As I write this post, debate rages in the US Congress over the cuts in this year’s budget – with the Republican majority seeking over $100 billion in cuts over and above Obama’s already cut down proposals. Time to accept this as a symptom of the austerity measures forced upon us by the global economic crisis? Not if you consider the small print, the small percentages, the less reported angles: the massive impact the US budget decision could have on the health of the world’s poor.
Obama’s budget proposes spending $27 billion in overseas aid this year. That’s less than US citizens spend on sweets in one year, or about $10 per person for the estimated 2.7 billion people living on less than $2 per day. In fact, US government aid is only 0.2% of the US’s Gross National Income (GNI) – much less than the 0.7% of GNI that the UN would like all major national donors to give. So a cut in this budget area hardly scratches the surface of the vast US budget deficit. Nevertheless, because of the sheer size of the US economy, its overseas development budget is big enough to make it still the single largest national aid donor in the world.
Longer term, Obama’s budget for next year will see spending on international aid reduce by 6.7%. This is at a time when global food price inflation is driving many of the world’s poorest into hunger and starvation as even basic foodstuffs such as wheat, maize and rice become unaffordable. There is already evidence emerging that the downward trend in US aid is having an impact on the health of the poor.
But the Republican dominated legislature seeks to pare back aid even further. This includes reducing the US contribution to the Global Fund to fight AIDS, TB & Malaria by 40%, child health programmes by 10%, AIDS treatment and prevention by 8%, some international food aid programmes by 50%. The fear is that this will adversely affect US national security, its global image (ironically undoing much of the good that George Bush’s initiatives on AIDS and malaria have achieved for the standing of the US in Africa), as well as withdrawing essential support from some of the poorest people on Earth.
And for Christian organisations providing health services to the poor, there could be a significant impact, as US aid has always been more favourable to funding faith based organisations than the British Government and other major donors.
Whatever the outcome of this budget battle in the US, it sets the tone for what will happen in global development for the next few years, for where the US leads, others tend to follow.
For its part, the UK Government is not cutting aid, indeed, it still aims to increase its aid to 0.7% of GNI by 2013, although controversially it is refocusing its aid priorities on areas of conflict and where UK security interests are paramount (including Somalia, Pakistan and Afghanistan), removing aid from a significant number of poor and middle income nations and cutting its contribution to international bodies. The impact that this will have on global health remains to be seen – but with the US and the UK now removing funding from several poor nations and some key international bodies, and with others likely to follow their lead, it is more than likely that healthcare to the poorest will suffer in the long run.
Christians do have an inherent responsibility to speak up for the cause of the poor to our governments and global institutions, and to challenge them about how our commitment to global justice is resourced and carried out. However, we have an even stronger obligation to be concerned about these issues directly ourselves. A concern for our neighbour is an innate response to God’s saving grace, and an integral part of the life of Christians. And our neighbour is not defined by Jesus as the person who lives near us or is like us, but rather to the one we find in need – on our doorstep or across the globe. As Tim Keller reflected in his recent book ‘Generous Justice’, concern for justice and the poor is not an add-on to the gospel, nor is ‘doing justice’ a side issue – it shapes and frames our whole lifestyle as Christians, arising as it does from God’s heart for the poor.
An exciting challenge was made to the church at last year’s Lausanne Congress on World Mission in Cape Town. Richard Stearns, author of ‘The Hole in the Gospel’ challenged the church globally, but particularly in the richer nations, about how we engage with global justice issues. If we reoriented our lives in giving our time, our money, or skills, to serve the poor in the name of Christ; and gave it not to expensive buildings and comfortable lifestyles, but in a radical commitment to justice; the church could have a significant impact on global inequalities and injustices, whether or not our governments get engaged.
And here is the big point – in many parts of Sub-Saharan Africa in particular, the national church is doing this – with scant support from the rich churches in the West on most occasions. 40-60% of healthcare in southern and eastern Africa in particular is coming from churches and Christian hospitals, clinics and community health projects. Christians in India make up about 3% of the population but provide 10% of the healthcare. Christians in the developing world are already grasping this nettle firmly. We fail them, and our Lord in heaven, if we do not support and match their generosity and commitment.
If our governments won’t trump up the resources, then maybe we should wake up and start to put our resources into areas such as global health, both as individuals and as churches. Then we would have an even stronger voice to challenge the governments of the world over their choices on behalf of the poor.