy social cohesion by impregnating women so that they bear the children of the enemy. The women who survive this act of warfare, broken and traumatised, are commonly stigmatised and rejected by their own families and communities. In 2005, the UN reported that one region of the DRC saw 25,000 such attacks a year.142 In Sierra Leone, a 2002 study found that more than half the women in the country had been sexually attacked during the war that ended that year.143 Mass rape in war has also been documented in Peru, Cambodia, Uganda, Liberia, and Somalia.144 In Darfur, the threat of sexual violence against women has been most prevalent when women leave villages or camps to collect firewood. They must choose between the threat of rape and feeding their families. (In response, Oxfam piloted the use of fuel-efficient stoves to reduce the need to collect firewood.) Even in democracies, the violence that one group inflicts on another is often rooted in the idea that the victims are ‘the other’ – inferior on the grounds of social, ethnic, or religious difference, and therefore without the rights that the perpetrators claim for themselves. In the Moluccan islands of Indonesia in 1999 a dispute between a Muslim youth and a Christian busdriver in Ambon city rapidly escalated into fighting that displaced 400,000 people, many of them for years. Periodic communal violence along religious lines has plagued India ever since independence. Such prejudice can be manipulated for political gain anywhere in the world – in Colombia to legitimise the murder of civilians allegedly collaborating with guerrillas, in Darfur to set ‘Arabs’ against ‘Africans’, in Iraq to stoke conflicts between Shia and Sunni communities, and in the Western media to deny basic rights to those branded ‘terrorists’. However, such divisions can be turned around through efforts by governments and the communities concerned. Since 1994, there has been remarkable progress in Rwanda in bridge building between Hutu and Tutsi communities. Similar efforts elsewhere, such as between Palestinians and Israelis, may not yet have reduced conflict, but are certainly part of any long-term solution. In practice, there is no neat dividing line between war and peace. The selfreinforcing cycle of poverty and violence makes it particularly difficult for poor countries to escape from conflict, even after ‘peace’ has been officially 230 4 HUMAN SECURITY signed. Although the DRC has supposedly been at peace since 2002, violence has continued, even after elections in 2006, and 2007 saw an upsurge of attacks on civilians, including mass displacements and reports of widespread sexual violence. In 2011, an Oxfam survey of more than 1,700 people across three eastern provinces found violent extortion and coercion still pervasive, and continuing episodes of brutality, particularly in areas affected by Uganda’s Lord’s Resistance Army.145 This is far from unique: 40 per cent of countries collapse into war within five years of signing peace deals.146 Even when all-out conflict is avoided, armed violence is a genie that is extraordinarily difficult to put back into the bottle, spilling over into domestic and sexual violence and violent crime, especially when there are no viable new livelihoods for the young men who previously lived from war. El Salvador and Guatemala, for example, ended civil wars in the 1990s, only to see a proliferation of gangs, kidnap rings, and other forms of violent crime, often involving demobilised soldiers and police. Wars and other complex emergencies represent the failure of political leaders to resolve social and economic problems. Their failure is in part due to the inability of national governments, particularly in poor countries, to provide effective, accountable state institutions such as the rule of law, or control of national borders. This is not just about the state’s capacity to provide these services; it is also about political leaders’ choice as to whether or not they will do so. In many places, like South Sudan, it is a combination of both; the new nation’s embryonic structures are still being built up, but that does not explain away the continued failure of the Sudan People’s Liberation Army to uphold the rights of children – according to recent reports some SPLA elements continue to recruit or conscript child soldiers and there are allegations of other violations of the rights of children. In conflicts around the world, the state’s security services can abuse human rights just as much as their non-state enemies – and that applies to some developed states, such as Israel, as well as developing ones. A strong state is essential, but by itself is not enough to guarantee that civilians are protected from the worst horrors of war. Conflict both undermines states and is more likely in situations where the state is already weak or non-existent. The UK’s Department for International Development (DFID) lists 46 such ‘fragile states’; 35 of these were in conflict in the 1990s. By 2010, according to the Brookings Institution, 40.8 per cent of those living in $1.25-a-day poverty were living in fragile states – double the proportion in 2005, partly as a result of development success elsewhere.147 Domestic factors tend to outweigh external ones in most crises, but international factors often exacerbate local problems. When global economics and politics marginalise large swathes of the world, some societies are stretched to breaking point. Climate change is already aggravating the process. According to one study in 2007, 102 countries will face an increased risk of violent 231 FROM POVERTY TO POWER conflict as climate change exacerbates the ‘traditional’ risks of inequality and unaccountable governance.148 The ready availability of weapons drastically increases the death toll of any given conflict, as well as the destruction of schools, health clinics and other parts of the infrastructure of development. Arms manufacturers, from both North and South, are flooding developing countries with guns. There is one ‘small arm’ for every ten people on the planet and a further 8m new weapons are added every year, along with another two bullets per member of the human race.149 In many of today’s conflicts, war has become an economically lucrative business, which political and military elites want to keep going for as long as they can. This is the ‘political economy of war’, a self-serving and selfsustaining system that in many instances has replaced the traditional quest for military victory. In the upper echelons, the war to control territory brings in its train the chance to extract revenue from the population, or from natural resources. At the bottom of the heap, war guarantees young men adrenalin, power, and income, while it destroys the very economy that could offer them peaceful alternative livelihoods. Ninety-five per cent of hard drug production occurs in countries that are engulfed by civil war i.e. in areas outside the control of a recognised government.150 While many local conflicts, as in Darfur, involve fighting over scarce resources, the world’s deadliest conflicts are more often fuelled by abundant resources. Globalisation has increased the opportunities to profit from exporting minerals, oil, and timber from war-torn areas to international markets (and is often linked to the growth in organised international crime). Resource wealth enriches combatants and allows them to prosecute war; it provided the continuing motive for fighting in around one-third of wars from 1990 to 2002.151 The resources vary from country to country and include timber in Cambodia; gems and opiates in Afghanistan; natural gas in Baluchistan; diamonds in Angola, Liberia, and Sierra Leone; oil in Sudan; coca and gold in Colombia; and the lucrative combination of copper, coltan, cobalt, gold, and timber for those who continue to plunder the DRC. Citizens and states build peace Violence, like other sources of insecurity, requires action on many fronts, but it especially requires efforts to build an effective and accountable state and to empower the individuals and communities most at risk from its depredations – poor people, women, and socially excluded groups such as ethnic and religious minorities. Faced with a world of threat and vulnerability, poor people are far from being passive victims, although they are often forced to make almost impossible choices in juggling risks. Poor people work to address chronic violence, 232 4 HUMAN SECURITY defuse potential conflicts, resolve them once they strike, and help each other to cope with their impact. Often religious leaders seize the initiative from combatants. In August 2002 in Nigeria’s Kaduna state, the epicentre of the country’s inter-communal violence where both Muslims and Christians see themselves as economically and politically marginalised, former militants from each community encouraged twenty senior religious leaders to sign a declaration of peace. Since then, these leaders have been credited with helping to restrain violence during state and federal elections, and have intervened in disputes in Kaduna schools, preventing minor arguments from turning into major incidents.152 Similarly, Christian church leaders in the DRC province of Maniema led their communities in calling on fighters to demobilise and disarm, helping to ease tensions between the communities and ex-combatants born of numerous instances of abuses during the fighting. Councils of respected community members, both men and women, designed reconciliation processes using traditional ceremonies. Medical and therapeutic help for women who had been raped, and the distribution of seeds and tools to revitalise the local economy, also helped to heal the scars of war. While communities must act to protect themselves, the primary responsibility for addressing violence and armed conflict and for alleviating the suffering it causes rests with national governments. They bear that responsibility under international human rights agreements, and in times of conflict, international humanitarian law. In a culmination of a decade of discussions, the UN agreed in 2005 that every government had a ‘responsibility to protect’ its population from genocide, war crimes, crimes against humanity, and ethnic cleansing. That responsibility ‘is held, first and foremost, by national authorities’, it stressed, before going on to outline the international community’s role when states fail to comply (see Part 5).153 Governments are more likely to want to fulfil their duty, and to be able to do so, if they are accountable to the victims of conflict. Unlike famine, war has taken place in modern democracies, when irresponsible leaders exploit grievances for political and economic gain, or when the lure of ‘simple’ solutions overwhelms common sense. Yet democracy and an active citizenry can be an effective antidote to war, since they encourage leaders to find political rather than military answers to differences. In Colombia, which has been dogged by conflict and human rights abuses for the past 50 years, human rights activists have risked their lives by consistently challenging the government in the courts and the media, and have won some notable victories. The Constitutional Court, for example found the government’s failure to protect internally displaced people to be unconstitutional – and in response, the government committed more than $2bn to IDPs for the period 2005–10. The state’s independent Human Rights Ombudsman’s office has set up a groundbreaking early warning system to investigate allegations of abuses made by civil society organisations.154 233 FROM POVERTY TO POWER Individual leaders can also make a remarkable difference. Nelson Mandela steered South Africa towards peace without retribution, while on the other side of the coin Jonas Savimbi, the Angolan rebel leader, pursued a relentless war until his death in 2002, after which a peace deal was agreed. Besides avoiding messages of hate and division, governments need to ensure peaceful livelihoods for those who, without them, are most likely to turn to violence. From Haiti to Sierra Leone, governments have proved better at disarmament and demobilisation than at the third task, reintegration of former fighters into peaceful society. All too easily, demobilised combatants drift into lives of banditry or crime. The reintegration into society of young women involved in conflict as fighters or sex workers is often forgotten by the authorities, and is complicated by the social stigma attached to their wartime activities. Many conflicts are born of felt grievances and are rooted in longstanding inequalities, and can only be resolved with measures that address the roots of discontent. Societies torn asunder by social, economic, or political exclusion will not achieve peace unless they seek, and find, genuine political solutions. The opposite approach to resolving conflict – seeking outright military victory – may seem superficially attractive, but it is never easy and can condemn a country to protracted pain. When warring parties seek that victory at all costs, ignoring the restraint that international humanitarian law demands, they fuel a cycle of atrocities that makes peace very much more difficult to find. The conflict between Israel and the Palestinians demonstrates all too clearly how a vicious cycle of violence sustains the very fear and hostility that make peace so difficult to achieve. Rooted in Israel’s occupation and its treatment of Palestinians, the 60-year conflict is sustained by a cycle of atrocities committed by both sides that, since the start of the second Palestinian uprising in 2000, has cost the lives of over 6,500 Palestinians and 1,090 Israelis, including in total 1,596 children.155 The occupation that lies at the heart of the conflict continues. Half-amillion Israeli settlers have illegally transferred into East Jerusalem and the West Bank. Two-and-a-half million Palestinians living there have been denied access to 43 per cent of the land, 90 per cent of water resources, and 1,600km of roads.156 The panoply of Israeli restrictions – checkpoints, permits, closures, and the ‘Wall’ that cuts through the West Bank – destroys Palestinians’ lives and livelihoods, and prevents thousands of people from taking their products to market. Of course, negotiating an end to conflict is never easy, but one of the more encouraging trends of recent years is that most conflicts that are resolved are resolved peacefully. For most of the twentieth century, the most common way of ending wars was through outright victory, often at enormous human cost. Since the end of the Cold War, that seems to have changed. Sadly, most 234 4 HUMAN SECURITY mediation efforts still fail, but between 2000 and 2005, peaceful mediation ended 17 conflicts, whereas only four were concluded by military victory. The empirical evidence that it is worth giving peace a chance is getting stronger.157 In preventing and resolving conflict, huge responsibilities also lie with rich country governments. International humanitarian law calls on every government to help uphold its protection of civilians around the world. Rich countries, and particularly the UN Security Council members, have the greatest ability to do this. And rich countries have often fuelled conflicts through their own actions, for example through their hunger for natural resources, their refusal to receive refugees, their unbridled arms production and exports, or the destabilising impact of the ‘war on terror’. These issues are discussed in Part 5. 235 Shocks and change For better or worse, shocks, whether wars, natural disasters, or economic crises, change history, but most development thinking is essentially gradualist, attempting to promote reform and progress within existing institutions and systems. It therefore ignores the possibility of sudden shifts and struggles to understand the link between social and political upheaval and change. The World Bank, for example, portrays war as ‘development in reverse’, whereas conflict has unpredictable consequences for development, triggering anything from human catastrophe and state collapse to economic modernisation – for example in Mozambique, where war accelerated a shift from subsistence to waged agriculture.158 Moreover, the weeks and months after a conflict ends are a crucial ‘moment of opportunity’ when, amid the chaos of disarmament, often violent elections, and feuds over political power, new institutions take shape, resources are allocated, and the peacetime order emerges. It is then that previously marginalised voices can make themselves heard – but they are all too often ignored, missing a chance to engage still-emerging political systems in tackling inequality and exclusion. Disasters are also ‘political moments’ that can make as well as break movements for change. They highlight corruption and political bias: in Nicaragua, popular outrage at the theft of relief money by the Somoza dictatorship after the earthquake of 1972 was a ‘tipping point’ in the upsurge of protest that led to the Sandinista Revolution seven years later. The feeble response of the Mexican authorities to the earthquake of 1985 galvanised independent social movements and weakened the stranglehold of the Institutional Revolutionary Party, which had ruled the country since 1929. Catastrophic famines in Bangladesh in 1971 and in Ethiopia in 1985 led respectively to independence and the fall of a dictatorship. The 2004 Asian tsunami set the stage for a resumption of peace talks between the separatist Free Aceh Movement (Gerakan Aceh Merdeka, or GAM) and the Indonesian government, culminating in the signing of a peace agreement in August 2005 that officially brought a 30-year conflict to an end. The historic peace deal was followed quickly by the release of Acehnese political prisoners, the withdrawal of government troops from the province, the decommissioning of rebel-held weapons, and the establishment of a government authority to oversee the reintegration of ex-combatants and co-ordinate assistance for conflict-affected communities. The following year saw a far-reaching autonomy law, giving the long-neglected province control over its natural resources. 236 4 HUMAN SECURITY On closer examination, even gradual change often turns out to have been a series of small shifts in which shocks played an important role. Key moments in the steady spread of women’s suffrage in Europe, for example, came after wars had redrawn social relations, sending women out into newly independent roles in the workplace. Heraclitus believed that ‘war is the father of all things’. Modern observers might not be so militaristic, but conflict is undoubtedly a major source of political and social upheaval, not all of which is negative, as the creation of the European welfare states following World War II demonstrates. War or other disasters hardly constitute a path to change for which reasonable people would advocate, because of the immediate human cost and because the changes that emerge are just as likely to be negative as positive. The point rather is to recognise the potential of shocks to bring about change and to seize the ‘moments of opportunity’ that arise, to encourage positive changes and to prevent negative ones. This raises challenging questions for the aid community about how to respond to wars, natural disasters, or political upheavals. Major changes (both good and bad) that would normally take decades to happen may occur in weeks or months. Should humanitarian and development practitioners respond differently to promote wider systemic change, embrace new approaches to old problems, or encourage shifts in positions and alliances of political actors and movements for change? Clearly there is a need to re-evaluate the division between a ‘humanitarian’ approach to shocks (governed by the strictly neutral imperative to save lives) and the ‘development’ approach to peacetime (driven by the often political support for social change), appreciating how the seeds of vulnerability to shocks are sown through bad peacetime development models and the role of shocks in triggering long-term change. Building real security All of us, but particularly people living in poverty, experience a bewildering and ever-changing world of risk and vulnerability. New threats such as climate change or HIV join ancestral fears of illness, hunger, poverty, and violence. Still other threats will doubtless appear in coming decades. In this complex and uncertain scene, ‘security’ is about much more than the absence of war or terrorism. In the lives of vulnerable individuals and communities, security covers a great span of daily anxiety and risk. Given the high price of inaction on climate change, violence, hunger, and disease, a combination of public pressure and far-sighted leadership is urgently needed, in both North and South. Vulnerable people must be equipped to cope with risk, by strengthening their own capabilities and by building the state’s capacity to provide support and protection. 237 FROM POVERTY TO POWER The concept of human security offers an invaluable compass in this task, as well as the seed for a new model of development. At a national level, governments need to understand security as an essential aspect of development that guarantees human dignity. Easing human suffering by addressing the causes of vulnerability and anxiety should be central to economic and social policy-making. The growth monomania of recent decades is self-defeating (it has not delivered better economic growth) and is insufficient. Governments need to generate sufficient resources to get the job done, in terms of volume and predictability and from both domestic taxation and international aid. They also need to build effective and honest civil services with the skills to manage complex processes, such as social protection, disaster risk reduction, and environmental and social adaptation. Moreover, they need the freedom to make the right decisions, without excessive interference from international financial institutions, aid donors, or vested interests, whether local or global. Creating the political will to build and then use this capacity wisely is a major challenge. The greatest source of hope lies in the long-term improvements in governance, such as the spread in recent decades of critical media, multi-party democracy, and an active civil society, all of which increase the pressure on governments to work for the benefit of their people. The extent of these changes is assessed in Part 2. For rich country governments, corporations, and other bodies to contribute positively to this effort – or at a minimum to do no harm – a shift in mentality is required at both government and corporate level, away from seeking shortterm profit and toward the pursuit of the longer-term benefits that accrue from stability and prosperity. Some governments have broadened their conception of the national interest to recognise, first, that security for one state and one group of people depends on the security of others in many parts of the world; and second, that states or inter-governmental bodies such as the European Union, which derive their internal legitimacy from their respect for universal rights, must for their own credibility and coherence act consistently to uphold those rights everywhere in the world. The role of the international community in human security is examined in Part 5. Progress on building the capacities of people and governments to reduce vulnerability will not come about simply through the jockeying and evolution of political and economic self-interest. Change is a much deeper process, involving ideas and beliefs and our changing understanding of rights and responsibilities, of what is natural, desirable, or acceptable. The vulnerability and anxiety that blight too many lives, especially those of poor people, must become unacceptable in every country, just as slavery or women’s exclusion from the vote passed from being ‘natural’ to ‘wrong’ in the public mind. In building a new global solidarity with and among poor people, tackling risk and vulnerability must be considered as urgent and necessary a task as ending hunger and poverty. 238