©Copyright United Nations Development Program
Human Development Report 2005
International cooperation at a crossroads: Aid, trade and security in an
This is, sadly, the last Human Development Report for which I will write the foreword,
as I will step down as United Nations Development Programme (UNDP)
Administrator in August. When I arrived at UNDP in 1999, I said that the Human
Development Report was the jewel in the crown of the organization’s global intellectual
and advocacy efforts. Six years and six reports later, I can report with some
pride that its lustre has only grown.
Building on the powerful foundation laid during
the Report’s first decade, when successive
Human Development Reports introduced and
fleshed out the concept of human development,
the Reports have gone from strength to
strength. From examining how best to make
new technologies work for rich people and poor
people alike to highlighting the critical importance
of strengthening human rights and deepening
democracy to protect and empower the
most vulnerable, the Human Development Report
has steadily widened the intellectual frontiers
of human development in the new millennium.
And that shift has been increasingly
mirrored in development practice through
work by UNDP and its many partners on the
ground in all these critical areas.
Kevin Watkins - Director
Human Development Report 2005
International cooperation at a crossroads: aid, trade and security in an
The year 2004 ended with an event that demonstrated the destructive power of
nature and the regenerative power of human compassion. The tsunami that swept
across the Indian Ocean left some 300,000 people dead. Millions more were left
homeless. Within days of the tsunami, one of the worst natural disasters in recent
history had given rise to the world’s greatest international relief effort, showing what
can be achieved through global solidarity when the international community commits
itself to a great endeavour.
The tsunami was a highly visible, unpredictable
and largely unpreventable tragedy. Other tragedies
are less visible, monotonously predictable
and readily preventable. Every hour more than
1,200 children die away from the glare of media
attention. This is equivalent to three tsunamis
a month, every month, hitting the world’s most
vulnerable citizens—its children. The causes of
death will vary, but the overwhelming majority
can be traced to a single pathology: poverty. Unlike
the tsunami, that pathology is preventable.
With today’s technology, financial resources
and accumulated knowledge, the world has the
capacity to overcome extreme deprivation. Yet
as an international community we allow poverty
to destroy lives on a scale that dwarfs the
impact of the tsunami.
1: The state of human development
“The test of our progress is not whether we add more to
the abundance of those who have much; it is whether we
provide enough for those who have too little.”
(US President Franklin D. Roosevelt, second inaugural address, 1937>
Sixty years ago the UN Charter pledged to free future generations from the scourge
of war, to protect fundamental human rights and “to promote social progress and
better standards of life in larger freedom”. At the start of the new millennium the
world’s governments renewed that pledge. The Millennium Declaration, adopted
in 2000, sets out a bold vision for “larger freedom” in the twenty-first century. That
vision holds out the promise of a new pattern of global integration built on the
foundations of greater equity, social justice and respect for human rights. The Millennium
Development Goals (MDGs), a set of time-bound and quantified targets
for reducing extreme poverty and extending universal rights by 2015, provide the
benchmarks for measuring progress. More fundamentally, they reflect the shared
aspirations of the global human community in a period of sweeping change.
This year marks the start of the 10-year countdown
to the 2015 target date for achieving the
MDGs. Today, the world has the financial,
technological and human resources to make a
decisive breakthrough in human development.
But if current trends continue, the MDGs will
be missed by a wide margin. Instead of seizing
the moment, the world’s governments are stumbling
towards a heavily sign-posted and easily
avoidable human development failure—a failure
with profound implications not just for the
world’s poor but for global peace, prosperity
Fifteen years after the launch of the first
Human Development Report, this year’s Report
starts by looking at the state of human development.
2: Inequality and human development
“There are only two families in the world, as my grandmother used to say: the haves and the
(Sancho Panza in Don Quixote de la Mancha, Miguel de Cervantes)
“What is it that impels the powerful and vocal lobby to press for greater equality?”
asked Margaret Thatcher, then UK prime minister, in 1975. She offered her own
answer: “Often the reason boils down to an undistinguished combination of envy
and bourgeois guilt.” Plato took a different view. Writing in the fifth century BC
he warned Athenian lawmakers of the threat posed by extreme inequality. “There
should exist among the citizens neither extreme poverty nor again excessive wealth”,
he wrote, “for both are productive of great evil.”
Two contrasting views on a question that retains
a powerful relevance today: does inequality
matter? If so, why? In this chapter we argue
that inequality matters because it is a fundamental
issue for human development. Extreme
inequalities in opportunity and life chance have
a direct bearing on what people can be and what
they can do—that is, on human capabilities.
Children facing a higher risk of death because
they are born into a low-income or indigenous
household or because they are female, for example,
clearly have less opportunity to realize their
potential. Inherited disadvantage in opportunity
is wrong for intrinsic reasons: it violates
basic precepts of social justice. There are also
strong instrumental reasons for a concern with
inequality. Deep disparities based on wealth,
region, gender and ethnicity are bad for growth,
bad for democracy and bad for social cohesion.
They are also bad for the Millennium Development
Goals (MDGs). The MDGs do not
directly address inequality. In this sense they
are distribution neutral. Progress is measured by
aggregating and averaging change at a national
level. In theory, the MDGs could be met even
if, say, households with low incomes were falling
behind on the income poverty and health
targets, or if the rate of reduction in child deaths
among boys was sufficient to compensate for a
slower rate of reduction among girls.
3: Aid for the 21st century
“Hunger is actually the
worst of all weapons of mass
destruction, claiming millions
of victims every year. Fighting
hunger and poverty and
promoting development are
the truly sustainable way to
achieve world peace….There
will be no peace without
development, and there will be
neither peace nor development
without social justice.”
(Brazilian President Luiz Inácio Lula da Silva)
International aid is one of the most powerful weapons in the war against poverty.
Today, that weapon is underused and badly targeted. There is too little aid and too
much of what is provided is weakly linked to human development. Fixing the international
aid system is one of the most urgent priorities facing governments at the
start of the 10-year countdown to 2015.
This chapter sets out an agenda for rethinking
international aid that is relevant to rich countries
and poor countries alike. Many people equate
aid with charity—a one-way act of generosity
directed from high-income countries to their lowincome
counterparts. That belief is wrong. Aid
should be thought of as a hand up, not a handout—
and as an investment in shared security and
shared prosperity. By enabling poor people and
poor countries to overcome the health, education
and economic resource barriers that keep them
in poverty, aid can spread the benefits of global
integration, expanding shared prosperity in the
process. It can also reduce the mass poverty and
inequality that increasingly threaten the collective
security of the international community.
Aid has not always played a positive role in
supporting human development, partly because
of failures on the side of aid recipients and partly
because donor countries have allowed strategic
considerations to override development concerns.
But whatever the failings of the past,
today there are new opportunities for reshaping
development assistance. For the first time in
history there is an international consensus that
human development should be the primary objective
of aid. That consensus was reinforced in
March 2002 when world leaders, gathered at
the International Conference on Financing for
Development in Monterrey, Mexico, agreed to
make aid one of the building blocks of a new
“global partnership” for poverty reduction.
4: International trade— unlocking the potential for human development
“The division of labour among nations is that some specialize in winning and others in losing.”
Until the lions have their historians”, declares an African proverb, “
tales of hunting
will always glorify the hunter.” The same is true of tales about international trade.
For globalization enthusiasts the rapid expansion of world trade over the past two
decades has been an unmitigated blessing, notably for the world’s poor. Reality is
more prosaic. Greater trade does offer enormous opportunities for human development.
Under the right conditions it has potential for reducing poverty, narrowing
inequality and overcoming economic injustice. For many of the world’s poorest
countries, and for millions of poor people, these conditions have yet to be created.
Improved multilateral cooperation on trade
is vital if the international community is to
achieve the Millennium Development Goals
(MDGs) and wider development objectives.
International trade rules and national trade
policies need to be aligned with a commitment
to poverty reduction. The starting point should
be a recognition that greater openness to trade,
like economic growth, is not an end in itself: it is
a means to expanding human capabilities. Indicators
for increased openness—such as export
growth and rising trade to GDP ratios—are
important, but they are not proxies for human
Trade is at the heart of the interdependence
that binds countries together. That interdependence
has contributed to some highly visible
human development advances, enabling millions
of people to escape poverty and share in
the prosperity generated by globalization. Yet
many millions more have been left behind. The
costs and benefits of trade have been unevenly
distributed across and within countries, perpetuating
a pattern of globalization that builds
prosperity for some amid mass poverty and
deepening inequality for others.
5: Violent conflict—bringing the real threat into focus
If human development is about expanding choice and advancing rights, then violent
conflict is the most brutal suppression of human development. The right to life and
to security are among the most basic human rights. They are also among the most
widely and systematically violated. Insecurity linked to armed conflict remains one
of the greatest obstacles to human development. It is both a cause and a consequence
of mass poverty. As the UN Secretary-General has put it, “humanity cannot enjoy
security without development or development without security, and neither without
respect for human rights.”
Almost 15 years after the end of the cold war
there is a perception that our world is becoming
less safe. In industrial countries public opinion
polls suggest that this perception is linked
to fears of terrorist threats. These threats are
real. Yet they also create a distorted perception
of the distribution of human insecurity. Since
1998 terrorism has been responsible for nearly
20,000 fatalities globally.3 Meanwhile, conflict
in the Democratic Republic of the Congo
is estimated to have caused nearly 4 million
deaths, the vast majority not from bullets but
from malnutrition and disease. In Sudan the
ongoing humanitarian tragedy in the Darfur
region flickers intermittently into world news
reports, yet it is claiming victims on a scale that
dwarfs the threats facing people in rich countries.
Every civilian death linked to conflict is a
violation of human rights. But the risk of violation
is heavily weighted against people living in
the world’s poorest countries.
Bibliographic note, Bibliography
This 2005 Human Development Report takes stock of human development,
including progress towards the MDGs. Looking beyond statistics; it highlights
the human costs of missed targets and broken promises. Extreme inequality
between countries and within countries is identified as one of the main
barriers to human development—and as a powerful brake on accelerated
progress towards the MDGs.
The report suggests that the world’s governments are faced with a choice.
They can start a decade for development with the financial resources, technology
and capacity to end poverty or we could have a human development failure.
“Business as usual” will not allow fulfilling the promises and the
commitments made in 2000. The cost of this failure will be measured in human
lives, increased inequalities, violations of human rights and threats to peace.
International aid, one of the most effective weapons in the war against
poverty, needs to be renovated and reshaped. It should be thought as an
investment as well as a moral imperative. In this respect, three conditions for
effective aid are:
- sufficient quantity;
- better quality (delivered on a predictable value for money basis,with low
transaction cost); and
- country ownership.
Failure in any one area undermines the foundations for future progress.
The 2005 Report presents:
- A comprehensive overview of international development assistance, looking
at both its quality and quantity;
- A critical review of progress in the “Doha Development Round” of trade
negotiations, highlighting how unfair trade rules reinforce inequality; and
- Evidence of the human development costs of violent conflict, and a review
of strategies for conflict prevention.
English | French
The national and regional reports
Human Development Reports (HDR) at the regional, national and sub-national
levels take the human development approach to the regional or country level and
are prepared and owned by regional and national teams. They both feed into and
draw upon the data and analysis of the global Report. Over 600 regional,
national and sub-national reports have been produced so far in over 140
- Sridhar, Devi, 2005. "Inequality
in the United States Healthcare System
Although the United States (US) has been rated highly in the United Nations Human
Development Index, the shining health indicators of the general population do not reflect
the great disparity in the health of certain subpopulations. Absolute health indicators
often make the suffering of the vulnerable, especially those living in the wealthiest
nation, invisible to the world.
In this paper, I will demonstrate why the US private-public healthcare system should not
be used as a model for other countries as it exacerbates the inequality in access to care
and health status between the haves and the have-nots.
Part I: I will first describe the variation in health status by location, race/ethnicity, gender,
and poverty level. This variation highlights the vast inequality in the health of the US
population, a reflection on insufficient access to care and health insurance coverage.
Part II: I will then establish the link between health insurance and health status to provide
evidence that the lack of adequate health insurance in certain subpopulations directly
results in their inferior health status.
Part III: To provide background, I will briefly discuss how most Americans obtain health
insurance and how the US healthcare system functions, or malfunctions.
Part IV: In this section, I will profile the uninsured by work status, poverty level,
location, race/ethnicity, and gender to show who is most likely to not have coverage and
who the losers are of the US healthcare system.
Part V: I will analyze how the US Healthcare system through a mostly private insurance
model is exacerbating these health inequalities.