Diseases of Poverty, Diseases of Affluence

I've been meaning to blog again about the rising rates of diabetes in India. My previous discussion, with some links to other bloggers' views on the issue, can be found here and here.

I think there is no doubt that the rise of diabetes is, in part, a function of changing lifestyles among the relatively small part of the Indian population that is reaping the benefits of the country's economic growth. There is another potentially important factor, and I will blog at greater length about that soon.

In this post I want to point out the dialectical nature of globalization (or economic liberalization, if you like). Only under the logic of globalization can a country experience both diseases of affluence and diseases of poverty. In a Marxian sense, this may be another important historical contradiction, or perhaps simply another manifestation of the central contradiction of capitalism (its simultaneous need to expand and its unsustainable exploitation of labor). Globalization, after all, as some argue, is merely the latest phase of capitalism.

This idea occurred to me as I read "The Hungry Bellies of South Asians..." at pass the roti. Commenting on the 2006 Global Hunger Index, a report issued by the Deutsche Welthungerhilfe and the International Food Policy Research Institute that uses three indicators to measure the extent of hunger in 97 developing countries and 22 countries in transition, Desi Italiana quotes the following from an article at Outlook India.com:

“Another value of the index is to demonstrate which countries have not been able to use their available economic resources effectively in reducing under nutrition,” Ms. Wiesmann noted.” High income inequality is one of the factors that causes countries to have higher levels of hunger and under nutrition than would be expected based on the gross national income per capita.”

Weisman, the IFPRI researcher who developed the index, does not go on to explain why high income inequality would exacerbate the problems of malnutrition and hunger. Perhaps the reason is obvious, but I will state it anyway: income inequality translates into disparities in power (not just economic, but political and even cultural power); and those with power work to maintain the status quo.

>Look at this optimistic headline from the Hindustan Times: "India shows improvement in tackling malnutrition: Index." But the article goes on to note that:

The hunger index for India has shown that from a score of 41.23 in 1981, it dropped to 32.73 but is holding steady at 25.73 for the years of 1997 and 2003. Bangladesh on the other hand would show its hunger index dropping from a score of 44.40 in 1981 to 28.27 in 2003.

I would be willing to bet that there is a pretty close correlation between the beginning of India's economic rise (and thereby the beginning of its growing income inequality and power disparity) and the slowing of the decline of its score on the Global Hunger Index. I am not arguing that globalization does not reduce poverty. I believe it does. But I also believe that it reduces poverty at a slower rate than alternative approaches.

Consider the following quote, from an article on Expat that draws from Welthungerhilfe’s f="http://www.welthungerhilfe.de/1550.html">press release on the report:

Ingeborg Schaeuble, Welthungerhilfe's chairwoman, said stable countries like Ghana have managed to reduce hunger, malnutrition and the child mortality rate ... "It is, however, wrong to think that economic progress alone is enough to reduce hunger," said Schaeuble, who is the wife of German Interior Minister Wolfgang Schaeuble.

"These countries cannot make headway without investing in agriculture, health and education. This is particularly applicable to countries which have endured acute crises and war," she said.

This is precisely my point. Currently, India's investments in agriculture largely benefit the economic elite, and its investments in health and education are dismally inadequate. Now, back to diabetes. Type 2 diabetes, at least to the extent that it is linked to the diet and lifestyle of affluent people, is likely to get the attention of India's political leaders.

Globalization is slow to reduce poverty because it operates under the same logic of, or arguably is the same as, capitalism. This logic privileges continued growth of the system above all else. Social or environmental problems are never dealt with sufficiently unless there is the potential for profit in their solutions. Yet in the constant push for growth, internal conflicts emerge. Marx focused on class struggles. Perhaps coexisting diseases of poverty and affluence are part of the synthesis of the dialect.

For Marx, or Hegel for that matter, dialectics consist of a thesis, antithesis, and synthesis (a term not preferred by Hegel). The coexistence of diseases of poverty and diseases of affluence could be viewed as part of the dialectic nature of globalization. But it might be that their coexistence is actually part of the synthesis of the dialectic of capitalism. In other words (bear with me as I simplify some of Marx's thoughts), the ever increasing exploitation of the labor class by the capitalist class, and the ever increasing income inequality that comes with this exploitation, is resolved through universal sickness.

The ultimate resolution, of course, will depend on whose sickness does them in first. Presumably, the "haves" will use their economic power to manage their diseases of affluence while the "have nots" continue to suffer. This is certainly, more or less, what the medical system in the U.S. looks like. Perhaps India will follow a different path.

Technorati tags: poverty, Global Hunger Index, diabetes, globalization