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“This is the battle of solidarity against egotism” Fidel

INTERNATIONAL COOPERATION. Before focusing hopeful eyes on the future, you must be grounded in reality. And the reality of international cooperation is fundamentally perverse, and that’s why it must be changed.” Ximena de la Barra. International Consultant, United Nations.

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“This is the battle of solidarity against egotism” Fidel

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  1. INTERNATIONAL COOPERATION Before focusing hopeful eyes on the future, you must be grounded in reality. And the reality of international cooperation is fundamentally perverse, and that’s why it must be changed.” Ximena de la Barra. International Consultant, United Nations “This is the battle of solidarity against egotism” Fidel

  2. Third World Countries: Economic Situation GROWTH of GDP (%) FOREIGN DEBT (trillions USD) 2,8 2,7 2,7 2,5 2,4 2005 2004 2003 2002 2001 2000 5,9 6,6 6,1 4,8 4,0 5,9 In 1980, the foreign debt was 600 billion dollars • The developed world spends USD $ 68 billion annually in development; developing countries spend 378 billion servicing their debt. (5.4 times what they receive). • In 2004, Latin America received 6.843 billion in official development assistance and had net transfer of resources abroad of 77.826 billion (10 times the aid received). • Latin America alone owes 780 billion in foreign debt, and the more it pays, the more it owes. In 2005, negative resource transfers from Latin America and the Caribbean were – 67. 494 billion. (Source: ECLA)

  3. Official Development Assistance Only 5 countries fulfilled the promise of 0.7% of GNI for official development assistance (Norway, Sweden, Luxembourg, Holland and Denmark), and the average among the 22 countries was 0.33 %. The USA is in next-to-last place with only 0.21 % of GNI.

  4. Cooperation and Development Aid vs. Military Aid Worldwide One trillion for military aid 68 billion for development aid 47% of this from the USA Latin America Receives proportionately less than any other region in development aid U.S Military Aid Develop ment Aid 13.6% 115 millon (+340%) In 2005, 122 million 3.4 million 11.6% 2003 1993

  5. Consequences for the World’s Population • A more unjust and unequal world. • Of the 6 billion people in the world: • 815 million are hungry (13.5 %) (300 million of them children). • Every 3.6 seconds a person starves to death, the great majority children under 5. • 2.4 billion people have no basic sanitation (40%). • Over 1 billion lack clean drinking water. 5 million people, mainly children, die every year from waterborne diseases. • 854 million are illiterate (14.2%). • 4.8 billion are poor people (80%). • In 1992, the income difference between rich and poor countries was 60-fold. Today, it is 74-fold.

  6. Consequences for the World’s Health • 40 million with HIV-AIDS (0.6%). Of those, 63% in Africa. • AIDS has left 13.2 million orphans in the world – 12.1 million of them living in Sub-Saharan Africa (Tanzania alone has 500,000 orphans). • 16,000 persons are infected daily with HIV-AIDS. • 11 million children under 5 die every year from preventable diseases (0.1%). • Every 30 seconds, a girl or boy somewhere in the world dies from malaria- 90% of them in Africa. • Africa has 11% of the world’s population, 25% of the disease burden and only 3% of he world’s health workforce. • In 2005, life expectancy in Europe was 68 for men and 77 for women; but in Africa it only reached 46 for men and 48 for women. In the next ten years, in Botswana it will reach 29; in Swaziland, 30; and in Namibia and Zimbabwe, 33.

  7. Global Crisis in Human Resources and Medicines • The WHO estimates a world shortfall of 4.3 million doctors, midwives, nurses and other health workers. • The Americas has over 35% of the world’s health workforce, and spends over of 50% of the world’s funds dedicated to health. 57 African countries have only 3% of the world’s health workforce, and make only 1% of the world’s health expenditures. • There are 50,000 doctors for Sub-Saharan Africa’s 700 million people. (1 x 14,000 inh). • Medicine sales are concentrated in the industrialized countries. In 2005, only 13.1% were made to developing countries; of these, 4.4% to Latin America and 1.1% to Africa. • The WHO budget for medicines is US $ 51.5 million annually. Reports from WHO indicate 58% (29 million) were spent in normative regulations, global policy and headquarters expenses.

  8. Tendencies in Global Health Cooperation Industrialized Countries and Most NGO’s Cuba • Minimize their historical responsibility for deteriorated development of our countries, condition aid to “good government”, “respect for human rights and the law”. Aid tied to structural adjustment and economic interests of donors. • Based on national consensus and political will; cooperation as key element in foreign policy as a means to real integration. • Mainly channeled thru central and local governments; aims to strengthen or create sustainable infrastructure. • Channeled thru private sector and NGO’s, often ignoring the role of government and thus the use of its infrastructure (lack of replicability and sustainability) • 80% of cooperation devoted to providing highly qualified human resources, dedicated to service and humanistic values; to training of human resources and transfer of modern technology. • Main contribution is financial, technological (often outdated), and smaller human resource development programs. • Developed as the sum of potential contributions from the countries involved, on a not-for-profit basis. • 80% of financial resources contributed actually return to industrialized countries.

  9. Tendencies in Global Health Cooperation Industrialized Countries and Most NGO’s Cuba • Aid does not always meet needs of receiving countries; frequently masks political and economic objectives. • Guided by the principle of responding to needs stated by authorities of the receiving countries. • For implementation, requires lengthy process, project proposals, exchange of experts, and finally signing of complex agreements. • Tends to develop quickly, without complicated formulations. Cooperation agreements signed in which local experts provide assistance. • Because of its institutional nature, attempts to benefit largest possible population, and is developed in poorest, most remote regions. • Generally develop pilot or small programs, benefitting limited populations, and usually in the cities.

  10. Cuban Global Cooperation: Current Situation (2006) • Cooperation with 155 countries; 1846 organizations of solidarity; and 228 political parties. • Over 800 projects in implementation. • 38,524 Cubans serve in 111 countries; of those 29,594 (76.8%) do so in the health sector in 68 countries. • Literacy program in 20 countries. • 27,235 young people from 120 countries study in Cuba. • 21,964 (80.6%) study medicine; 10,585 from 10 countries enrolled in the new community medicine program. • In Venezuela, the same program enrolls 14,185 students. • 536 students enrolled in schools founded with Cuban assistance in Gambia, Equatorial Guinea, Eritrea, Guinea Bissau and East Timor. • Vision restoration (Operación Milagro) developed in 29 countries in Latin America and the Caribbean, including Cuba.

  11. Total Personnel Collaborating Abroad, Agency and Geographic Region (May 31, 2006)

  12. Cuba’s Health Programs: Summary * Total is 68, since some countries have more than one modality.

  13. GLOBAL HEALTH PROGRAMS: SOCIAL IMPACT • Medical Attention • Office visits: 259,594,529 (in 7 years). • Home visits: 89,857,702. • Lives saved: 1,433,649 (five times the 285,700 lives lost in recent disasters in Central America, Indonesia, Sri Lanka, Pakistan and Indonesia). • Surgeries: 1,983,429. • Medical and paramedical equipment repaired: 59,568 (for a saving of USD $ 35,500,800 to the receiving countries) • 600 comprehensive diagnostic centers (CDC) and rehabilitation centers (CRC); and 35 high-technology centers (HTC). • CDC – 125 completed. CRC – 145 completed, of these 133 operating; 12 in startup. HTC – 4 operating, 4 in startup, 11 in construction, 16 in project phase.

  14. GLOBAL HEALTH PROGRAMS: SOCIAL IMPACT • Community optical services in Venezuela: 4,785,525 cases seen, resolving health problems of 3,602,504 (75.3%). One of every 8 inhabitants has received this service. • Vision restoration: benefitted 327,586 patients, of whom 36,703 from Latin America, 18,843 Caribbean, 71 816 Cuba, and 200,224 Venezuelan (one of 1393 inh. of these countries). • Henry Reeve Disaster Contingent: 3,989 sent to Guatemala, Pakistan and Bolivia. • In Pakistan: 32 mobile hospitals donated by Cuba. • Human Resource Training • Since 1961: 45,352 graduates from 129 countries. • 30,109 (66,4%) from 41 Sub-Saharan countries. • 8,718 (19,2%) from 18 Latin American countries. • Cuban medical teams abroad have graduated 3,392 paramedical and technical health workers.

  15. GLOBAL HEALTH PROGRAMS: SOCIAL IMPACT • Opening of the Caribbean Nursing School in Dominica with 150 students; preparations for second school in Belize. • Literacy: 2,451,509 persons learned to read and write in 13 countries. Declared illiteracy-free: Venezuela and Canton Cotacachihi.

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