Welcome to a new generation of ‘development issues’ | Duncan Green

16 Jan 2014

woman having blood pressure measured Health problems such as obesity, once more common in countries of the Global North, are increasingly rising in the South, and the development focus for health may need to shift as a result. (Photo: UNDP Fiji)

As I browsed my various feeds over the Christmas break, one theme that emerged was the rise of the “North in the South” on health, or what I call Cinderella Issues: things like traffic accidents, the illegal drug trade, smoking or alcohol that do huge (and growing) damage in developing countries, but are relegated to the margins of the development debate. If my New Year reading is anything to go by, that won’t last long.

ODI kicked off with Future Diets, an excellent report on obesity that shows the number of obese/overweight people in developing countries (904 million) has more than tripled since 1980 and has now overtaken the number of malnourished (842 million, according to the FAO).

Other key messages include that diets are changing wherever incomes are rising in the developing world, with a marked shift from cereals and tubers to meat, fats, sugar and fruit and vegetables. While globalisation has led to a homogenisation in diets, their continued variation suggests that there is still scope for policies that can influence the food choices people make, particularly in the face of the serious health implications.

Meanwhile, the Economist ran a two-page report and editorial on “the new drugs war”:

“The resurgence of conflict over drug pricing is the result not of a sudden emergency, but of broad, long-term changes. Rich countries want to slash health costs. In emerging markets, people are living longer and getting rich-country diseases. This is boosting demand for drugs for cancer, diabetes and other chronic ailments. In emerging markets, governments want to expand access to treatment, but drugs already account for a large share of health-care spending…. Meanwhile, a wave of innovation is producing expensive new treatments.”

This all poses a bit of a conundrum for NGOs and aid agencies. While (rightly) focusing on the outrage of 842 million hungry people in a world of plenty, should we also start to discuss public health issues such as obesity, which is no longer confined to the well-off? If we shy away from doing so, we risk our description of life in the Global South being increasingly at odds with reality.

Similarly, what would happen if in addition to our work on the diseases of underdevelopment (malaria, HIV, polio) we acknowledge the increasing importance of the non-communicable diseases we worry about for ourselves and our parents (cancer, heart disease, Alzheimer’s)? Would the loss of an exotic “other” reduce public or media interest? And if so, should we care?

The positive aspect is that governments, scientists and others in the North have lots of experience in these issues, and their advice and assistance would probably be a lot more useful to developing countries than banging on about stuff the rich world is currently not very good at (growth, jobs, small-scale agriculture, etc).

Talk to us: Should the development focus be shifted as countries in the Global South increasingly confront health problems common in the North? If so, how?  

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