In the 1950s and 1960s, the world could be divided, on the one hand, into a small group of rich ‘developed’ countries with functioning social welfare systems, small families and good health outcomes and a larger group of ‘developing’ countries with low incomes, poor education and health services, high birth rates, poor health and low life expectancy. However, over the last fifty years, this picture has changed radically.
Most countries have achieved higher incomes, better social welfare services and health outcomes, and lower family size. The majority of the world’s population of 6.7 billion people now live in countries with a gross domestic product (GDP) per capita of over US$ 2,000, with access to basic health services for most people and life expectancy above 65 years and falling family size. However, in countries like Brazil, Russia, India, China and South Africa, there are still many people living in absolute poverty with poor access and poor health outcomes.
Development has left behind a group of 50 least developed countries (LDCs), identified by the United Nations as having the lowest levels of socio-economic development and showing the lowest Human Development Index ratings. Most of these countries also feature on the list of the heavily indebted poor countries (HIPCs). These are mostly in Africa and Asia and in areas affected by conflict, natural disasters and poor government such as Gaza, Afghanistan, Somalia, Yemen, Haiti and Bangladesh. These countries suffer from a range of specific problems including poor governance and corruption, conflict, a lack of education (particularly for women), lack of access to global markets, climatic and soil conditions that limit agriculture and have a negative effect on health, and the impact of specific diseases such as HIV and AIDS. Some 770 million people live in LDCs, 36 per cent of them in extreme poverty with an income of less than US$ 1 per day and 75 per cent with an income of less than US$ 2 per day (in 2005 in purchasing power parity as at 1985 levels).
Many suggest that it is no longer appropriate to lump countries or even subcontinents together as developed or developing because this implies common problems and solutions. It also seems to suggest that the development route taken by rich countries can be followed by poor countries, which would be unsustainable for the environment. While LDCs are amongst the highest recipients of aid per capita, it is often difficult for them to utilize aid effectively due to problems of poor governance, conflict and access.
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