Module/Week 5 PPOL 505 DB

Chapter 11 Population and Migration

CHINA’S ONE-CHILD POLICY WAS BEGUN IN 1979 TO REDUCE POPULATION GROWTH. Residents of Guangdong Province looked at a propaganda billboard for the policy. However, after more than 35 years, the one-child policy was rescinded in October 2015 after its long-term demographic and economic implications caused many to question it.

Learning Objectives

1. 11.1Evaluate the causes as well as negative consequences of high and low population growth rates

2. 11.2Recall the types, causes, and gender roles of global migration

3. 11.3Identify the push factors of migration

4. 11.4Identify the pull factors of migration

5. 11.5Illustrate how migration and population issues are important components of human, national, and global security

6. 11.6Examine the social, economic, and political implications of migration on the sending and receiving countries

Population and migration issues, perhaps more than any other global problem, demonstrate the reality of globalization. Hunger, inequality, ethnic conflicts, environmental degradation, sustainable development, the treatment of women, global security, economic development, trade, poverty, democratization, human rights concerns—all aspects of globalization are intertwined with population. To a large extent, population factors will determine the future of humanity and the world. Rapid population growth is a silent threat to both human and global security, making it as grave a concern as the proliferation of weapons of mass destruction.

Demographic disparities among countries generally influence the distribution of economic, military, and political power among states. For example, France dominated continental Europe for a long time partly because of its relatively large population, although Britain used its geographic location and its navy to counter French power. America’s growing population is likely to consolidate its power, whereas Europe’s aging and declining population is likely to diminish its power in the global system. Russia’s population decline has contributed to its loss of power globally. Population growth in the developing world is helping shift economic and political power to emerging market economy countries. 1

Migration makes population issues an even more pressing global concern. Each wave of globalization has been accompanied by migration. The movement of capital, technology, and products across national boundaries is inseparable from the migration of people. The current period of globalization is marked by an unprecedented movement of people around the world. The creation of global institutions and the globalization of human rights and democracy have facilitated migration as well as given rise to a global human rights regime that protects migrants, independent of their nationality. This chapter focuses on population growth and its global implications. The different kinds of migrants and migrations are discussed. The pressure on Western Europe due to migration from Africa and the Middle East, and the possible effects from the November 13, 2015 terrorist attack on Paris, are also noted in this chapter. The role of gender in migration, rural-to-urban migration, transcontinental migration, forced migration, refugees, reform migration, and the global smuggling of immigrants are all examined. The causes of migration are as old as human civilization. After analyzing them, we will look at case studies that illustrate the dynamics of global—as opposed to regional and internal—migration. The chapter concludes with a case study of global aging and pensions.

11.1: Population

1. 11.1 Evaluate the causes as well as negative consequences of high and low population growth rates

At the heart of population as a global issue is the extent to which population growth threatens the Earth’s carrying capacity.  Overpopulation  (i.e., too many people living in an area that has inadequate resources to support them) has been a global preoccupation for centuries. Population problems must be seen in the context of consumption. In this context, the population of the developed world, which consumes much, is seen as a bigger problem for the world’s resources than the population of the developing world, which consumes little. Often, population problems can be avoided if population growth remains stable, assuming that resources are also carefully managed. The rate at which the population remains relatively stable is referred to as the  replacement rate . To achieve this, fertility rates must average 2.1 children per couple. Migration influences the replacement rate, population growth, and population decline.

Thomas Malthus (1766–1834), an English economist, sociologist, and pioneer in demographics, wrote An Essay on the Principle of Population in 1798. In it, he argued that because population increases by a geometrical ratio and food supplies increase by an arithmetical ratio, the world would have high rates of population growth and suffer from poverty and starvation. The widespread practice of family planning and technological and scientific revolutions in food production, transportation, and storage essentially rendered these dire predictions false. The invention of genetically modified crops and other agricultural scientific breakthroughs further challenge Malthus’s argument. However, food shortages and higher prices, due partly to the use of corn to produce biofuels, complicate the discussion on food and population. High population growth remains a serious threat to most developing countries and, as we discussed in  Chapter 9 , frustrates efforts to reduce global poverty and economic inequality. Malthus was concerned about the Earth’s carrying capacity.  Carrying capacity  refers to the maximum number of humans or animals a given area can support without creating irreversible destruction of the environment and, eventually, humans and animals themselves.

Combined with fervent nationalism and a perception that survival itself is at stake, population pressures often result in military conflict. The Palestinian-Israeli struggle is an example of how demographic changes are perceived as determining destiny. Jews now comprise roughly 50.5 percent of the population in Israel and the Palestinian territories. By 2020, the proportion of Jews will decline to 42.1 percent, whereas the Palestinians, who now make up 44.3 percent of the population, will see their share of the population grow to 52 percent. The birthrate for Palestinians in the West Bank and Gaza is 40 for every 1,000 people. The birthrate for Palestinians in Israel is 36 per 1,000 people. Compare this with a birthrate for Jews of 18.3 per 1,000, and you will see why demographic changes are perceived as threats to Israel’s security.

11.1.1: Population Issues in Developing Countries

Most developing countries have high population growth rates and suffer from vast differences in income. Inadequate education, low rates of contraception usage, cultural norms that value large families and male virility, the need for labor in subsistence economies, and the need to have children to support parents are some of the reasons population growth is higher in poorer countries. Most of the countries with the largest populations and the highest growth rates are in the developing world. Roughly 97 percent of the increase in the global population is occurring in Africa, Asia, the Middle East, and Latin America, with the more prosperous countries in these regions experiencing declining growth rates. Industrialized countries, on the other hand, are experiencing declining growth rates and even depopulation in some cases.

In India, more than 400 million people—roughly the combined populations of the United States and Britain—live in dire poverty and are illiterate. Nonetheless, the population in India grows by about three people a minute, or two thousand an hour, or forty-eight thousand per day. In other words, the growth of India’s population each day is equivalent to that of a medium-sized American city. By 2025, India is projected to surpass China as the world’s most populous country, with about 1.5 billion people, compared with China’s 1.4 billion people. China and India alone account for one out of every three children added to the global population.

Problems arising from rapid population growth have influenced governments, nongovernmental organizations (NGOs), and women to take action to limit population growth. It is generally agreed that women’s level of education strongly influences fertility rates. Education helps to determine factors that affect population growth rates, such as contraceptive usage, the age of marriage and childbearing, social status and self-perception, and employment opportunities outside of the home and residence.

An interesting development is the declining birthrates in Brazil, Mexico, Bangladesh, India, the Philippines, Iran, Vietnam, Indonesia, and Egypt, where poverty and illiteracy remain serious and pervasive problems. Even women who are less educated have become more assertive about their reproductive choices. Factors influencing this change include economic and cultural globalization, greater access to education, increasing urbanization, the declining influence of religion on women’s reproductive lives, greater access to medical technologies, and the cumulative effects of satellite television and other media that stress the advantages of having fewer children.  Sexism  strongly influences population decisions in developing countries. In many societies, tradition supports having large families by praising the fertility of women and the virility of men. The  son complex —the preference for having boys instead of girls—influences many parents worldwide to continue having children until a boy is born. Parents, especially mothers, are demeaned in many societies if they do not produce boys. In many traditional South Asian families, a boy is expected to live with his parents, be employed, inherit property, provide financial security for aging parents, and light their funeral pyres. A daughter, by contrast, is widely perceived as a financial and social liability. When she marries, her family is required, by tradition, to provide the bridegroom’s family with a substantial  dowry , which can be money, property, or both. Parents often incur significant debt to provide dowries. Sexism also conspires with advanced medical technology to reduce the number of girls in some countries such as India and China. With the use of ultrasound machines to determine the sex of the fetus, many parents often decide to abort female fetuses. India passed a law in 1996 prohibiting medical staff from informing parents of the gender of a fetus, but it appears to be ignored. Based on the predominance of male births, researchers estimate that more than six million girls have been aborted in India since 2000. Those practices plus female infanticide have contributed to a widening divergence in the ratio of females to males in many parts of India and China.

China’s  one-child policy , initiated in 1979 by Deng Xiao Ping, China’s leader, and rescinded in October 2015, was the most controversial approach to dealing with rapid population growth. China established the state family planning bureau to formulate policies and procedures for enforcing the one-child policy. Family planning committees at the local level, a part of the Communist Party, were responsible for rewarding those who complied with the policy and punishing those who violated it. Those who complied with it received a monthly stipend until the child was fourteen years old and got preferential treatment when applying for housing, education, and health benefits for the child; they were also granted a pension in old age. Those who failed to comply with the one-child policy risked the loss of benefits for the first child, jeopardized their employment with the government, and risked having their property seized. Women often were forced to be sterilized, especially after the birth of a second child. Exceptions to the one-child policy included the following cases: (1) if the first child had a defect; (2) in the case of a remarriage; (3) if couples are involved in certain jobs, such as mining; or (4) if both partners came from families with one child. Demographic and economic implications of the one-child policy influenced more Chinese to question it, leading first to a modification of it and finally to its being rescinded. 2

11.1.2: Population Issues in Developed Countries

Compared with the developing world, Europe has always had a smaller population. Among the reasons for this disparity are:

1. Europe was settled by humans who migrated from Africa into Asia. In other words, it started out with a smaller population.

2. Geography and climate discouraged large numbers of people from settling in Europe.

3. Confronted with overpopulation, Europe was able to conquer, colonize, and settle in North America, South America, parts of Africa, parts of Asia, Australia, and New Zealand.

The Industrial Revolution and scientific advances in agriculture made Europeans prosperous and diminished the need to have large families.

Europe is faced with the spread of  subreplacement fertility regimes : that is, patterns of childbearing that would eventually result in indefinite population decline. The sharpest dip in population is in Russia. Widespread environmental problems, alcohol poisoning, sexually transmitted diseases, and an abortion rate that is twice as high as live births have combined to decrease Russia’s population by roughly 700,000 each year. If current demographic trends continue, Russia will see its current population of 140.4 million drop precipitously to 100 million in forty to fifty years. 3  Such long-range predictions are often highly speculative and turn out to be inaccurate. Nevertheless, it is clear that Russia is going through a population implosion. Though immigration has slowed the decline of Western Europe’s populations, immigration levels are not high enough to alter the demographic realities. The United States, Canada, and Australia are actually gaining population largely due to increased immigration and rising fertility rates.

As  Table 11.1  shows, by 2010, the median age in the United States reached 36.6, compared to 43.3 in Italy and 44.3 in Germany, due to the rapid growth in the number of the elderly and the subreplacement problem. Three major reasons account for Europe’s aging societies:

1. Life expectancy has climbed due to medical advancements, a healthier environment, improved nutrition, and greater concerns about safety and public health.

2. The huge baby boom generation of the 1940s and 1950s is now entering middle age and moving into the old-age category.

3. Declining fertility rates, below the replacement rate, increase the proportion of the population that is old.

America’s aging population, while growing, will comprise a smaller percentage of the overall population because of the number of young immigrants and higher fertility rates. Japan faces not only an aging population but also subreplacement fertility rates.

Developed countries face many challenges that require the implementation of difficult and controversial strategies. These strategies include the following:

1. Substantially increasing immigration to offset declining fertility rates

2. Postponing or abandoning retirement

Table 11.1 Demographic Contrasts Between Rich and Poor Countries

Adapted from UN Development Programme, Human Development Report 2010 (Basingstoke, Hampshire, UK, and New York: Palgrave Macmillan, 2010).

Country	Median Age, 2010 (years)	Total Fertility Rate, 2010–2015 (births per woman)	Population Annual Growth Rate, 2010–2015 (%)
Rich Countries
Japan	44.7	1.3	20.2
France	40.1	1.9	0.4
United States	36.6	2.0	0.9
Italy	43.3	1.4	0.2
Germany	44.3	1.3	20.2
Poor Countries
Bangladesh	24.5	2.2	1.3
Haiti	21.6	3.2	1.5
Nigeria	18.6	4.8	2.1
Zambia	16.8	5.3	2.4
Sierra Leone	18.2	5.0	2.3

3. Encouraging higher fertility rates

4. Investing more in the education of workers to increase productivity

5. Strengthening intergenerational responsibilities within families

6. Targeting government-paid benefits to those who need them most

7. Requiring workers to invest for their own retirements

The implications of these changes are far reaching. Significant tensions within rich countries over such strategies are already evident in many European countries.

11.2: Global Migration

1. 11.2 Recall the types, causes, and gender roles of global migration

Migration —the movement of people from one place to another—is an integral component of human behavior. Our ancestors moved out of curiosity and a sense of adventure; to find food, to search for better grazing and agricultural lands; to seek protection from adversaries; to conquer land for new settlements; and to obtain religious, political, social, and economic freedoms. Contemporary migration is rooted in the earlier periods of political, military, economic, and financial globalization that we discussed in  Chapter 1 . Migration includes the movement of people within a country’s geographical boundaries as well as movement across national boundaries. People who migrate fall into several categories. A  migrant  is a person who moves from one country or area to another country or location. Migrants often move from one part of a country to another location within that country. The broad category of migrant is subdivided into refugees, displaced persons, and immigrants.  Refugees  are essentially migrants who live outside their country and are unable or unwilling to return because of documented cases of persecution or a well-founded fear of persecution. Historically and today, conflicts, famine, natural disasters, and political, religious, and economic oppression have been dominant factors contributing to the creation of refugees. Refugees who attempt to obtain permanent residence in the country to which they fled are referred to as  asylum seekers . The immigration laws of most countries distinguish asylum seekers from other categories of migrants and generally grant them preferential treatment, in accordance with international law. A  displaced person  is someone who has been forced to leave his or her home because of violence, conflict, persecution, or natural disaster but has not crossed an international border. Many displaced people eventually cross national boundaries, thereby becoming refugees. An  immigrant  is someone who goes to a foreign country to become a permanent resident. Most migration occurs in a relatively limited geographical area, despite growing  transcontinental migration  (i.e., the movement of people from one continent to another).

11.2.1: Gender and Migration

Men are more likely than women to migrate under ordinary circumstances. There are several reasons for this. Who migrates is determined to a large extent by the requirements imposed by countries, companies, or individuals who need labor. Much of the work to be done is culturally defined as work for men. Large numbers of men from Turkey, North Africa, and the Caribbean migrated to Germany, France, and Britain, respectively, after World War II to help rebuild these countries. Men throughout the world have been recruited to work in industry, construction, and mining. Cultural norms and sex roles within sending countries also determine whether men are more likely than women to migrate. Gender roles also influence men to migrate in search of employment. Men are generally perceived as breadwinners in most countries, whereas women are viewed as being responsible for taking care of the home. Economic development and greater access to education for women change cultural views of gender roles and provide more employment opportunities for women. Demographic changes and greater employment opportunities for women in developed countries are transforming gender migration. Women migrate to rich societies to work in factories, tourism, education, hospitals, businesses, and private homes. As more women work outside the home in rich countries, more women from poor countries are hired to do domestic work.

11.2.2: Types of Migration

Although migration, as a contemporary global issue, is often thought of primarily as movement from developing countries to rich countries, far more common is the movement of people within countries and from one country to another within a particular geographical or cultural region.  Regional migration  is fueled by increasing economic opportunities in a country or group of neighboring countries. For example, people in North Africa move to Spain, France, and Italy to find employment, and people from Zimbabwe, Mozambique, Botswana, and Lesotho have migrated to South Africa to work in mining and other industries.  Rural-to-urban migration  is the dominant pattern of migration in both rich and poor countries. Many rural areas across the United States are losing population as residents seek better opportunities in urban areas. Much of the migration in the developing world is from rural areas to cities. Rural-to-rural migration (i.e., the movement of people from one rural area to another) is common in many parts of the world, despite the relatively limited economic opportunities found in most small towns or agricultural areas. Many migrants follow the planting, cultivation, and harvesting of various crops. Urban-to-urban migration is common in most countries. Families and individuals move from one city to another to find employment, to pursue a college degree, or to be in a culturally dynamic area. Urban-to-rural migration is usually designed to encourage the economic development of the countryside and to relieve population pressures on urban centers. Brazil, China, Indonesia, and Nigeria are countries that have used this strategy. Another type of migration is  seasonal migration . People often move from one area to another because of the seasonal demand for labor. Agricultural industries often demand more labor at certain times of the year than at others. Harvesting fruit, sugarcane, coffee, and other crops requires intensive labor for a short period of time. Seasonal migration is also driven by other industries such as tourism.

Another type of migration is  transit migration . In this case, those seeking to enter a specific country pass through another country or stay there temporarily. For example, migrants use Mexico as a transit point for illegal entry into the United States. Visiting Mexico’s main immigration detention center, you see migrants from Ecuador, India, Cuba, China, Albania, Russia, Ukraine, Tanzania, Sierra Leone, Sri Lanka, Bangladesh, and other countries. Similarly, migrants attempting to enter Western Europe use countries such as Italy, Greece, Bosnia, Croatia, Serbia, Bulgaria, Hungary, Poland, and the Czech Republic as transit points. Many migrants also stop temporarily in Europe on their way to the United States and Canada. Within Europe, France is used as a transit point for migrants attempting to enter Britain to take advantage of its asylum policies.

Forced and induced migration  is an integral component of human history. Various minorities have been routinely expelled from countries because of political, social, ethnic, and religious differences. The Spanish crown forced Jews to leave Spain in 1492; Africans were forcibly removed from their homeland and enslaved in the Americas, the Middle East, and other parts of the world; and the Cuban and Chinese governments have used forced migration to achieve various political and economic objectives. 4  Another type of migration—one that is becoming common in an age of globalization—is  return migration . For example, many American citizens retain meaningful ties with another country. Throughout history, some migrants have returned to the places they left. In the late nineteenth century, roughly a third of European migrants to the United States were returning after a few years. Immigrants from Southern Europe, particularly Italy, were most likely to return after saving enough money to build homes, start small businesses, or buy farms. This trend of migration was strengthened by the relative newness of migration from Southern Europe and by declining transportation costs and faster and more reliable means of transportation. Economic success in the new country also motivates people to return to their country of origin. India and China, for example, encourage return migration to assist economic development. The global financial crisis slowed economic growth in Europe and the United States, which influenced Latin Americans who had migrated to Spain and the United States to return home. 5

11.2.3: Causes of Migration

Although the causes of migration are diverse and vary from one individual to another, demographers generally divide them into two categories: namely, push factors and pull factors. 6   Push factors  are negative developments and circumstances that motivate or force people to leave their homes. These include widespread abuses of fundamental human rights, political oppression, forced resettlement programs and expulsion, high levels of violence and endemic political instability, rapid population growth, high rates of unemployment, poverty, natural and environmental disasters, the relative lack of educational and cultural opportunities, globalization, and discrimination that excludes specific groups and individuals from competition for resources and power.  Pull factors  are positive developments and circumstances in other areas or countries that attract people away from their homes. These include economic opportunities, higher wages, political and cultural freedom and stability, a comparatively healthy environment, educational and cultural opportunities, and family reunification.

11.3: Push Factors

1. 11.3 Identify the push factors of migration

Widespread abuses of fundamental human rights, discussed in  Chapter 3 , have traditionally pushed people from their homes. The United States was settled by many individuals who were deprived of basic human rights. Many Jews, political dissidents, homosexuals, and others fled Nazi Germany because of the government’s systematic and profound violations of the most basic human rights, including the right to life. During the Cold War, many Central and Eastern Europeans fled oppression in the Communist countries. Cubans migrated in large numbers when Fidel Castro came to power and imposed severe restrictions on fundamental freedom.

Forced resettlement programs and expulsion are significant push factors. Governments have both forced and encouraged people to migrate for several reasons. These include the following desires:

1. To achieve cultural homogeneity. This is particularly the case in newly independent countries that were faced with incompatible ethnic groups living in their artificially constructed boundaries. Yet, the practice of achieving cultural homogeneity by expelling people perceived as different has deep historical roots. Catholic Spain expelled the Jews in the fifteenth century, and Catholic France expelled the  Huguenots  (i.e., French Protestants and followers of John Calvin) in the sixteenth century.

2. To subdue a region or a people. China’s occupation of Tibet in 1950 was followed by the mass migration of  Han Chinese  settlers. During the  Cultural Revolution  (1966–1976),  Mao Zedong , China’s leader, sent his Red Guard storm troopers to subdue Tibet.

3. To evict dissidents and opponents of the government. Fidel Castro, determined to build a Communist society, influenced and coerced almost a million people to leave Cuba.

4. To achieve foreign policy objectives. Forced emigration is sometimes implemented as a component of broader foreign policy objectives. Governments use forced emigration to exert pressure on neighboring countries. For example, Castro has used emigration as an instrument of his foreign policy toward the United States.

5. To achieve economic and national security objectives. Several governments have forcibly removed people from one area of the country to another as part of an overall economic development or national security strategy.

High levels of violence and political instability are factors that push people away from home. Declining population growth rates in rich countries facilitate migration that is driven by high population growth rates in the developing world. High rates of unemployment and poverty are widely regarded as dominant and constant push factors. Natural disasters, environmental problems, and famines push people away from their homelands or force them to relocate within their countries.

Globalization and discrimination are also push factors. Globalization has contributed to the creation of strong economic regions within, as well as among, countries. Globalization’s emphasis on economic liberalization, free trade, and diminished government involvement in the economy has resulted in the displacement of millions of small farmers in the developing world. Thousands of farmers in Mexico, unable to compete with subsidized agriculture in the United States and Europe, move to urban areas in Mexico or make the dangerous journey to the United States. Migration is often induced by governments that fail to provide adequate support for rural communities or alternative sources of employment. These problems are compounded by  competitive exclusion , which occurs when governments allow more land to be taken by large agroexport companies to create megafarms. This generally drives up land prices and decreases the amount of land available to small subsistence farmers. Discrimination also contributed to emigration. Successful ethnic minority groups have historically been scapegoated for problems within societies, the most obvious being the Jews in Nazi Germany. Idi Amin forced Ugandans of Asian descent to leave Uganda because of their economic success. Ethnic Chinese in Indonesia and other Asian countries have had similar experiences.

11.3.1: Refugees

In 2001, the European Union (EU) decided to recognize as refugees women and homosexuals fleeing violence or sexual abuse. The 1951  UN Geneva Convention  stressed that individuals or groups persecuted on the grounds of race, religion, nationality, membership in a particular social group, and holding certain political opinions would be recognized as refugees and granted asylum. However, these categories have been expanded to reflect a growing awareness of other forms of persecution. In many ways, the interaction of economic problems, political instability, and violence makes it difficult to separate economically motivated migrants from refugees.

Most governments are reluctant to accept large numbers of refugees and generally prefer to provide humanitarian assistance to displaced persons to stem the flow of refugees. Widespread refugee problems in Europe and elsewhere during and after World War II influenced the United States, Western Europe, the Soviet Union, and China to develop institutions, such as the office of the  UN High Commissioner for Refugees (UNHCR) , to help with refugees. Established in 1950, the UNHCR is funded primarily by governments, NGOs, and individuals. Because the proliferation of ethnic conflicts and natural disasters has severely restrained UNHCR’s resources, other UN agencies, the  International Committee of the Red Cross , and various NGOs are involved in helping refugees globally. Their task is often made even more difficult by the inability or unwillingness of some countries to separate fighters from innocent civilians in refugee camps, despite international legal guidelines for doing so. Increasingly, the United Nations is pressured to take measures to prevent the outbreak and escalation of ethnic conflicts, which are a major cause of the refugee problem. More countries, including the United States, favor selective  humanitarian intervention  (i.e., the military invasion of a country) to prevent or diminish human rights abuses that drive people away from their homes.

Numerous ethnic conflicts and civil wars in Africa have left that continent with more than four million refugees. In the Middle East, violence against the Kurds has not only led to the growth of Kurdish refugees in the region but also influenced many Kurds to seek refuge in Europe and North America. There are more than five hundred thousand Kurds in Western Europe, with Germany and France receiving most of them. Germany has about four hundred thousand, and France has sixty thousand. America’s invasion of Iraq led to more than two million refugees and internally displaced persons. The conflict in Pakistan and Afghanistan created millions of refugees. For example, fighting in the Swat Valley in Pakistan between the Taliban and Pakistan forced nearly three million people to leave their homes. The Vietnam Conflict produced a mass exodus of Vietnamese, with most of the refugees settling in the United States. As economic conditions deteriorated, and as the Communist government consolidated its power, many Vietnamese also sought refuge in neighboring countries. More than two hundred thousand ethnic Chinese who lived in Vietnam fled to China when conflict erupted between China and Vietnam in 1978 and 1979. Another seventy thousand Vietnamese arrived in Hong Kong in small boats or were rescued from small boats by oceangoing ships on their way to Hong Kong.

The wave of protests for democracy across the Middle East and North Africa and subsequent political and economic instability created new refugees as people fled from Tunisia, Libya, and Syria and elsewhere to escape violence. Conflicts in Ivory Coast, the Central African Republic, Afghanistan, the Democratic Republic

An Overloaded Boat of North African Asylum-Seekers Headed to Italy. The Italian Navy rescued many people making the dangerous journey in such boats.

of Congo, Mali, and Somalia are major contributors to the growing number of displaced persons and refugees. The Syrian civil war is by far the major cause of the escalating global refugee problem, creating roughly nine million displaced persons and refugees. Brutal sectarian violence in Iraq by fighters from Islamic State of Iraq and Syria (ISIS) forced millions of people from their homes. There are more than fifty million displaced persons and refugees globally. 7

The Palestinian refugee problem is one of the oldest, most serious, and most intractable global refugee cases. Resolving this problem remains a central challenge to efforts to secure peace between the Israelis and Palestinians. The creation of the state of Israel in 1948 as well as wars and low-intensity conflicts between the Israelis and Arabs led to the creation of roughly 3.5 million Palestinian refugees. Many Palestinians have lived in refugee camps throughout the Arab world for more than half a century. Many of them were born and raised in these camps, and many have also died in these camps. Between 1947 and 1948, approximately 800,000 Palestinians became refugees. The 1967 war, during which all of Palestine was occupied by Israel, created a second wave of Palestinian refugees. Roughly 400,000 Palestinians, out of a population of 2.5 million, left Palestine to seek refuge in Jordan, Lebanon, Kuwait, Syria, and other Arab countries. The civil war in Lebanon in the 1970s and 1980s and Israel’s invasion of Lebanon in 1982 forced more Palestinians to become refugees again. Roughly 5.1 million Palestinians live abroad, mostly in Jordan, which has 3 million of them. 8  The  UN Relief Works Agency for Palestinian Refugees in the Near East (UNRWA)  was established in 1949 to provide relief, education, and welfare services to Palestinian refugees.

11.4: Pull Factors

1. 11.4 Identify the pull factors of migration

Pull factors are developments and circumstances that attract people to specific areas or countries. Freedom has always been a significant pull factor, both within countries and across international boundaries. Freedom, associated with cities, enticed many individuals to leave the countryside with its relative lack of freedom. Freedom in Britain, Holland, and the United States has served as a magnet for European migrants and, more recently, for migrants from the developing world. Religious, artistic, economic, political, and scientific freedoms remain almost irresistible pull factors, which, in turn, usually enhance the degree of freedom that existed. New York, London, Paris, Sydney, Toronto, Los Angeles, Seattle, Chicago, Miami, and Boston are vibrant and dynamic because of the freedom that characterizes them and attracts talent and financial resources from around the world.

Economic opportunities are one of the most powerful pull factors. People have historically migrated to industrial areas that offered employment and financial and entrepreneurial opportunities. Income inequality between rural and urban areas or between developing and developed countries generally induces people to migrate to seek higher income. Economic opportunities of an earlier period of globalization, between 1870 and 1910, influenced roughly 10 percent of the world’s population to immigrate. Millions of Europeans migrated from poor countries to industrialized societies on the Continent and to the United States, Canada, Australia, Argentina, Brazil, and other Latin American countries. It is estimated that 12 million Chinese emigrated between 1815 and 1914, many of them from the south of China. Mexicans are motivated to migrate to the United States partly because many of them can earn much more money doing similar jobs in the United States. This is a global phenomenon. Higher wages in Britain, France, and Germany, combined with labor shortages in those countries following World War II, attracted immigrants from the Caribbean, India, Africa, and Turkey. Similarly, higher wages in the mining industry in South Africa induced people from neighboring countries to migrate to South Africa. Oil wealth and jobs in the Persian Gulf countries pulled more than 3.5 million Asians to the region. Demand for inexpensive and reliable labor contributed to the development of an Indian diaspora that covers sixty-three countries and has more than 20 million people. A  diaspora  is a community of people living outside their original or ancestral country.

Colonization and financial globalization combined to create a very powerful pull factor between 1820 and 1920. European colonization of the Americas, Asia, and Africa was accompanied by massive flows of capital. Industrialization in Europe generated a significant supply of capital, which stimulated an expansion of industrialization overseas. Colonization enticed millions of Europeans and others to emigrate. Many of these areas had been settled long before the arrival of Europeans, a reality that often resulted in the forceful removal and even death of native populations. More than sixty million Europeans migrated to the Americas, Asia, and eastern and southern Africa. Demand for inexpensive labor in the European colonies led to the migration of roughly twelve million Chinese and thirty million Indians to areas conquered and colonized by Europeans. The British, who colonized India, encouraged Indians to migrate to British colonies, including Burma (now Myanmar), Malaysia, Singapore, Australia, Fiji, Trinidad and Tobago, British Guyana, Kenya, South Africa, and Uganda. Many Indians returned to India eventually, but a significant number, estimated to be six million, remained abroad. 9

Globalization is widely viewed as one of the most significant pull factors in relation to migration. Globalization, especially economic and cultural globalization, enables poor people to see prosperity in rich countries. Movies, magazines, television, and tourism contribute to promoting glamorous and desirable lifestyles in developed countries. Globalization shrinks the world, thereby making it easier for people to compare themselves not only with their immediate neighbors but also with people around the world. Globalization creates dreams that many individuals in poor countries find irresistible.  Global cities  enable immigrants to blend into the population and become low-wage workers in hotels, restaurants, sweatshops, homes of American families, manufacturing and retail companies, and agribusiness.

Family reunification  and  cultural ties  are major pull factors. In many parts of the world, people migrate to places where they know someone, which gives rise to a concentration of immigrants from a particular country or a region of a country in certain areas. For example, many early Scandinavian immigrants went primarily to the United States and settled in Midwestern agricultural states, including Minnesota, Wisconsin, Nebraska, Illinois, and Iowa. The largest group of migrants is composed of relatives of individuals who are already living in a specific country. Family reunification is a leading objective of immigration policies in several countries. In many cases, one family member will immigrate to a particular country and, once relatively economically secure, will encourage family members to join him or her. This phenomenon is known as  chain migration .

Sparsely populated areas, as we have seen, provide a significant pull factor. As we mentioned earlier, European conquest and colonization of the Americas, Asia, and Africa provided opportunities for certain parts of Europe to relieve their population pressures. North America and Australia attracted millions of European emigrants. However, anthropological evidence supports the view that the Americas had vast human populations when the Europeans arrived. Today, many European countries have declining population growth, a development that is inducing the growth of both legal and illegal migration to that region. Many countries have large areas that have few inhabitants. In Brazil, for example, the vast and sparsely settled Amazon region continues to attract settlers from other parts of Brazil and other countries. Earlier we pointed out how many states in the American Midwest have been losing population. To ease this population decline, Iowa, for example, has responded by creating an  immigration enterprise zone . Iowa hopes to become a priority destination for refugees and foreigners who are willing to migrate in search of economic opportunities.

Closely related to freedom and economic opportunities as pull factors is the availability of educational and cultural opportunities. Western Europe, Canada, and the United States have long been magnets for students, artists, and professionals from many countries. Globalization has facilitated educational and cultural exchanges to an unprecedented degree and, in the process, is creating a global community of individuals who are connected by common educational and cultural experiences. Many foreign-born students and professionals achieve great success in the United States, which encourages more students and professionals to immigrate to that country. For example, the unpopularity of careers in science among American students reinforces the demand for foreign students to study

A Serbian Wanting to Enter the European Union Waited at the Razor-Wire Border with Hungary, Which Had Sealed Off Access from Serbia and was Arresting Migrants.

science and engineering and to become part of the science and engineering workforce in the United States. 10

11.5: Case Studies

1. 11.5 Illustrate how migration and population issues are important components of human, national, and global security

The following case studies provide examples of migration to specific countries. The case studies show that governments and nonstate actors regard migration and population issues as extremely important components of human, national, and global security. The way the world views migration is likely to be affected by the November 13, 2015 terrorist attack on Paris, which, in early reports, implicated Islamic terrorists from Africa and the Middle East.

11.5.1: The United States

More than any country in the world, the United States is known as an immigrant country. Consequently, most Americans—with the exception of Native Americans and Americans of English and African descent—are descendants of people who migrated to the United States less than three hundred years ago. The demand for labor in the United States, together with poverty, conflict, and oppression in Europe, led to the migration of millions of Europeans to America. Rapid westward expansion and the need for a growing population to develop agriculture as well as industry attracted emigrants primarily from Western and Northern Europe until the early 1900s. Agricultural problems in Scandinavia, for example, prompted Swedes, Danes, Norwegians, and Finns to emigrate and settle in agricultural states in the Midwest. 11  By 1901, most emigrants came from Southern and Eastern Europe. Chinese and Japanese immigrants came to California in the 1850s to work in the gold mines, on the railroads, and in agriculture.

The United States adopted policies that excluded Asians and restricted immigrants from non-European countries. Growing fears about America’s changing ethnic composition and about competition from new arrivals among “old stock” Americans led to the passage of legislation in 1921 that initiated the national quota system, which remained in place until 1965. The  national quota system  was designed to preserve the ethnic or national composition of the United States as of 1920. Quotas for emigrants from any one country were calculated in terms of one-sixteenth of 1 percent of persons of that national origin already in the United States. There was an absolute ceiling of two thousand emigrants from the Asia-Pacific region. 12  Improved economic conditions in Europe and the abolishment of the national quota system in 1965 changed the pattern of U.S. immigration. Most of the new arrivals are from the developing world, with various groups dominating particular parts of the country. For example, Mexicans comprise the majority of new immigrants in California, Texas, and Illinois; Dominicans, Chinese, and Indians are prominent in New York; and Cubans are the leading group in Florida. Immigrants make up a large proportion of America’s population, and demographic projections indicate that they will be largely responsible for the country’s population growth.

Mexico’s geographic proximity to the United States and historical factors combine to make the growing number of Mexican migrants in the United States a contentious issue. Many Mexicans were already living in Texas, California, Arizona, New Mexico, Utah, Nevada, and Colorado when these areas were taken by the United States from Mexico during the  Mexican-American War , which lasted from 1846 to 1848. The annexation of these territories by the United States did not significantly alter migration across the newly established borders. Economic and political problems in Mexico have traditionally served as push factors, and the demand for labor and economic opportunities in the United States have functioned as pull factors. For example, the demand for labor in the United States during World War II brought Mexicans to America under the  Bracero Program . The Bracero Program was a set of agreements between the United States and Mexico that facilitated the migration of Mexican workers, on a temporary basis, to work principally in agriculture. The increase in legal migration under the program was accompanied by the growth of illegal immigration. From 1942 to 1952, roughly nine hundred thousand Mexican workers entered the United States under the Bracero Program, compared with more than two million illegal workers during the same period. In response to economic competition as well as fears about Communists entering the country through Mexico, the United States launched  Operation Wetback  (from 1954 to 1959) in which hundreds of thousands of Mexicans were arrested and deported. However, by the time the Bracero Program ended in 1964, the relationship between Mexican workers and American employers was so well established that controlling the flow of migrants across the U.S.-Mexican border was almost impossible. Emigration from Mexico, both legal and illegal, became a reality of American life. Mexican emigrants throughout the United States are employed in all sectors of the economy.

11.5.2: Western Europe

The growing unification of Europe, manifested in the creation and strengthening of the European Union, also enables illegal immigrants to move from one country to another once they enter a member country of the European Union. Italy and Greece provide many entry points for migrants desperate to settle in Western Europe. Illegal immigrants come from North Africa, Eastern and Central Europe, the Middle East, Latin America and the Caribbean, China, sub-Saharan Africa, India, Russia, the former Soviet Republics, and elsewhere. Political turmoil in Libya and civil war in Syria contributed to an increase in migrants from those countries. Variations in immigration policies among EU members make some countries more attractive than others to migrants. For example, thousands of refugees gather in France at the entrance of the English Channel tunnel waiting for an opportunity, often fatal, to hide in trains and trucks going to Britain, which has more generous refugee policies than France even though facing economic stagnation, Britain tightened its immigration policy. Germany’s strong economy makes it a magnet for migrants from Spain, Portugal, and Italy. With the unprecedented flow of immigrants from Africa and the Middle East, xenophobic, nationalistic, and sometimes anti-Muslim political sentiment has been strengthened, represented by such parties as Ukip (UK Independence Party) in Great Britain, Golden Dawn in Greece, and Pegida (Patriotic Europeans Against the Islamization of the West) in Germany. Several preliminary European plans for dealing with the flow of migrants surfaced at an emergency summit in Brussels shortly after the April 2015 deaths of 800 migrants in the worst single Mediterranean migrant disaster in history. Those possible plans included increasing sea patrols and search-and-rescue missions, systematic efforts to destroy vessels before they can be used by traffickers, fingerprinting every immigrant, and gathering intelligence from countries bordering Libya in an attempt to stem the flow of migrants. Weeks after that emergency summit, European leaders agreed to use naval power to stop smugglers with human cargo before or soon after they leave African ports, return the migrants to the ports or take them to Europe for asylum consideration, and destroy the ships being used to transport them. Pressures were growing on Western Europe from the flow of migrants from Africa and the Middle East when the scenario may have changed dramatically with the November 13, 2015 terrorist massacre in Paris, which was the most destructive attack on Paris since World War II. The terrorist group Islamic State claimed credit for the act, and early reports indicated that at least one of the terrorists may have entered Europe as a migrant from Syria.

France

 The influx of large numbers of immigrants from developing countries into France must be seen in the broader context of French colonialism and the demand for labor. France, like the United States, views its revolution as having universal significance and has developed a tradition of respecting the civil and human rights of foreigners. Its self-perception as a champion of the developing world reinforced its policy of accepting migrants from poor countries. France adopted a  policy of assimilation  toward its colonies in Africa, Asia, the Caribbean, and the Pacific, under which many residents of French colonies gained French citizenship and were free to migrate to France. Many Africans, Asians, and people from the Caribbean found employment in France, especially following World War I, which had such a devastating impact on the French population that the country had to import labor for its industries. World War II also created demand for labor from the colonies. Algeria’s struggle for independence from France (1954–1962) resulted in hundreds of thousands of Algerians gaining asylum in France because of their support for France. More migrants from France’s former colonies arrived in the 1960s to meet the labor needs of France’s growing economy. The largest number of migrants came from Muslim countries—such as Algeria, Tunisia, Morocco, and Senegal—a development, as we have seen, that resulted in the large number of Muslims in France today.

As in other parts of Europe, rising immigration is fueling political and social extremism in France.  Jean-Marie Le Pen , who led the National Front party, consistently advocated ending legal immigration and deporting illegal immigrants. His daughter, Marine Le Pen, who replaced him, holds strong anti-Muslim views. As is the case throughout Europe, Romanies (Gypsies), who migrate from Bulgaria, Hungary, the Czech Republic, Romania, and Slovakia to France face harsh discrimination. Many Romanies are viewed as being responsible for rising crime rates, street begging, and squalid shantytowns. France deported more than eight thousand Romanies to Bulgaria and Romania and cleared hundreds of illegal camps. 13  France’s actions were widely criticized and compared to Nazi treatment of the Romanies, which we discussed in  Chapter 3 .

Germany

 Unlike the United States, Canada, and Australia, Germany is not traditionally an immigrant country. Instead, Germany encouraged its citizens to immigrate to North America, Eastern Europe, Latin America, and elsewhere to diminish population pressures and economic problems at home. Between 1920 and 1950, almost seven million Germans settled in the United States, many of them in the Midwestern agricultural states. This pattern of migration was radically altered by Germany’s initiation of World War II and the devastation it experienced in that conflict. Similar to Britain and France, Germany lost so many of its citizens in the war that it was forced to import labor to help in its economic reconstruction. This was especially so after the construction of the  Berlin Wall , built by the Soviet Union to divide East Germany from West Germany. The Berlin Wall effectively reduced to a trickle the flow of migrants from Communist East Germany to the more prosperous capitalist West Germany.

The growing domestic and global market for West Germany’s cars, machine tools, appliances, and other manufactured products influenced the government to recruit foreign workers, primarily from Spain, Greece, Turkey, and Portugal. The government and trade unions agreed that Germans and foreigners would receive equal wages. Under the  Gastarbeiter rotation system , foreign workers were regarded as guest workers who would remain in Germany for one to three years and then return to their home countries. Today, almost 3 million Turks live in Germany. The fall of the Berlin Wall in 1989 and the reunification of Germany complicated immigration issues as millions of East Germans migrated to West Germany for economic opportunities and as Germany struggled to develop the former East Germany. Unemployment became a major issue as Germany’s economy weakened. Faced with the influx of migrants from Eastern Europe, the former Yugoslavia, and other countries, Germans began to perceive immigrants as economic competitors and threats to their country’s cultural values.

11.5.3: Australia

Wars, terrorism, and escalating religious violence in Afghanistan, Pakistan, Sri Lanka, and other places in the Middle East and Central Asia have created a wave of migrating people who have well-founded fears of being killed or severely harmed. Indiscriminate killing in Pakistan and Afghanistan of  Hazaras , who are Shiities, by Sunni sectarian death squads has forced Hazaras to make a long and perilous journey by air, land, and eventually sea to seek asylum in Australia. Their main goal is to get to Christmas Island, a small Australian territory roughly 240 miles from Indonesia, from where they board unseaworthy boats with the help of smugglers. In 2013, more than twenty thousand migrants in around 250 boats sought asylum in Australia.

Unlike the United States and Europe, which share land borders with areas with large numbers of people who want to emigrate, Australia is isolated and extremely difficult to reach from the Middle East and Central Asia by people in boats. What makes Australia an interesting case study is the disconnect between how prominently the issue of people in boats is in the country’s domestic political struggles and the actual scale of the problem, especially when compared to Italy, Greece, or the United States.

Australia has engaged in wide-ranging efforts to discourage and prevent refugees from attempting to reach Christmas Island, even though it is aware of the conditions they are fleeing. John Howard, Australia’s conservative prime minister, opened camps for people in boats in Nauru, an eight-square-mile island state in Micronesia, and on Manus Island in impoverished Papua New Guinea. He called this policy the Pacific Solution. Australia has tried to disrupt smuggling networks by collaborating with Pakistan’s intelligence services; using undercover agents in Indonesia; and offering up to $180,000 for information leading to a smuggler’s arrest. Subsequent leaders supported that approach. Prime Minister Julia Gillard, who initially viewed the Pacific Solution policy as wrong and costly, later decided to embrace it, claiming that it would save lives. In the struggle for political leadership in 2013, Kevin Rudd, Australia’s prime minister, decided to prevent the settlement in Australia of any refugee arriving by boat. Instead, they would be intercepted at sea, detained, and eventually resettled in Nauru and Papua New Guinea. 14  This practice was reinforced by Tony Abbott, who became prime minister in September 2013, in his  Operation Sovereign Borders  policy, which enables the Australian Navy to send asylum seekers intercepted at sea back to Indonesia. Even if they prove they are genuine refugees, they have little or no chance of settling in Australia.

Australia’s approach to asylum-seeking people in boats is a contentious issue and an impediment in its relations with Indonesia, a country considered by Abbott to be the centerpiece of Australia’s foreign policy. Many Indonesians viewed Abbott’s offer to pay them to spy on traffickers and his plan to purchase boats from fishermen to prevent them from selling them to smugglers as violations of their sovereignty. Australia’s policy is also criticized by human rights groups and UN officials. Australia’s Human Rights Commissions launched an investigation to determine the impact of lengthy detainment of children in asylum detention camps and whether Australia is violating the UN Convention on the Rights of the Child. Australia’s policy, which was upheld by the Australian High Court, has ended the flow of migrants.

Unprecedented flows of migrants from the Middle East and North Africa across the Mediterranean into Europe, especially Italy and Malta, reinforced the confidence of several Australian leaders in the pragmatism of the Operation Sovereign Borders policy. Many suggested that Europe should adopt Australia’s approach.

Indonesia, faced with growing numbers of migrants arriving by boat, primarily from Myanmar and Bangladesh, adopted a policy similar to Australia’s. Indonesia, which had been highly critical of Australia, decided to prevent migrants from reaching its shores and told Indonesian fishermen not to rescue them. Thailand and Malaysia implemented similar policies. Responding to strong global opposition to their policies, Indonesia and Malaysia agreed to allow the migrants to stay in their territories for one year, after which they would be resettled elsewhere. Disturbing accounts emerged about the discovery of mass graves in Malaysia and abusive treatment of migrants by people smugglers.

11.6: Social, Economic, and Political Implications of Migration

1. 11.6 Examine the social, economic, and political implications of migration on the sending and receiving countries

As we have seen throughout this chapter, migration has profound social economic, and political implications for both sending and receiving countries. Migration deepens cultural, economic, and political ties among countries, thereby creating an increasingly global community in which nationalism, ethnicity, and traditionalism are weakened, and broader and more complex forms of identity are emerging. Combined with other aspects of globalization such as communications, transportation, finance, and trade, migration challenges the traditional nation-state and transforms international relations. Migration has contributed to the increase of dual citizenship and the rise in the number of people with multiple passports.

11.6.1: The Impact of Migration on Sending Countries

Both gains and losses result when large numbers of people migrate.  Brain drain  (i.e., the migration of highly educated and trained people) is widely regarded as a serious problem and a major impediment to development in poor countries. Many doctors, nurses, teachers, and university professors leave poorer countries and rural areas for higher-paying jobs and better opportunities in neighboring countries as well as in rich industrial countries. As many as seventy thousand educated and skilled Africans migrate to Western Europe, Canada, the United States, and elsewhere each year. This brain drain has significant implications for poor countries. Many medical problems in poor countries are negatively impacted by a shortage of medical personnel.

It is estimated that half the recent graduates from the prestigious Indian Institute of Technology migrate to the United States. They are driven out by push factors such as overregulation, higher taxes, stagnant career paths, and numerous impediments to entrepreneurship. Many are attracted to the United States by better economic opportunities and a dynamic environment conducive to economic success and personal growth. The fact that most Indian immigrants speak English enables them to easily integrate into American society. It is estimated that one third of the engineers in Silicon Valley are of Indian origin. About 7 percent of Silicon Valley’s high-tech firms are managed by Indians. 15  But the migration of talented individuals is seen as detrimental to India’s economic development. On the other hand, many countries have a problem of  brain overflow , which is essentially an oversupply of skilled individuals. Many poor countries, such as the Philippines, India, and Egypt, have become exporters of highly educated people because of their inability to utilize their talents.  Remittances  (i.e., money earned abroad that is sent by migrants to their home countries) play a crucial role in the economic development of poor societies. Given the fact that remittances are transferred by millions of migrants in various ways, it is extremely difficult to know how much money migrants send to their families or invest in their home countries. Remittances clearly create networks of interdependence among countries, NGOs, and individuals. Organizations such as the Inter-American Development Bank (IDB) and the U.S. Agency for International Development (USAID) have developed strategies to assist migrants in transmitting remittances more economically. This development reflects the growing economic impact of remittances on developing countries. It is estimated that remittances totaled $500 billion in 2013.

11.6.2: The Impact of Migration on Receiving Countries

Most receiving countries are characterized by increasing cultural and ethnic diversity. Think about New York, London, Toronto, Miami, and Paris. Migration has profoundly influenced food, social relations, education, communications, art, literature, music, fashion, and architecture. Migration also raises questions about nationality. Are you a citizen? Migration challenges traditional ideas about who belongs or should belong to receiving countries. These questions are at the heart of anti-immigration nationalism and multiculturalism in Western Europe and, to a much lesser degree, in the United States. Since 2000, the Hispanic population in the United States has grown by 43 percent, compared with 5 percent for the rest of the population. Migration has transformed politics in many receiving countries, especially the United States. Because many migrants maintain links with their home societies, they influence international relations as well as the domestic politics of sending countries. Many anti-immigration nationalists view these links as threats and as a part of the broader issue of a clash of civilizations, as we will discuss in  Chapter 14 . President Obama used executive action to introduce a program to defer the deportation of millions of undocumented immigrants in the United States. Just before the program, named Deferred Action for Parents of Americans and Lawful Permanent Residents (DAPA), was to go into effect, it was blocked by a federal judge in Texas.

Economic issues are at the heart of migration. As fertility rates decline and the population ages in rich countries, the need for young workers becomes a priority. But many countries remain divided on the issue. 16  Migrants provide flexible workers and highly skilled professionals to labor-scarce economic sectors. They help reduce inflation by lowering prices of domestically produced goods and services, and also contribute to entitlement programs such as Social Security. Immigrants have contributed billions of dollars more to Medicare than the program has paid out on their behalf. 17  On the other hand, migrants often depress local wages, put pressure on health and education services, and undermine labor rights. Simultaneously, they help create a cultural generation gap that often engenders hostility and a reluctance of the older population to allocate resources to programs for the young.

As we saw in  Chapter 1 , the rise and fall of great powers cannot be separated from demographics. Migration played an essential role in the rise of Holland, Britain, and the United States. Migration is giving America a demographic advantage over other developed countries where population is aging rapidly. Young migrants are crucial to America’s renewal, economic growth, cultural vitality, and military power.

In Europe, some anti-immigration forces fear that ISIS militants are entering Europe illegally by mixing in with refugees traveling the dangerous route by boat to Italy from Africa and the Middle East, and they recommend cutting back on rescue and aid to those asylum seekers. The November 13, 2015 terrorist attack on Paris, for which Islamic State (ISIS) militants claimed credit and which early reports traced to at least one migrant from Syria, is likely to have profound political repercussions regarding migration.

Case Study Global Aging and Pensions

Demographic changes have profound implications for a wide range of global issues. In many ways, population problems help determine the fate of nations and human survival. National security is affected as the proportion of younger people, who fight wars, declines, and as governments are pressured to reduce military spending in order to allocate more scarce resources to the elderly population. The broader issue of human security, discussed in  Chapter 1 , is becoming increasingly important as the consequences of aging populations become more acute, especially in Japan, Western Europe, the United States, China, and Canada. The proportion of people aged sixty and older in those countries comprises between 20 and 30 percent of the population, a proportion that is rapidly growing. Due to low fertility rates and the one-child policy in China, the longer people live there means there will be fewer young people to support them, thereby diminishing the traditional intergenerational contract that provided a safety net for the elderly. Faced with growing poverty and loneliness among the elderly, China passed a law requiring children to visit their elderly parents and to support them financially. However, these legal obligations are difficult to enforce due to the mass migration of young people from rural areas to urban industrial centers. High suicide rates among the elderly in South Korea are due primarily to declining Confucian traditions that require children to take care of aging parents. Many elderly Koreans live alone and in poverty.

Pensions are expensive to provide as people are living much longer and as investments to fund their retirement are not yielding high returns and actually lost money during the global financial crisis. When the United States implemented pensions in 1935 to alleviate economic hardships in old age, the official pension age was sixty-five, and the average life expectancy was sixty-two. Now, America’s pension age has risen to sixty-six, but people on average retire at sixty-four and many live for another twenty or thirty years. In America, state and local pension benefits are generally guaranteed by law. This means that even as states are facing growing budget deficits, they are constitutionally required to meet their obligations to retirees. There are two main types of retirement plans: defined benefit plans, under which retirees are paid a proportion of their final salaries (which is as high as 90 percent, in Colorado), and defined contribution plans, under which employees’ pensions are determined by the performance of investments they and their employers made. Many pension plans cover health insurance, which is becoming increasingly expensive as the population ages. Efforts to deal with the problems of aging and pensions by raising the retirement age (from sixty to sixty-two, in France, for example) were met with large protests in France, Greece, and elsewhere. Labor unions, mainly teachers and other public employees, staged extended protests in Wisconsin to prevent the state government from weakening their collective bargaining power.

Finding solutions to problems related to aging and pensions is difficult, due partly to political pressures and the fact that those making decisions on pensions want to protect their own retirement benefits. An important part of the solution is to limit the practice of early retirement to special cases. Raising the retirement age is widely viewed as being responsible toward young people who have to support aging populations and simultaneously secure their own retirements. A later retirement age increases the number of workers as well as tax revenues. Raising the retirement age for lower-paid workers is generally opposed on the grounds that their jobs are strenuous and their life expectancy is shorter than that of higher-paid workers. Many countries are already implementing less expensive defined benefit plans or switching to defined contribution plans. Some countries encourage people to have more children, an idea that has been rejected in rich countries such as Singapore. A more realistic alternative is to encourage immigration to help take care of the elderly, strengthen the economy, and provide more tax revenues to fund pensions and healthcare costs.

Summary

Migration is an important issue throughout many countries and regions of the world today. It has greatly contributed to globalization and to an increased interdependence among many countries and peoples. This chapter illustrates how population and migration issues are essentially about politics, economics, and culture. Population issues are an increasing problem in the developed and developing countries as they hinder economic growth and place great pressures on already strained populations. Underpopulation has become a major problem due to a rapid increase in aging populations throughout developed countries. In an attempt to rectify this problem, some states have attempted to increase fertility rates domestically and encourage immigration from abroad. High rates of population growth have had devastating consequences in the developed world as well. In an effort to ease overpopulation, many developing countries have resorted to strict population controls; an example is China’s former one-child policy. Other countries have encouraged their citizens to migrate to other states.

Migration has various forms. It can be forced or induced. Sometimes it is temporary, as when workers return to their countries of origin. Migration can be regional or transcontinental, and it can be seasonal or permanent. Many factors have contributed to increased migration. Push factors—such as environmental disasters, high unemployment, high population growth rates, state repression, and discrimination—have encouraged many to look for safer homes where they can pursue prosperous futures. Pull factors have also enticed many to migrate, seeking economic and political freedoms, a safer environment for themselves and their families, educational opportunities, and a chance to earn higher wages.

Discussion Questions

1. How will the global aging and pensions problems affect you?

2. What are some of the causes, as well as negative consequences, of high and low population growth rates?

3. Make arguments for and against Australia’s refugee policy.

4. Can you identify some of the push and pull factors that traditionally lead to increased regional and global migration?

5. Discuss the economic, political, and social implications of migration for both sending and receiving countries.

Chapter 12 Global Crime

India’s Rapid Economic Growth has Contributed to Government Corruption by Providing More Money and Opportunity. The broom, for “sweeping up,” is the party symbol of the anti-corruption Aam Aadmi Party (AAP), or Common Man’s Party, shown here at a rally in New Delhi.

Learning Objectives

1. 12.1Outline ways in which globalization facilitates the growth of global crime

2. 12.2Compare European and American approaches to dealing with illegal drugs

3. 12.3Report causes behind the global issues of sexual crimes against women

4. 12.4Recognize causes behind the global issues of smuggling of migrants

5. 12.5Assess the growing problem of human trafficking with respect to women and children

6. 12.6Outline the factors that provide fertile grounds for kidnapping and gang violence to flourish

7. 12.7Examine the global issue of illegal trade in endangered animals and plants

8. 12.8Evaluate how the rise in internet usage and advances in technology have contributed to cybercrimes

9. 12.9Analyze why globalization has been far more beneficial to nonstate actors who commit crimes than it has been to nation-states

Global crime is intricately intertwined with revolutionary technological, financial, communications, economic, cultural, and political changes that characterize globalization, and it is increasingly difficult to separate criminal activities from legitimate global transactions. Wars and ethnic conflicts create an environment in which crime is prevalent. When armies are reduced and militias are disbanded after conflicts end, crime continues. The wars in Central America contributed to the rise of violent gangs and drug trafficking.

The disintegration of the Soviet Union contributed to the strengthening and unleashing of criminal organizations that have constructed global networks involved in drug trafficking, human trafficking, money laundering, illegal arms sales, and other criminal activities. Global crime is also linked to global poverty and inequality, failed states, global migration, growth of global cities, the expansion of free trade, rapid communications and computer technologies, and easy global financial transactions. Criminal activities of government officials facilitate global crime. This chapter examines the globalization of crime, the perpetual global drug problem, sexual crimes, the global smuggling of migrants, contemporary slavery and human trafficking, criminal gangs and kidnapping, illegal trade in exotic animals and plants, cybercrimes, piracy, and global responses to crime. It concludes with a case study of government corruption in India.

12.1: The Globalization of Crime

1. 12.1 Outline ways in which globalization facilitates the growth of global crime

Global crime has existed with legal commerce for centuries. In fact, crime has been an integral component of human society. By diminishing the significance of geographic distance, globalization enables criminal networks to grow alongside legal global activities and to establish connections within many different countries. As we will discuss, alliances are common among criminal organizations involved in trafficking in humans, drugs, weapons, and various illicit products.

Although globalization has contributed to increased economic equality among and within nations, it is widely perceived as contributing to more inequality. To an unprecedented degree of poignancy, globalization heightens the awareness of the economic and social disparities between the rich and the poor within nations and between rich and poor countries. Not only do poor people perceive themselves as losers in the process of globalization, they have little incentive to adhere to rules that they perceive to be adverse to their interests. For example, convincing coca farmers in Peru, Colombia, and Bolivia that they should not participate in illegal drug production has been difficult. Similarly, small farmers in Afghanistan continue to produce poppies that are used to make heroin. The insatiable demand for illegal drugs in the United States, Western Europe, and elsewhere perpetuates efforts by drug traffickers to supply drugs. Although organized crime imposes excessive burdens on society, particularly the poor, many criminal groups, to gain political influence and legitimacy, invest in social services, athletic facilities, housing, and medical services. These areas have been largely neglected by many governments as part of the privatization process required by economic globalization. Ultimately, global crime is integrated into the fabric of these societies and enjoys significant official and unofficial protection. In some cases, weak institutional capabilities have prevented governments from reducing global crime. Consequently, there has been an unprecedented escalation in crimes such as trade in pirated goods, illegal arms, human trafficking, and illegal drugs.

The disintegration of the Soviet Union in 1991 was one of the most important developments contributing to the emergence and growth of global crime. Rapid political and economic changes in Eastern and Central European countries further enhanced opportunities for widespread criminal activities. Exploiting the weakness of the Russian government, organized criminal groups consolidated their power domestically and built strategic alliances with global criminal organizations in Latin America and the Caribbean. Russian criminal groups proliferated throughout Central Europe, in countries such as the Czech Republic, as successful revolutions against Communism ushered in social disorganization, poorly guarded national borders, free-market economies, and a willingness of young people to experiment with drugs. Furthermore, as we discussed in  Chapter 1 , the expansion of the European Union (EU) into Central and Eastern Europe and the removal of many national barriers to the movement of people and products facilitated the growth of criminal activities.

2.2: The Global Drug Problem

1. 12.2 Compare European and American approaches to dealing with illegal drugs

From Shanghai to San Francisco, from London to Buenos Aires, in Christian, Jewish, Islamic, Hindu, and Buddhist societies, in small towns and big cities, and in rich and poor countries, the use of illegal drugs is a serious problem. Illegal drug use is one of the most important global issues. No society has managed to escape the consequences of the global drug trade, largely because the global drug problem is so closely intertwined with other areas of globalization. The foundations of the contemporary global drug problem

Ranking of Crime Index by Country, 2015

The index estimates the overall crime level in a given country (index numbers greater than 80 are considered very high; between 60 and 80 are considered high; between 20 and 40 are considered low, and below 20 are considered very low)

Adapted from NUMBEO, Crime Index for Country 2015 Mid Year,  www.numbeo.com/crime/rankings_by_country.jsp  (accessed May 4, 2015).

Top 10 Countries by Crime Level	Crime Level Index
South Sudan	85.32
Venezuela	84.07
Guatemala	79.34
South Africa	78.44
Afghanistan	77.34
Guyana	76.88
Nigeria	76.60
Trinidad and Tobago	75.28
Honduras	74.91
Bahamas	72.93
United States	50.1
Australia	42.16
Bottom 10 Countries by Crime Level	Crime Level Index
Taiwan	21.88
Qatar	21.04
Japan	20.24
Hong Kong	19.24
Rwanda	19.16
Faroe Islands	18.53
South Korea	17.99
Turkmenistan	17.86
Singapore	17.59
Isle of Man	15.10

were laid during an earlier period of globalization that was marked by European expansion, colonization, and trade.

The discoveries of tobacco in the Caribbean, chocolate in South America, coffee in the Middle East and Africa, and tea in Asia marked the beginning of a global trade that eventually included opium. The growth of the opium trade was influenced partly by China’s huge trade advantage with Portugal, Holland, and Britain. Whereas China had silk, teas, pottery, and other items that Europeans wanted, Europe had little to trade with China, thereby creating a trade deficit in China’s favor. Europeans, who had trafficked in opium in parts of Asia, decided to sell it to China to reduce the trade imbalances. 1  The  British East India Company , for example, paid Asian farmers to produce opium, which was then sold to independent wholesalers. Opium cultivation in India grew steadily, and the British pressured China to import it. Chinese resistance to the importation and consumption of opium ultimately led to the  Opium Wars  with Britain in 1839 and 1842, in which Britain forced China to import opium, despite an already horrendous drug addiction problem in China. British military power was instrumental in the legalization of opium in China in 1858. The Portuguese, French, Spanish, and Dutch also participated in the trade, creating opium addicts in their colonies as well as in Europe. The Spanish, for example, promoted the use of coca leaves to enable enslaved Indians to endure harsh physical labor. Miners in Peru, for example, continue to chew coca leaves before going to work. Coca leaves also are widely used legally in Bolivia. Toward the end of the nineteenth century, the demand for opium in Europe and America was on the rise due to several factors:

1. The advancement in medical practices, especially the discovery of morphine and heroin (both obtained from opium) and the invention of the hypodermic needle to administer them

2. Significant cultural and economic changes that resulted from the Industrial Revolution, particularly the consumption of natural stimulants

3. The migration of Chinese, many of whom used opium, to America and elsewhere

4. The growth of global trade

5. The rise of mass consumption habits, influenced by marketing and mass communication 2

6. Military conflicts, including the U.S. Civil War, which increased the demand for drugs to diminish pain

Globalization combined with major cultural changes worldwide—especially in the United States, Canada, and Europe—is driving the global drug trade. Most experts agree that widespread use of illegal drugs in Western societies during the 1960s and 1970s created a global demand for drugs, which in turn stimulated worldwide illegal drug production. Heroin was smuggled in from areas that cultivated opium poppies, primarily the  Golden Triangle  countries (Burma/Myanmar, Thailand, and Laos) and the Golden Crescent countries (Afghanistan, Pakistan, and Iran). Cocaine came primarily from Colombia, Peru, Bolivia, and other South American countries. Marijuana, now increasingly grown within consuming countries, came primarily from Mexico, Jamaica, Colombia, and Thailand. Global trafficking networks quickly developed or were expanded to produce, distribute, and sell illegal drugs. Global commerce and migration have helped consolidate the global drug trade. For example, Mexican drug traffickers take advantage of the growing number of Mexican immigrants in U.S. cities to turn those areas into distribution centers for methamphetamine and other drugs. Industrial countries are now themselves major sources of illegal drugs. Nightclub crowds worldwide routinely use ecstasy, a euphoria-producing psychedelic drug that was initially used in Europe around 1912 as an appetite suppressant. What’s more, distinctions between legal and illegal drugs are diminishing as more people abuse prescription medications. The abuse of prescription drugs accounts for by far the largest component of the drug problem in the United States.

12.2.1: Efforts to Control the Drug Problem

The reality of the global drug trade and the inability of governments to prevent drugs from entering countries have spawned essentially two different approaches to dealing with the drug problem. The first approach, the  war on drugs , stresses supply side control and harsh treatment of drug users. The second approach,  drug prevention and harm reduction , emphasizes the need to keep drugs out of society and to treat drug abuse as a disease. The first approach is strongly embraced by the United States; the second approach is widely practiced in Europe. Before discussing these two strategies, we will briefly examine historical efforts to control the use of illegal drugs. Drug-exporting countries usually become major drug-consuming societies. As we saw earlier, European countries openly and aggressively built a global drug trade. By the beginning of the twentieth century, the widespread use of cocaine-based tonics, heroin, opium, and other narcotics in Europe, the United States, Japan, and China raised concerns about their negative impact on public morals. Religious groups, temperance societies, and others in Britain and the United States advocated ending the opium trade. As the United States expanded its power into Asia, especially after the Spanish-American War in 1898 (which resulted in the end of Spain’s empire and America’s acquisition of the Philippines), Americans became more concerned about drug abuse. The Philippines had many drug addicts.

Partly because of its interest in gaining greater influence in China, the United States collaborated with China to persuade other countries to participate in an international conference designed to convince drug-exporting countries to reduce their production of drugs. The conference, held in Shanghai in 1909, created the International Opium Commission. Although the twelve countries involved agreed to gradually suppress opium smoking in their territories, very little progress on controlling drugs was made. The  Hague Convention  of 1911 broadened the drug-fighting effort by including morphine and cocaine and committed the signatories to reducing their production and distribution of drugs. However, the Hague Convention was ineffective, partly because some countries—such as Germany, which at the time was the world’s largest cocaine producer—insisted that the implementation of the treaty be made conditional on its worldwide acceptance. 3  Given the lucrativeness of drugs, few countries were willing to comply with the restrictive agreements. A turning point in the effort to control the drug trade was America’s enactment of the  Harrison Act  in 1914, which required distributors and medical prescribers of specified drugs to be registered and pay taxes. Britain and other European countries enacted similar legislation. The League of Nations (1919) helped consolidate drug-control efforts by stressing the development of mandatory international controls to be supervised by international organizations. The  Opium Control Board  was established by the League of Nations to monitor countries’ compliance with international agreements on controlling drugs. The rapid spread of drug usage in the 1960s and 1970s influenced the United Nations to sponsor the International Conference on Drug Abuse and Illicit Traffic in 1987 to discuss strategies for dealing with the problem. In 1988, strongly influenced by America’s emphasis on the war-on-drugs approach, the global community signed the UN Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances. This convention stressed sharing law enforcement evidence, providing mutual legal assistance, controlling the sale of chemicals used in producing drugs, and escalating the eradication of drug crops. 4  Founded in 1990, the  UN International Drug Control Program (UNDCP)  stressed the need for both demand reduction and alternative development. In 1998, the UN General Assembly Special Session on Drugs had advocated the goal of a drug-free world by 2008. Obviously, this goal has not been achieved.

Confronted with the rapid rise in drug abuse, the United States mobilized financial, law enforcement, and military resources to combat the problem. The war on drugs concentrates primarily on reducing global drug trafficking and drug use by eliminating supplies and implementing punitive drug laws. It is estimated that between 50 and 80 percent of Americans who are imprisoned have committed a drug-related offense. The United States has cooperated with governments throughout Latin America to eradicate drug crops, implement crop substitution programs, and destroy trafficking networks. In 2000, for example, the United States and Colombia launched  Plan Colombia , an antidrug program that had the goal of reducing Colombia’s coca crop by half by 2005. The plan involved aerial spraying, promoting crop substitution, destroying cocaine labs, and disrupting transportation routes. The United States allocated $1.3 billion to Plan Colombia. Given how lucrative the drug business is, the war on drugs has not significantly reduced the drug trade. Drug production increased in Bolivia, Mexico, Central America, and in the United States. Poverty and tradition motivate many small farmers in Latin America and Asia to grow drug crops. The money they earn from crop substitution is only a fraction of what they can earn from drug crops. Ironically, success in removing drugs from the market increases the demand for declining supplies, thereby driving up prices. This, in turn, influences people to cultivate drug crops. Corrupt law enforcement officials worldwide  also undermine the war on drugs. Most importantly, the war on drugs largely ignores the demand for drugs within the United States, Europe, and elsewhere. Coca production in Colombia was not significantly reduced, despite the more than $6 billion pumped into that effort by the United States. Homicides have escalated at the U.S.-Mexican border as drug cartels fight to dominate the illegal drug trade. Drug cartels moved to Honduras, which provides landing points for 40 percent of the cocaine destined for the United States. Drug smugglers use impoverished small corrupt West African countries such as Guinea-Bissau as new transshipment points for drugs going to Europe from Latin America. 5  Conflict in Syria and improved law enforcement against drug trafficking in Central Europe have led to an increase in the smuggling of heroin from Afghanistan into Western Europe through East Africa. Caribbean islands are major transshipment points for cocaine imports into the United States and Europe. As drug trafficking through Central America and Mexico has declined, the volume of drugs moving through the Caribbean has surged, demonstrating the  balloon effect , which means that pressure on one drug route creates a bulge in another area. The prevalence of private yachts, private planes, huge cruise ships, corrupt governments, weak law enforcement, and extensive connections between Caribbean islands and Europe and America facilitate drug trafficking. More than a hundred thousand Mexicans have been killed since 2007. The drug war and weapons sales became a major issue in U.S.-Mexican relations. In an effort to diminish violence and reduce drug sales, the United States began sending drones over Mexico to locate traffickers and follow their networks. Fast and Furious, an undercover operation by the U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives, became a scandal after Americans learned that the operation, in hopes of following weapons purchased illegally in the United States for Mexican drug bosses, lost track of many weapons that were later used to commit crimes in Mexico. Also, concerned about increasing murders, many Mexicans demonstrated and called for an end to the drug war and for the legalization of drugs. President Enrique Peña Nieto promised to rely less on using force to reduce drug-related violence.

By contrast, Europeans concentrate on treating drug addiction more as a medical problem while supporting efforts to reduce drug supplies. Harm reduction approaches acknowledge the weaknesses of the war-on-drugs approach. Holland and Australia became pioneers in implementing the harm-reduction approach. Holland decriminalized possession and use of small amounts of “soft” drugs such as marijuana and provides “safe injection rooms” so that addicts can avoid public places. Both Holland and Australia distribute supplies of clean needles and sterile syringes to drug addicts to reduce the spread of HIV and AIDS and support medical treatment for addicts. More countries are debating legalizing marijuana. Uruguay became the first country to legalize the production, sale, and consumption of marijuana. Washington, D.C., and Alaska were pioneers in legalizing recreational marijuana use. Also, more than twenty states plus the District of Columbia have legalized the use of medical

Drug Violence is Escalating in Mexico. How can the United States Help Reduce Crime there? Mexican forensic specialists work in a mass grave where they found eight bodies of people who had been murdered in drug violence.

marijuana. The Organization of American States suggested that legalizing marijuana should be considered among a range of ideas to reassess how the drug war is conducted. Jamaica allows the use of marijuana for religious, scientific, and medical purposes and has decriminalized possession of small amounts (two ounces or less) of the drug. West African leaders have called on countries to decriminalize low-level drug use and focus on prevention and treatment rather than incarceration of individual drug users, reasoning that the sophisticated high-level drug trade is the true problem in that region.

12.3: Sexual Crimes

1. 12.3 Report causes behind the global issues of sexual crimes against women

A sharp increase in brutal gang rapes in 2013, especially in India, concentrated worldwide attention on sexual violence as a leading global crime. Violence against women is extremely high in Asian, Latin American, and African societies.  Chapter 3  discusses rape as an instrument of war. Countries that are very violent in general, such as South Africa, Brazil, and El Salvador, have high rates of sexual violence. An underlying cause of crimes against women is an obsession with the punishment of women. This is reflected in the practice of  honor killings . Some women who are raped are blamed for violence against them and are killed by their relatives to preserve the honor and reputation of the family. This encourages men to rape women and discourages women from reporting rape. Approximately 125 million girls and women globally are victims of  female genital mutilation (FGM) , which includes removal of all or part of the clitoris and infibulation, or sewing up of the labia. A majority of girls and women in Somalia, Egypt, Mali, Sudan, Ethiopia, and Mauritania have experienced FGM. This violence against females is concentrated in the Middle East and Africa. This is a cultural norm that results in deaths, disfigurement, and lifelong suffering. In 2015, Nigeria passed a law seeking to eliminate FGM in that country, where an estimated 25 percent of girls have undergone the act. Rights groups in Nigeria acknowledge the law is only the first step and must be followed by a change in traditional cultural views. Ingrained cultural values, beliefs, and attitudes are at the foundation of sexual violence. Male domination is perpetuated by social, religious, political, and economic institutions in most countries. Societies generally value girls less than boys. Millions of female fetuses are aborted in India, China, and elsewhere. Millions more girls than boys die in childhood as a consequence of violence, neglect, and malnutrition. Attacks on women are generally ignored, and laws that purport to protect women and girls against sexual abuse are frequently unenforced. The general societal indifference to the abduction and sale of girls and women in West Africa underscores this practice. Believing that they are following purified teachings of the Prophet Muhammad, both ISIS and Boko Haram jihadists, discussed in  Chapters 5, 11,  and  14 , have raped and enslaved women. ISIS recruits fighters from around the world by stressing that forcing captured women to be sex slaves is sanctioned by Islamic law and customs.

Globally, millions of girls sixteen years and younger are forced into child marriages by their families. Traditions, poverty, and lack of education are among the main factors perpetuating sexual crimes against girls. West African countries such as Chad, Niger, and Nigeria are particularly notorious for having child brides. Most child brides remain uneducated, are frequently abused, and as a group suffer high rates of maternal mortality.

The case that galvanized global awareness, intense debate, protests, and demands for fundamental change was the shockingly brutal gang rape and torture of a twenty-three-year-old Indian college student on a bus. She died from severe injuries. Rape is so common in India that virtually every woman has encountered some form of sexual violence or is aware of women who have. Younger educated urbanized Indians are more likely to reject traditional views about women and are leading efforts to effectuate change. What seems like a sudden burst of anger against sexual violence has its foundations deep in Indian society. Resentment against violence has been building for some time. The official number of rapes greatly underestimates the vast scale of sexual crimes. Women are routinely abused and ignored.  Eve teasing , a trivializing and condescending euphemism for sexual harassment, is ingrained in Indian culture. Women who are raped are blamed by police and others for causing rape by promiscuous behavior. Police often fail to respond in cases of violence against women and less than one-fourth of reported rapes end in conviction. Many women who marry across caste or religious boundaries are murdered. The ancient custom of  dowry , which requires a woman’s family to pay a man to marry her, remains embedded in Indian culture. More than 8,000 women are killed each year in dowry disputes.

One of the most serious sexual crimes is the widespread practice of sex-selective abortions, also called  female feticide , which has resulted in roughly 160 million girls not being born. This practice is most prevalent in India and China. Also, infanticide of girl babies who have been born has been a problematic practice in India and China for centuries. Cultural practices and religious attitudes encourage parents to believe that boys are more prized and will be the children who will take care of them in their old age.

South Africa has one of the highest rates of sexual crimes in the world. Even children are routinely raped by men who believe that this crime will cure them of HIV/AIDS. The brutal practice of  apartheid , or strict legal racial segregation and discrimination, was based on pervasive violence. Consequently, like the American South with its history of slavery and legal racial discrimination, South Africa developed a culture of violence. Although South Africa was the fifth country in the world to legalize same-sex marriage, a unique step on a continent vehemently opposed to homosexuals, the society has deeply held biases and hatreds toward gays and lesbians. There is also the belief that homosexuals can be “cured” of their sexual orientation through  corrective rape . Women and men are correctively raped routinely, often by relatives. Given the prevalence of HIV/AIDS in South Africa, discussed in  Chapter 13 , rape often results in the transmission of AIDS and sometimes death.

Following massive protests in Egypt that led to the downfall of President Hosni Mubarak, discussed in  Chapter 4 , sexual violence increased dramatically. Women, men, and children were subjected to rape, gang rape, forced virginity tests, and other sexual crimes committed by the police, the military, national security agents, and ordinary Egyptians. The violence increased even more after Abdul-Fattah el-Sisi became president of Egypt. The intention of the sexual violence is often to humiliate and oppress people viewed as departing from cultural mores concerning virginity and family honor.

When a twenty-one-year-old American student was raped on a public transit van in Copacabana, a beachfront area frequented by tourists, global media focused on pervasive rape in Brazil. Rates of violence against women in Latin America are much higher than the global average. Criminals are rarely punished. Acid is often thrown into women’s faces. More than half the world’s  femicides , the killing of women primarily because of their gender, occur in Latin America, with El Salvador being the worst in the world. It is estimated that every fifteen seconds, a woman is a victim of sexual violence in São Paulo. Out of more than 1,800 rapes reported in Rio de Janeiro in the first three months of 2013, only seventy men were arrested. 6  Despite agreeing with the  Convention of Belém  in 1994, which requires Latin American countries to educate their citizens about women’s rights, change cultural values that foster male domination, and pass laws to protect women from violence, sexual crimes are increasing.

In the United States, universities and the military have come under fire for fostering climates in which there is a high incidence of sexual assault that is not dealt with adequately. Higher education institutions are under new pressure to create policies and practices to reduce sexual assaults on campus, to protect victims, and to punish offenders. When figures and reports of a culture of sexual assault in the armed forces became public, the Department of Defense was pressured to create new policies regarding sexual assault and an office to oversee them. In 2014 in the U.S. military, there were reportedly 20,300 sexual assaults.

12.4: Global Smuggling of Migrants

1. 12.4 Recognize causes behind the global issues of smuggling of migrants

The global economic recession significantly diminished the demand for migrant workers. In fact, as we have seen, return migration is now the global trend. However, desperate people continue to be smuggled to areas where they perceive economic and social opportunities. In June 2000, British customs officials discovered the bodies of fifty-eight illegal Chinese immigrants in a sealed compartment of a Dutch-registered tomato truck. They had been smuggled into Dover after a five-hour journey across the English Channel from the Belgian port of Zeebrugge. France is also a transit point for illegal immigrants who pay global smuggling operations to get them into Britain and, in many cases, eventually to the United States and Canada. Many migrants from Africa are smuggled to Italy.

The extensive U.S.-Mexican border provided smugglers with a relatively easy way to get migrants to the most popular destination. Increased U.S. border control activities have contributed to reduced illegal immigration. Immigrant communities along the border, the existence of criminal organizations that operate between the countries, the well-established drug trade, and the flow of people and products across the U.S.-Mexican border facilitate the successful smuggling of migrants from around the world. But the tragic deaths of nineteen migrants who were being smuggled across the border in May 2003 refocused national attention on the illegal and brutal nature of global smuggling. At least seventy-seven migrants were packed into an unconventional tractor-trailer without water for a 325-mile journey across the scorching desert. Some who survived had body temperatures as high as 105 degrees. Many migrants become victims of traffickers and drug gangs. In 2010, the Zetas, a Mexican drug-trafficking gang, killed seventy-two migrants from Central and South America when they refused to get involved with smuggling drugs into the United States. An additional 145 bodies were found in ten mass graves in the same area in 2011. The financial crisis and economic recession significantly reduced the smuggling of migrants from Latin America into the United States.

Chinese global smuggling organizations are generally regarded as the most sophisticated and most brutal. Many migrants come from Fujian Province in southern China and take advantage of connections with family members and friends already established in the United States, Canada, and European countries. Chinese communities worldwide, especially those in large cities, provide extensive networks of connections that enable global smuggling operations to be efficient and lucrative. Chinese migrants pay smugglers between $30,000 and $60,000 to be transported to Europe, the United States, or Canada. They travel across many countries or across nine thousand miles of the Pacific Ocean for five weeks in unsanitary, unseaworthy ships. Many of them land in Central America and make a long and perilous journey across Mexico and into the United States, where they find employment in Chinese communities to repay their debt for being smuggled. Often, they pay an initial 10 percent of the smuggling cost, and relatives pay the rest once the migrants arrive at their destinations. 7

12.5: Contemporary Slavery and Human Trafficking

1. 12.5 Assess the growing problem of human trafficking with respect to women and children

Human trafficking  (i.e., the forced or coerced movement of people across national borders as well as within countries) is probably as old as human civilization. Throughout history, human beings have enslaved each other and forced each other to work under the most inhumane conditions, justifying this exploitation in many ways.  Contemporary slavery  is the transporting of victims under false pretenses from one nation, or province, to another, where they are subjugated to forced labor or prostitution. Compared with the global drug trade, human trafficking receives much less attention. Nonetheless, it is a growing problem. According to the Global Slavery Index published by the Walk Free Foundation, there are thirty million slaves worldwide. This foundation is based in Australia and is dedicated to fighting human trafficking. 8  Although the U.S. Central Intelligence Agency estimates that almost a million people worldwide are enslaved each year, including twenty thousand in the United States, it is impossible to know how many people are actually trafficked.

India leads the world with roughly fourteen million enslaved people, many of whom were born into slavery, based on the caste system or other obligations. Some are trapped into debt bondage, a practice that was outlawed more than forty years ago. Europe has the lowest number of enslaved people. Although slavery was finally abolished in Mauritania in 1981, an estimated 4 percent of the population is still enslaved. Slavery is supported by political, economic, and cultural institutions, including mosques. Most of those enslaved are black, and most slaveholders are Arabs. Children inherit the status of slaves and can be bought and sold. Slaves are routinely sexually abused by men, and most children do not know their fathers. They work constantly without pay and do not receive health care. The abduction and sale of approximately three hundred schoolgirls by Boko Haram in Nigeria, discussed in  Chapter 5 , focused global attention on the widespread practice of the contemporary enslavement of girls and women in West Africa and the indifference of leaders and citizens in these countries to this global crime. Many Brazilians from poor communities are enslaved on large farms, cattle ranches, and plantations. They endure degrading and inhumane conditions, violence, and food deprivation. They find themselves permanently indebted to shareholders who prevent them from leaving. Some enslaved Brazilians are murdered. China’s practice of “re-education through labor” received global attention when the media publicized a letter stuffed in a package of Halloween decorations that was bought at Kmart by a woman in Oregon. The letter, written by a prisoner in a forced labor camp, told about long working hours, inhumane conditions, and sadistic guards. 9

The exponential growth in contemporary slavery and human trafficking is inseparable from increasing levels of economic and cultural globalization. Global inequality and demographic factors contribute to the rapid growth of labor migration, a development in which most countries participate. Migrants are employed to do the most strenuous and undesirable jobs in most countries, including the United States. Globalization and changing attitudes about women have led to a dramatic increase in women migrants. Many women are employed as domestic helpers in service industries and as dancers, strippers, and sex workers in the entertainment industry. This  feminization of migration  (i.e., the increasing percentage of women in the migrant population) complicates the human trafficking problem. 10

Despite the global emphasis on women and girls being trafficked for sexual exploitation, the International Labor Organization (ILO) found that of the estimated 9.5 million victims of forced labor in Asia, less than 10 percent were trafficked for commercial sexual exploitation. Globally, less than half of all trafficking victims are involved in the sex trade. 11  Women and girls are generally perceived as replaceable commodities by human traffickers. Although virtually all societies have experienced human trafficking for sexual purposes, this practice seems to be more prevalent in several Asian countries. Prior to the Russian Revolution in 1917, Russian and Eastern European women were trafficked into China and Argentina. Between the 1970s and today, there have been four distinct waves of sexual human trafficking, all of which are manifestations of increasing globalization. The first wave began in the 1970s and was primarily composed of trafficked women from Southeast Asia, particularly Thailand and the Philippines. The second wave started in the early 1980s and involved trafficked women mostly from Africa, especially Ghana and Nigeria. The third wave, from the 1980s to the 1990s, was made up of Latin Americans, with most of the women coming from Colombia, Brazil, and the Dominican Republic. The fourth wave, which mirrors the rapid expansion and growing complexity of globalization, is closely connected to the demise of the Soviet Union. The women are coming from Eastern and Central Europe. 12

Although women are trafficked globally, the Netherlands, Germany, Japan, Spain, the United Arab Emirates, Israel, Greece, South Korea, Turkey, Austria, Belgium, Bosnia, the United States, and Canada are the principal destinations. Criminals collaborate to maximize their profits from human trafficking. Groups in the Russian Far East cooperate with Japanese and Korean organized crime to transport women to China, Japan, Korea, Thailand, and other countries of the Pacific Rim. Groups in the Caucasus collaborate with human traffickers in Turkey to transport women to brothels in Turkey, Cyprus, and countries in the Middle East. Women from Kazakhstan are trafficked to Bahrain, where the Muslim links of the traffickers provide women for this free-trade zone. 13

Although trafficking across national boundaries for sexual exploitation is a significant component of global crime, most trafficked women and girls remain within their countries or regions. In India alone, for example, more than half a million girls are in brothels, more than any other country in the world. The rapid growth of sex tourism in Asia and elsewhere reinforces the sexual exploitation of women and girls within their own societies. What’s more, the AIDS pandemic is influencing human traffickers to find younger women and girls, especially virgins, because customers believe they are less likely to be infected with HIV and AIDS. 14

Child-sex tourism is a growing global crime. Usually, predators from rich countries cooperate with people in poor countries, including family members of victims, to sexually exploit children. This problem is most pronounced in Southeast Asia, especially in the Philippines. The globalization of communications, particularly fast and inexpensive Internet connections, has given rise to  virtual trafficking , which involves creating video chat rooms where predators meet children.

Complicating the issue of human trafficking for sexual exploitation is a growing acceptance of commercial sex that is initiated and controlled by women and men involved in prostitution. Increasingly, the Internet is being used to allow independent prostitutes to advertise their services online and conduct business privately away from brothels, madams, and pimps.

The global response to human trafficking has largely been ineffective. Several efforts to address this problem have been made at both national and global levels. In 1989, the European Parliament adopted a resolution that called for tough measures to eradicate human trafficking. Meeting in Beijing at the  Fourth World Conference on Women  and declaring that women’s rights are human rights, delegates from 189 countries unanimously adopted a platform for action, which called on governments to dismantle criminal networks engaged in trafficking women. In response to the unprecedented growth in human trafficking, the  UN Protocol Against the Trafficking in Women and Children  was adopted along with the UN Convention on Transnational Crime in 2000. At a world summit on organized crime in 2000 in Palermo, Italy, leaders from eighty countries signed the UN protocol. Also in 2000, a coalition of Democrats, Republicans, feminists, and evangelical Christians pressured the U.S. Congress to enact the  Victims of Trafficking and Violence Protection Act  to prosecute traffickers in the United States and to take action abroad against this global crime. This law recognized human trafficking as a federal crime and requires the U.S. Department of State to publish an annual report on the state of human trafficking globally. 15

While the global community was responding to the problem of human trafficking, several countries were legalizing the sex trade, which consists predominantly of foreign women in most European countries. For example, roughly half a million women are trafficked as prostitutes in Europe every year. In Germany, three out of four sex workers are foreigners, and in the Netherlands, one out of two sex workers comes from another country. In 2000, the Netherlands legalized prostitution, which is a billion-dollar-a-year industry and represents roughly 5 percent of that country’s economy. Germany legalized prostitution in 2001. The sex trade contributes approximately $4.5 billion to Germany’s economy. 16  Very few traffickers are prosecuted and convicted.

12.6: Criminal Gangs and Kidnapping

1. 12.6 Outline the factors that provide fertile grounds for kidnapping and gang violence to flourish

The same communications and technological revolutions that drive globalization also help gangs to grow. The Internet enables them to form alliances, to learn from each other, and to terrorize. Repeated exposure to cultural globalization—especially violent television programs, movies, video games, and magazines—reinforces their violent behavior. Ethnic conflicts and civil wars, combined with easy access to guns, provide fertile ground for gang violence to flourish. Aspects of globalization—especially global migration, global inequality, and fewer government-provided public services due to privatization and trade liberalization—contribute to the growth of gangs. Demographic factors also play an important role. Young people between the ages of sixteen and twenty-four tend to commit most of the crimes, especially in densely populated areas. As we discussed earlier in this chapter, poverty and the decline of social services often combine to influence parents to abandon their children, making them vulnerable to gangs. Gang violence threatens peace and security, increases political instability, weakens democratic institutions, increases human rights violations, and impedes economic development. Kidnapping is often an integral component of gang violence. Gang violence usually generates counterviolence by vigilante groups, the military, and police officers.

Foundations for rising gang violence in Central America were laid during the civil wars that devastated the region in the 1980s, driven partly by military and political rivalry between the United States and the Soviet Union. The Cold War in Central America was accompanied by widespread human rights abuses, rape, torture, extrajudicial executions, kidnappings, and drug production and trafficking. In Guatemala alone, more than two hundred thousand people were killed or missing (out of a population of fourteen million) during these conflicts. Civil wars also bring with them the proliferation of weapons. As we discussed in  Chapter 11 , violence is a factor that pushes people to migrate. Many Central Americans came to the United States and settled in the ghettos of Los Angeles and other major American cities. Many young migrants soon became involved in street gangs, committed violent crimes, including murder, and participated in drug trafficking. When the U.S. Congress decided to enact very punitive immigration laws in 1996, noncitizens who were sentenced to a year or more in prison could be repatriated to their country of origin. Foreign-born U.S. citizens who committed felonies could lose their American citizenship and be expelled from the country after serving their sentences. Consequently, roughly twenty thousand young Central American criminals were seventy thousand gang members in Central America. Gang members recreated their violent lifestyles in Central America. Drug trafficking escalated. Central America has the world’s highest murder rates. As the United States escalated its war on drugs in Colombia, drug-trafficking organizations moved into Central America and used drugs to pay gang members. Central America is a bridge between Colombia, the world’s largest producer of cocaine, and Mexico, which is the transit point for the United States, the world’s largest consumer of cocaine and other drugs. Gang members routinely force residents of poor neighborhoods to pay what they call protection fees, demand war taxes from businesses, and often murder individuals who refuse to or cannot pay them. Rapes of young women have increased, homes are robbed, schoolchildren are turned into drug addicts, and kidnappings occur frequently. Gang violence, instability, and poverty triggered unprecedented flows of unaccompanied child migrants from Honduras, El Salvador, and Guatemala to the United States.

Previously, most victims of kidnappings were wealthy individuals who could arrange to pay large ransoms. Today, however, ordinary individuals are being kidnapped for a variety of reasons. Terrorists have used kidnappings as bargaining chips and to create widespread fear. Many of the kidnappings in Africa and the Middle East are by terrorists who use the ransom to fund their activities. Islamic terrorists in the Philippines routinely kidnap foreigners, especially Westerners, to extract money to finance terrorism. Kidnappings are an integral component of violence and drug trafficking in Colombia. Mexico is by far the world’s leader in kidnappings. A quarter of all kidnappings occur in Latin America. 17

12.7: Illegal Trade in Endangered Animals and Plants

1. 12.7 Examine the global issue of illegal trade in endangered animals and plants

The illegal trade in  endangered species  coexists with legal transactions, thereby making it difficult to ascertain the magnitude of the problem. Nevertheless, there is general agreement that many of the factors we discussed earlier about the globalization of crime combine to sustain and expand both the legal and illicit aspects of this trade. Local and individual decisions directly affect trade in endangered animals and plants. These decisions have significant global consequences. For many individuals, the trade liberalization that characterizes globalization augments perceptions that almost anything can be traded, regardless of long-term consequences for the environment. Economic inequality between conservationists in rich countries and poor people in the developing world, where most animals and plants are located, often gives rise to divergent perceptions of and approaches to illegal trade. For example, elephants are generally regarded as exotic by many residents in rich countries, but many Africans view them as threats to their safety and their crops. On the other hand, carefully managed animals and plants can play a major role in ecotourism and other aspects of economic development. Political instability and ethnic conflicts in many countries often facilitate both trade in and the destruction of many endangered animals and plants. Illicit trade fuels many conflicts. Illegal wildlife trade also raises issues such as sustainability and biological diversity. Also, imports of animals and plants sometimes contribute to problems associated with invasive species that threaten native species.

Given the global reach of traffickers in endangered animals and plants and the numerous small illegal transactions that occur daily by individuals worldwide, ascertaining the financial gains from this global crime is extremely difficult, if not impossible. While global attention was drawn to illicit trade in endangered animals by large sales of African elephant tusks to Japan and elsewhere, the expansion of legal trade and the Internet have significantly broadened this criminal activity. The most endangered species—such as tigers, Asian bears, rhinoceros, hyacinth macaws from the Amazon, Australian palm cockatoos, Saiga antelopes, and hawksbill turtles—command high prices. As we saw in  Chapter 10 , rhinoceros horns are more valuable than gold. Many of the highly valued illegally traded species are believed to have medicinal properties and are usually in great demand in several Asian countries. Many traditional Chinese medicines contain ingredients composed of tiger bone, bear bile, deer musk glands, and shark fins. The demand for shark fin soup is of great concern to environmentalists who believe that sharks are an endangered species. Many animals are sold for food and to pet shops worldwide. Products derived from endangered wildlife include exotic leather goods, ornaments, and tourist souvenirs. Increasing wealth, engendered by economic globalization, has also led to a growth in demand for expensive products such as caviar. As countries around the Caspian Sea attempt to conserve the sturgeon population, illegal trade in caviar has escalated. Global trade in plants and forest products is accompanied by illegal logging operations and lumber sales, especially in Southeast Asia, Central Africa, the Amazonian countries, and Russia. Millions of plants are sold illegally, and medicinal plants that are in great demand due to a global preoccupation with finding easy solutions to health problems are threatened with extinction. These include hoodia (which is used in diet pills), cistanche (a natural tonic), and the Chinese yew tree (which is believed to have cancer-fighting properties).

Concerned about animal and plant extinction, the global community responded by signing the  Convention on International Trade in Endangered Species of Wild Flora and Fauna (CITES)  in 1973. This convention provides a framework within which countries adopt domestic legislation to ensure that CITES is implemented at the national level. Combating illegal trade in endangered animals and plants is an integral component of efforts to strengthen wildlife management, promote sustainability, and diminish deforestation. Several nongovernmental organizations (NGOs) participate in efforts to protect endangered species, including the World Conservation Union, World Wide Fund for Nature, Fauna and Flora International, Trade Records Analysis of Flora and Fauna in Commerce, and the World Conservation Monitoring Center. CITES accords varying degrees of protection to roughly five thousand animal species and twenty-five thousand plant species. The global community has achieved significant success in its effort to protect elephants. A worldwide ban on ivory in 1989 reduced elephant poaching. Poaching is increasingly being used by terrorist organizations in Africa to fund their activities. China and other Asian countries continue to purchase ivory and rhino horns. In 1992, the United States, a leading importer of parrots for pets, enacted the  Wild Bird Conservation Act , which bans imports of all wild-caught threatened parrots listed in CITES. Consequently, parrot imports dropped sharply. The global community collaborates with various countries to regulate hunting certain animals in ways that promote both conservation and economic benefits. Hunters, conservationists, and local farmers are collaborating to protect Africa’s wildlife.

A businessman wearing a mask and holding a credit card at a computer represents cybercrime, which is committed online.

12.8: Cybercrimes and Piracy

1. 12.8 Evaluate how the rise in internet usage and advances in technology have contributed to cybercrimes

Cybercrimes  are standard crimes committed online or harmful behavior that is connected to computers. Examples of cybercrimes are fraud, pornography, smuggling, copyright and software piracy, identity theft, and extortion. The proliferation of online shopping has been a boon for cybercriminals.  eBay , the biggest online marketplace, has roughly 180 million members worldwide, who are connected to the Internet, and more than sixty million items for sale at any particular moment. Both distance and anonymity conspire to render these global online shopping centers perfect places for fraudulent activities. As a marketplace that links buyers and sellers, eBay has very little control over transactions.

The global expansion of the Internet, the widespread use of credit cards, and the growth of electronic banking combine to facilitate a wide array of fraudulent activities. The  Nigerian scam  is one of the most common cyberspace crimes and one of the most persistent. A Nigerian sends an e-mail asking prospective victims to assist him or her to transfer millions of recently acquired dollars out of Nigeria in exchange for a substantial part of the money. Prospective victims are instructed to deposit their own money into a specified bank account to demonstrate their honesty and willingness to cooperate. If these instructions are followed, the money and the Nigerian e-mail sender simply vanish. Credit card fraud on the Internet involves the use of stolen credit card numbers and information, such as the date of expiration and delivery address, to purchase products from virtual shopping malls and auction sites. Financial institutions are very vulnerable to cybercrimes. For example, in 2013, an operation that included sophisticated computer experts worldwide stole $45 million from ATMs (automated teller machines) in 24 countries in 10 hours.

Despite increasingly sophisticated computer security measures, criminals are becoming adept at crashing computer systems and impeding their operation. A growing concern among governments, including the U.S. government, is that cybercriminals could be successful at penetrating security organizations and threaten vital national interests. For example, China and Russia focus on stealing U.S. military secrets in an effort to undermine American military superiority. The United States’ vulnerabilities range from its nuclear power plants and electrical grids to the information systems of government agencies and major U.S. companies. The Chinese government collaborates with hackers to steal corporate secrets of Western companies. Universities are facing many cyberattacks. They are the most open and robust centers of information exchange in the world and producers of research in many different areas that drives technological and scientific innovation. China, in particular, steals much valuable information from them. The high-profile attack against Sony in late 2014 that the United States attributed to North Korea elicited the first instance of the U.S. government imposing sanctions on a country in retaliation for a cyberattack on a company. The Sony attack, which exposed confidential files and involved threats against movie theaters, came just as Sony was preparing to release the movie The Interview, which treated the fictitious assassination of North Korea’s leader as comedy. Extortion schemes by organized criminal groups based primarily in Russia and Eastern European countries have been implemented in Australia, Britain, Canada, Thailand, the United States, and elsewhere. Criminals employ sophisticated viruses to disable computer systems. An Internet virus named  Kama Sutra —named after the venerable Indian guide to eroticism—was programmed to overwrite documents, images, and compressed computer files. Aimed principally at home computers, the virus infected computers through an e-mail that promised racy pictures. Russian criminal gangs use software tools to infect thousands of personal computers in corporate and government networks with programs that steal passwords and other information.

Global trade, computer technologies, and the globalization of American and European cultures have contributed to the growth of  global piracy , which includes online music piracy, counterfeiting, and old-fashioned piracy on the high seas. Online music piracy and counterfeiting deal with  intellectual property rights , copyrights, and patent laws. Downloading music is generally regarded as a harmless activity by those engaged in it. However, the music industry views online music piracy as theft. Throughout China, one can purchase inexpensive counterfeit DVDs of the most recent American movies, as well as counterfeit shoes, clothes, computer software, books, and many other products. Counterfeit prescription drugs are a major problem that threatens human security. China and India are the leading sources of faked drugs. 18

12.8.1: Piracy at Sea

Piracy on the high seas has re-emerged as a significant threat to global shipping. It also demonstrates new threats from nonstate actors to global military powers such as the United States. Modern piracy ranges from desperately impoverished people committing petty larcenies at sea to highly organized syndicates slaughtering ships’ crews to steal not only the valuable cargo but also the multimillion-dollar ships. The failure of the Somali state, the withdrawal of the Soviet and American military forces from the area with the end of the Cold War, the widespread poverty and violence in Somalia, and the ease with which cargo ships could be seized and large ransoms could be collected by small groups of men in small speed boats armed with grappling hooks, assault rifles, rock-propelled grenades, knives, and satellite telephones had contributed to escalating pirate attacks. When pirates seized the U.S.-flagged cargo ship the Maersk Alabama and held the captain for ransom, a U.S. Navy–guided destroyer and other warships were sent to the Somali coast. U.S. Navy Seals on the destroyer Bainbridge were experienced snipers. They killed the three pirates and rescued the captain, Richard Phillips, of the Maersk Alabama. Piracy along the Somali coast stopped when the United States, the European Union, China, India, Russia, and other countries increased naval task forces in the region. Ships were made more difficult to attack, and many carry armed guards. Pirate havens in Somalia have also been attacked. Piracy in West Africa, especially by Nigerians in the Gulf of Guinea, has increased significantly. It is intertwined with drug trafficking, arms smuggling, and terrorist groups that use it to raise funds.

Petro-piracy, similar to that in the Gulf of Guinea, has risen sharply in the Strait of Malacca and the South China Sea. The Indonesian Island of Batam has historically been a haven for pirates. Its location provides excellent views of passing ships, and its low level of law enforcement facilitates organized criminal activities. About a fourth of global seaborne oil trade, primarily between the Middle East and East Asia, goes through the Strait of Malacca. Pirates capture oil tankers, siphon their oil into other vessels, and sell it on the black market.

12.9: Global Responses to Crime

1. 12.9 Analyze why globalization has been far more beneficial to nonstate actors who commit crimes than it has been to nation-states

Global crime is inextricably linked to poverty, extreme economic and gender inequality, lack of education, the proliferation of small arms, environmental problems, corruption, and a general disregard for the rule of law. Efforts to address these underlying problems are essential to reducing crime. Countries are ill equipped to effectively respond to global criminal activities. As we pointed out earlier in this chapter, globalization has been far more beneficial to nonstate actors, including smugglers, drug traffickers, and other global criminal networks, than it has been to nation-states. The hierarchical structure of countries is a liability in an increasingly decentralized, global society. Furthermore, globalization has diminished the ability of states to exercise effective jurisdiction over their territories and to regulate trade and other activities. The nature of globalization makes it difficult to determine where the crimes occurred and which country or countries have jurisdiction over them. Few governments have the resources to effectively control global crime, especially in light of reduced government budgets for public services. Furthermore, divergent views among countries about crime and different priorities render effective collaboration among states difficult to achieve.

The International Criminal Police Organization, commonly known as  Interpol , is a global clearinghouse for police information based in France. As we have seen, global crime is proliferating so rapidly and on such a vast scale at a time when cultural attitudes are generally much more tolerant of many global criminal activities that global efforts to reduce the crimes we have discussed are significantly undermined. Nevertheless, Interpol’s role in combating drug trafficking and other global crimes is important. Interpol collects and analyzes data, supports global crime investigations, organizes operational working meetings among countries, and organizes regional and global conferences on a wide range of criminal activities. Despite support from Interpol, fighting crime is essentially a local activity, and states themselves are ultimately responsible for reducing global crime. But as with many domestic crimes, states confront many serious obstacles in fighting global crime. Several countries, including Indonesia, Iran, Saudi Arabia, China, Singapore, and Malaysia, impose the death penalty on individuals found guilty of drug smuggling. Indonesia’s policy was widely condemned when several foreign nationals, including two Australians, were executed by a firing squad in 2015 despite pleas from Australia’s Prime Minister Tony Abbott to spare their lives. Australia recalled its ambassador to Indonesia in protest.

Attempting to be more effective in countering global crime, 178 countries have joined Interpol. Most of these countries signed the  UN Convention Against Transnational Organized Crime , a global agreement that outlaws bank secrecy, keeps prosecutors worldwide in contact by e-mail, allows international arrest warrants to be sent by e-mail, provides for videoconferences to allow witnesses to testify without having to travel around the world, and creates international witness protection programs. The challenge confronting the global community is the ability to implement these provisions. The forces of globalization are likely to give global criminals the advantage in the worldwide struggle to reduce global crime.

A global response to cybercrime is just being contemplated by world and business leaders. Cybercrime, a crime of hacking and data theft and sabotage, is rapidly growing and bleeding businesses of $1 trillion per year. Some called the high-profile hacking attack on Sony Pictures Entertainment in late 2014 a global wake-up call. At the World Economic Forum in Davos, Switzerland, in early 2015, a business leader stated that there is no longer any secure data center in the world. Cybercrime is a threat not only to businesses but to critical infrastructure of nations.

Major considerations have stood in the way of a global response to cybercrime that would show international cooperation. Because cybercrime is so new, experts are still attempting to define it and to determine accurate figures for the financial losses it causes. The issues that would have to be resolved in a global fight against cybercrime would touch on privacy, trade, overregulation, and intelligence-sharing. 19

Case Study Government Corruption in India

Government corruption is the illegal use of official positions for private gain. It includes taking bribes, stealing state property, embezzling public funds, selectively and arbitrarily enforcing the law, and cooperating with criminals. Government corruption perpetuates poverty, inequality, global crime, the globalization of diseases, environmental problems, and undemocratic regimes. Corruption creates a lack of accountability along with a culture of fear, dishonesty, secrecy, cynicism, lawlessness, mistrust. Consumers pay higher prices for almost everything as corrupt officials help create illegal monopolies in the economic sector. Government bureaucracy grows and becomes more inefficient, and bribery proliferates. Official corruption filters down through society and is accepted as a way of life.

There are many reasons for government corruption. They include basic human greed, cultural values that encourage helping relatives and friends, lack of accountability, weak and ineffective judicial systems, economic hardships for public sector employees, and the growth of global crime as a component of globalization. Rapid economic growth also is conducive to increasing government corruption.

India’s rapid economic growth has contributed to a “season of scams” by government officials by increasing the amount of money available to steal. More than 80 percent of Indians perceive corruption to be an urgent problem, despite a long history of corruption in the country. There is an estimated $450 billion derived from illegal activities by Indians deposited in foreign bank accounts. Money is routinely stolen from programs intended to benefit the poor. For example, almost half of state fuel subsidies are stolen, amounting to roughly $2 billion a year. In Uttar Pradesh alone, more than $40 billion of food and other subsidies over a five-year period did not reach the poor due to government corruption. One of the leading cases of corruption occurred in India’s telecom industry, the world’s fastest-growing market. Andimuthu Raja, the telecom minister, refused to auction licenses. He awarded them arbitrarily and to favored companies for below market value. The government lost $40 billion. In another high-profile corruption case, nicknamed Coalgate, India’s former prime minister, Manmohan Singh, was summoned as one of the accused in a government investigation into illegal selling of coal field leases to Indian corporations.

There are many initiatives globally to diminish government corruption. One is the proliferation of anticorruption units around the world. There is an upsurge in grassroots democracy with those who are most affected by corruption—the poor—taking measures to hold corrupt officials accountable. Villagers perform social audits to ascertain that money is not stolen. They are helped by the rapid growth of communications technologies, which they use to enhance transparency. The opposition Bharatiya Janata Party (BJP) made government corruption a leading political issue, supported by popular anger about corruption. That forced the governing Congress Party to implement reforms that remove discretionary powers abused by politicians. Furthermore, the courts reinforce the anticorruption campaign by trying accused officials. Technology also is being used to circumvent India’s largely corrupt and inefficient bureaucracy. Payments bypass bureaucrats and go directly into individuals’ bank accounts. As villages gain access to broadband and government databases, they can obtain documents, assess property taxes, and pay bills online. Bids for government contracts also are made online, enabling anticorruption groups to monitor them. Global coalitions of anticorruption nonstate actors have persuaded the U.S. government to enact legislation requiring companies to disclose payments to governments. There also are global efforts to recover stolen assets that are in foreign secret bank accounts.

Corruption Ranking of Countries, 2014

(zero means a country is perceived as highly corrupt, and 100 means it is perceived as very clean)

Adapted from Transparency International, the Global Coalition Against Corruption, “Corruption Perceptions Index 2014”  www.transparency.org/cpi2014/results  (retrieved May 4, 2015).

Top 10 Most Corrupt Countries	Scores
Somalia	8
North Korea	8
Afghanistan	8
Sudan	11
South Sudan	14
Libya	15
Iraq	16
Uzbekistan	17
Turkmenistan	17
Syria	17
India	38
United States	73
Australia	80
Top 10 Least Corrupt Countries	Scores
Denmark	92
New Zealand	91
Finland	89
Sweden	87
Norway	86
Switzerland	86
Singapore	84
Netherlands	83
Luxembourg	82
Canada	81

Summary

Global criminal activities have proliferated with the rapid growth of economic, financial, technological, cultural, and other forms of globalization. Increased global migration, global inequality, the growth of global cities, the explosion of global trade, inexpensive communications, revolutions in computer technologies, and the disintegration of the Soviet Union have contributed to the spread and intensification of global crime. As we saw, global crime is intricately intertwined with politics, economics, and culture. This chapter shows how illegal activities occur alongside legal activities and how difficult they sometimes are to separate. Furthermore, there are divergent perceptions about global crimes as well as different approaches to dealing with them. Globalization has weakened states in ways that prevent them from effectively combating many global crimes. Furthermore, as the case study shows, government corruption is global crime that facilitates other criminal activities. We discussed major global crimes such as drug trafficking, sexual crimes, human trafficking, illegal trade in endangered species, and cybercrimes. Throughout history, the world has experienced an increase in the global drug trade, accompanied by growing drug use and addiction. This global crime commands the attention of the global community, although countries adopt divergent approaches to dealing with illegal drugs. There are global responses to the crimes discussed. Organizations such as Interpol provide information on criminal activities and cooperate with countries in an effort to reduce global crime.

Discussion Questions

1. Discuss ways in which globalization facilitates the growth of global crime.

2. How and to what extent has globalization affected the ability of states to diminish global criminal activities?

3. Compare European and American approaches to dealing with illegal drugs. Make arguments for and against legalizing drugs.

4. Discuss the problem of government corruption.

5. Discuss the growth of piracy, and the causes, and possible ways to reduce it.

6. Discuss the problem of sexual crimes. Give examples.

hapter 13 Global Health Challenges

MANY INDIVIDUALS AND NONGOVERNMENTAL ORGANIZATIONS (NGOS) HELP FIGHT GLOBAL DISEASE. The Bill and Melinda Gates Foundation plays a key role in the war against malaria, AIDS, and other diseases. Melinda and Bill Gates met with doctors and patients at the Manhica Research Center and Hospital in an area of Mozambique heavily affected by malaria.

Learning Objectives

1. 13.1Recall the causes and effects of noncommunicable diseases

2. 13.2Evaluate the role of global travel and trade in facilitating the globalization of infectious diseases

3. 13.3Outline the three developments that gave rise to the concept of human security

4. 13.4Describe the three epidemiologic transitions to better understand contemporary concerns about infectious diseases

5. 13.5Report the cause, spread, effects, and control measures of influenza and avian flu

6. 13.6Report the cause, spread, effects, and control measures of malaria

7. 13.7Recognize the causes and preventive measures of HIV

8. 13.8Report the origin, spread, effects, and control measures of SARS

9. 13.9Report the origin, spread, effects, and control measures of Ebola

10. 13.10Outline role of the WHO in preventing the spread of infectious diseases

Noncommunicable diseases (NCDs) such as heart disease, cancer, diabetes, chronic respiratory disease, and mental illness in general and Alzheimer’s disease in particular are the leading causes of death and disability globally. Long associated with affluent Western standards of living, NCDs are now a global problem. While rich countries are better equipped to deal with chronic diseases, they are far more deadly in poor countries. Growing numbers of old people and the spread of middle-class lifestyles make NCDs more prevalent than infectious diseases. Globalization also contributes to the growth of NCDs by helping expand the global middle class and by promoting fast foods, sugary drinks, alcohol, smoking, processed foods, and sedentary lifestyles. A major global health threat that undermines efforts to cure diseases is the emergence of germs that are resistant to antibiotics. This is due mainly to the excessive use of antibiotics in medicine and agriculture.

Infectious diseases are intertwined with numerous global issues and are inseparable from political, economic, and cultural components of globalization. Ethnic conflicts make populations vulnerable to infectious diseases. Fighting contributes to the collapse of public services, which means that many people die from what would ordinarily be treatable diseases, such as diarrhea and respiratory infections. Conflicts also create refugees, overcrowding, and unsanitary conditions, thereby creating environments conducive to the spread of infectious diseases.

Environmental degradation and deforestation expose humans to a variety of infectious diseases. They also contribute to global warming and flooding, which facilitate the emergence of infectious diseases. Rising temperatures in winter enable germs to survive in large numbers, and flooded areas become potent breeding grounds for mosquito-related diseases and cholera. Rapid population growth and urbanization bring more people closer together and into contact with infectious diseases. Trade has long been a major facilitator of the spread of infectious diseases. Consequently, trade suffers greatly when outbreaks occur. In many ways, trade liberalization contributes to the spread of infectious diseases by reducing the role of many governments in providing essential basic health care and other services. Infectious diseases have far-reaching social, economic, demographic, security, and political consequences.

This chapter examines the globalization of noncommunicable and infectious diseases, the concept of human security, and the nature and spread of infectious diseases. The chapter discusses global responses to the growth, persistence, and transmission of infectious diseases. It concludes with a case study of obesity as a global epidemic. The American Medical Association officially classified obesity as a disease in 2013.

13.1: Noncommunicable Diseases (NCDs)

1. 13.1 Recall the causes and effects of noncommunicable diseases

Modern medicine was primarily focused on curing and preventing infectious diseases, precisely because they were the leading causes of mortality and disability. The success of modern medicine in eradicating and controlling many infectious diseases combined with industrialization, urbanization, dietary changes, economic prosperity, and changing lifestyles has focused more attention on  noncommunicable diseases (NCDs) . These diseases are not caused by infections. They require long-term treatment and care and cause long-term harm.

Major NCDs are cancer, heart disease, diabetes, obesity, Alzheimer’s disease, respiratory diseases, and other chronic diseases. Depression and other mental health issues are interrelated with NCDs. More than thirty-five million people die each year from NCDs. Roughly 75 percent of all adult deaths and half of all disability globally are caused by NCDs. Eighty percent of these deaths occur in middle- and low-income countries, and the death rate before the age of sixty for people in the developing world is twice as high as it is for people in rich countries. 1  Rates of cancer and other NCDs are rising sharply.

13.1.1: The Impact of NCDs

NCDs have profound economic, social, and political implications. They affect many issues discussed earlier. NCDs increase poverty and drain financial resources of individuals, families, and governments. Businesses are also affected. Workers with NCDs usually miss work, underperform at work, become disabled, and leave the workforce before they reach retirement age. Chronic diseases require extensive medical care and a variety of services that are very expensive. Payment for treatment and care often reduces families to financial ruin, trapping them in cycles of debt, impoverishment, and sickness. Poor people are the most vulnerable to the negative effects of economic costs associated with NCDs. Many lack economic assistance and health insurance and often have to leave their jobs to care for relatives. Some children are forced to leave school to supplement their family’s income. Demographic transitions in many countries, especially Western Europe, the United States, Canada, and Japan, have reduced the proportion of working-age adults while rapidly increasing the number of older people who need care. Throughout the world, including the United States, Canada, and Western Europe, women are the indispensable caregivers. This means that many women leave work and abandon opportunities for economic advancement and diminish their chances of achieving gender equality. Diseases such as Alzheimer’s disease require intensive and prolonged care that is generally not provided by most national health care systems. Furthermore, few families can afford the expense associated with such care and must rely primarily on unpaid informal care by the family. Many NCDs are the result of aging. Governments are challenged to develop comprehensive and sustainable long-term care plans and support for older people. This inevitably leads to political struggles over the allocation of scarce resources and the setting of national priorities. 2

13.1.2: Causes of NCDs

Globalization

 Leading causes of NCDs include unhealthy diets, lack of exercise, smoking, the harmful use of alcohol, affluence, poverty, and pollution, especially black carbon, which is discussed in  Chapter 10 . Globalization is playing a pivotal role in the growth of NCDs. The spread of medicine and technology to distant parts of the world to treat diseases directly contributes to longevity, a major cause of NCDs. Globalization also spreads Western lifestyles that enhance the development of NCDs. Throughout the world, even in many small communities, people have retreated from the outdoors and spend most of their time with technological devices, especially the Internet and television. Combined with rapid urbanization, these technologies encourage sedentary lifestyles that contribute to obesity, heart disease, and other NCDs. In a world that is always busy, stress becomes toxic. Stress impairs the immune system and is an underlying cause of many diseases, including cancer. Global connectedness engenders chronic sleep deficits which are implicated in many NCDs, including depression, heart disease, chronic pain, diabetes, and cancer.

Globalization promotes free trade, which includes the spread of fast food and processed foods even to remote parts of the world. Profits, not proper nutrition, are the primary concern of global food companies. Rising obesity rates around the world are directly linked to the consumption of vast quantities of sugary drinks. The Institute for Agriculture and Trade Policy in Minnesota has shown that following the passage of the North American Free Trade Agreement in 1994, discussed in  Chapter 8 , there has been a more than 1,200 percent increase in high fructose corn syrup exports from the United States to Mexico. Mexico now has the highest obesity rates in the world. Turkey tails, which are about 40 percent fat, are frequently consumed in Samoa, which has strong ties with the United States. Similarly, many Pacific islands close to New Zealand have diets that include mutton flaps, which are mostly fat. Consequently, Pacific islands have very high rates of obesity. 3

Smoking

 Smoking is the leading cause of NCDs and preventable deaths. More than six million people die each year from tobacco use, a number that is higher than all the deaths caused by HIV/AIDS, tuberculosis, and malaria combined. With more than 300 million smokers, about one-third of the global total, China has one million deaths each year from smoking. While rich countries have sharply reduced smoking, countries in Central and Eastern Europe, Asia, Africa, and Latin America are experiencing a rise in tobacco use, due partly to aggressive marketing efforts of tobacco companies. Tobacco use is the leading cause of cancer, heart disease, and chronic respiratory disease.

Alcohol, Affluence, Poverty, and Pollution

 Alcohol, a leading cause of NCDs in Eastern Europe, Central Europe, Latin America, and the Caribbean, is the third leading cause of deaths worldwide. Heavy drinking, especially when combined with smoking, can cause cancers of the mouth, larynx, pharynx, esophagus, liver, and breast. Affluence, often equated with Westernization, has long been a leading cause of NCDs. Some NCDs, such as colorectal and breast cancers, are still more prevalent in rich countries than in the developing world. Poverty also contributes to the increase in NCDs. People in poorer countries tend to smoke more, are more obese, and have higher blood pressure. Most poor countries lack adequate medical care, and many diseases are not diagnosed early. Even if a diagnosis is known, the disease often goes untreated. This results in higher death rates from NCDs in poor countries than in rich ones. 4  Pollution is among the top seven leading causes of NCDs and accounts for more than three million deaths globally each year. Women and girls suffer most from indoor pollution that comes from wood-burning stoves. Chronic obstructive pulmonary disease and lung cancer increase with greater industrialization. China, which has many factories and relies mostly on coal for energy, heating, and cooking, has very high levels of pollution, as we discussed in  Chapter 10 . Pollution causes an estimated 1.2 million deaths in China and is the fourth leading risk factor for deaths in China.

13.1.3: Major NCDs

Cancer

 Cancer kills more than eight million people each year globally. Approximately 70 percent of these deaths are in developing countries. Cancers are caused by many different things, including smoking, nutrition and diet, obesity, sunlight, alcohol, and environment hazards such as chemicals and pollution. Smoking is the leading cause of lung cancer, and dietary intake can increase the risk of colon, breast, kidney, prostate, and endometrial cancers. Patients with cancer in high-income countries have twice the survival rates of people in developing countries, due largely to the quality of medical care. For example, many cases of breast cancer in middle- and low-income countries are not diagnosed until it has reached stage 4, the final stage, when it has invaded organs or bones and cannot be cured. Enormous tumors develop. Stigma, poverty, misinformation, and lack of knowledge are impediments to getting medical treatment. In many parts of the developing world, many people with cancer rely on useless herbs from traditional healers. The unavailability of modern medical technology that can help make sure that a lumpectomy is done correctly often leads to unnecessary mastectomies. 5

Heart Diseases

 Heart disease, once concentrated in affluent societies, is increasing in the developing world, especially among middle-class individuals. Heart disease is the leading cause of death in China, a country that has experienced unprecedented economic growth and poverty reduction. As we have seen, many NCDs are interrelated and are caused by many of the same things. Heart disease is connected to high blood pressure, or hypertension. Excess sodium in processed foods, fast food, and food prepared at home is a key risk factor for hypertension. Heart disease is also caused by diets that contribute to high blood cholesterol. Other causes include obesity, physical inactivity, smoking, and diabetes.

Diabetes

 Diabetes is rapidly growing globally as more people are able to afford foods that contain large amounts of sugar. Sugar is addictive and toxic. The consumption of large containers of sugary drinks is mainly responsible for the rapid growth of diabetes. The average individual in the United States and Mexico consumes forty gallons of soft drinks a year. China, with a rapidly growing middle class, has 114 million people with diabetes, the highest proportion of the population (around 11.6 percent) in the world. Diabetes affects around 26 million Americans, or 8.3 percent of the population. Type 2 diabetes is by far the most common form of the disease and accounts for about 95 percent of those over age twenty with diabetes. Type 2 diabetes usually begins later in life and is caused by lifestyle, especially excessive sugar consumption. In contrast, Type 1 diabetes, or juvenile diabetes, usually begins early in life and is an autoimmune disorder with genetic origins. Diabetes can have many devastating health consequences. It is the seventh leading cause of death in the United States. It is the dominant cause of kidney failure, nontraumatic lower limb amputations, blindness, heart disease, and stroke.

Alzheimer’s Disease

 Alzheimer’s disease is the most feared noncommunicable disease because many individuals will get it if they get old, and there is no cure for it. Alzheimer’s disease is the dominant cause of dementia. The greatest risk for developing Alzheimer’s disease is old age. This disease is growing rapidly as the number of old people increases globally, as we discussed in  Chapter 11 . More than thirty-five million people suffer from Alzheimer’s disease globally. It is a degenerative disease that poses severe challenges for the global community. Symptoms include memory loss, cognitive impairment, difficulty communicating, and mood changes.

There are three stages of Alzheimer’s disease

1. The early stages, during which those affected become forgetful and have problems with orientation, making decisions, and doing household work.

2. The middle stages, in which the symptoms from stage one get worse. There is a greater need for personal care, which extends to personal hygiene. Behavioral changes include wandering, clinging, agitation, and aggression.

3. The final stages, in which individuals become unaware of time and place; unable to recognize relatives, friends, or familiar objects; unable to eat without help; severely restricted in their mobility; and bedridden. Care, support, and supervision needs are constant. Families are under severe stress and face huge financial burdens. 6

13.1.4: Global Responses to NCDs

Since many NCDs, with the exception of Alzheimer’s disease, can be prevented or significantly diminished, there is an emphasis on lowering the risks of getting them. Conventional medical approaches that work well with infectious diseases are less appropriate and less effective when dealing with NCDs. Effective ways to reduce the growth of NCDs are to promote healthy diets, encourage more physical activity, reduce stress, and clean up the environment. These are essentially lifestyle changes. To help treat these diseases, global pharmaceutical companies such as GlaxoSmithKline and Merck provide inexpensive drugs to people in developing countries.

Many governments are focusing on promoting healthier diets. This means eating more fresh fruits and vegetables and whole grains and limiting fast foods, processed foods, and sodium. When Michael Bloomberg was mayor of New York City, he stressed limiting the sale of large sugary drinks and reducing the calories of food served in restaurants. Similar approaches are being tried globally. Mexican president Enrique Peña Nieto, for example, proposed a tax on the sale of all sugary drinks to discourage their consumption. Bloomberg provided financial support for Mexico’s National Institute of Public Health to promote policies such as taxing soft drinks, controlling junk food advertising targeted at children, and improving nutrition labeling. Global fast food companies such as McDonald’s, KFC, Taco Bell, and Pizza Hut are under increasing pressure to serve more nutritious and healthy food.

Governments in Europe, Australia, the United States, Canada, and elsewhere have implemented policies that restrict smoking in public places. Australia has led the world by requiring cigarette companies to place gruesome images of people who have been harmed or disfigured by tobacco on plain dark brown cigarette packages. Similarly, Uruguay requires tobacco companies to cover 80 percent of their cigarette packages with graphic pictures showing detrimental health consequences of smoking. The Centers for Disease Control and Prevention (CDC) has an advertising campaign that shows graphic images of people harmed by smoking. The World Health Organization (WHO), CDC, Johns Hopkins Bloomberg School of Public Health, World Lung Foundation, Campaign for Tobacco Free Kids, and several NGOs collaborate to reduce smoking.

The CDC’s Field Epidemiology Training Programs help health professionals deal with NCDs in Brazil, China, Colombia, Jordan, Tanzania, and Thailand. The emphasis is on prevention. A global organization that works to prevent and treat NCDs is the  NCD Alliance , a partnership of the World Heart Federation, International Diabetes Federation, Union for International Cancer Control, and International Union Against Tuberculosis and Lung Disease. Alzheimer’s Disease International is a global federation of Alzheimer’s associations that support people with Alzheimer’s disease. Its goal is to make dementia a global health priority.  Bupa  is a leading health care group that focuses on dementia care and treatment. The  Global CEO Initiative on Alzheimer’s Disease  is an organization of private sector leaders who partner with public leaders to provide treatment and care for patients with Alzheimer’s disease and to support research to find a cure for the disease.

13.2: Globalization of Infectious Diseases

1. 13.2 Evaluate the role of global travel and trade in facilitating the globalization of infectious diseases

The rapid spread of globalization underscored links between infectious diseases in poor countries and

Table 13.1 Deaths from Noncommunicable Diseases (NCDs) by Country, 2012

In 2012, a total of 68 percent of global deaths were due to noncommunicable diseases.

Adapted from Global Health Observatory (GHO) data on deaths from NCDs, published in 2014 by the World Health Organization,  www.who.int/gho/ncd/mortality_morbidity/ncd_total/en/  (retrieved May 2, 2015).

Top 10 Countries for NCD Deaths	NCD deaths per 100,000 population, both sexes
Turkmenistan	1,025
Guyana	1,024
Mongolia	967
Sierra Leone	964
Kazakhstan	950
Mali	866
Armenia	848
Afghanistan	846
Uzbekistan	811
Fiji	804
United States	413
Bottom 10 Countries for NCD Deaths	NCD deaths per 100,000
Spain	323
Luxembourg	318
France	313
Israel	311
Italy	304
Australia	303
Republic of Korea	302
Switzerland	292
Singapore	265
Japan	244

outbreaks of these diseases in rich countries. The most dramatic development was the discovery of HIV/AIDS in the United States, Western Europe, and other rich countries. Although perceived initially as a disease limited primarily to homosexuals, HIV/AIDS began to spread to the general population through blood transfusions, intravenous drug usage, and heterosexual practices. Furthermore, prominent people who were suffering from the disease fought to put it on both domestic and global agendas. Many of the diseases that were believed to have been eradicated in rich countries re-emerged and were placed on the global agenda. Two factors explain this re-emergence: (1) growing resistance to common antibiotics and (2) the devastating impact of new epidemics. The new epidemics included cholera in Latin America, particularly in Peru and Haiti; plague in India; the Ebola virus in Africa; and the West Nile virus in the United States.

13.2.1: Global Travel and Communications

Human beings are the most efficient transmitters of diseases. In the past, large proportions of populations were killed by plagues as people traveled to distant places. The Plague of Justinian, which occurred around 541 CE, devastated Europe. In the twelfth and thirteenth centuries, the bubonic plague, known as the Black Death, killed twenty-five million (or one of every three) Europeans. The decimation of Native American populations by European diseases is another example of how travelers spread infectious diseases. More recently, China and other Asian countries have spawned deadly infectious diseases that have spread quickly to the rest of the world because of travel and excellent global links. In 1968, the Hong Kong flu, originating in South China, spread from Hong Kong to other countries. About seven hundred thousand people died worldwide. Following a devastating earthquake in 2010, Haiti faced an outbreak of cholera that killed more than eight thousand people. UN peacekeepers from Nepal brought the deadly cholera strain to Haiti.

Trade also has been a major facilitator in the globalization of infectious diseases. The bubonic plague (Black Death) was transmitted to Europe through trade with Asia. Today, the rapid expansion of trade with China exposes the world to many diseases. The global trade in agricultural products has also escalated the risk of the global transmission of diseases. Human activities have profoundly affected the natural environment. People have migrated to areas that bring them into contact with animals and soils that play a role in the spread of infectious diseases. Furthermore, gradual increases in the Earth’s temperature (i.e., global warming) are conducive to the global spread of diseases.

Conflicts have always contributed to the outbreak of disease and often the spread of infectious diseases. Combatants are often more likely to die from infectious diseases than from actual fighting. It is estimated that more than two-thirds of the roughly six hundred thousand deaths in the American Civil War were caused by infectious diseases. 7  Furthermore, the movement of troops and mass migrations of civilians as a consequence of war have contributed to the wider transmission of infectious diseases. During the Spanish flu pandemic of 1918–1920, many American soldiers who were transported on trains and troop ships perished. On the battlefields of Vietnam and Iraq, American troops suffered from infectious diseases, many of which are drug resistant. Endemic ethnic conflicts in Africa play a leading role in that continent’s struggle with infectious diseases.

Conditions that influence people to leave one area to settle in another initiate the downward spiral leading to infectious diseases. The deterioration of health services, the destruction of infrastructure, food shortages, and the lack of proper sanitation make refugees susceptible to communicable diseases. The poorest countries, like poor individuals, are generally more vulnerable to contracting infectious diseases. Poverty is usually a reliable incubator of disease. Overcrowding, malnutrition, inadequate medical care, and unsanitary conditions facilitate the growth and transmission of infectious diseases.

A growing problem that assists in the spread of infectious diseases is overuse and misuse of antibiotics. The increasing use of antibiotics in agricultural products has contributed to a process of  pathogenic natural selection , which promotes the emergence of more virulent, resilient, resistant, and powerful disease strains. The spread of infectious diseases has focused attention on human security.

13.3: Human Security and Infectious Diseases

1. 13.3 Outline the three developments that gave rise to the concept of human security

As we discussed in  Chapter 1 , the forces of globalization have strengthened the concept and reality of  global security , which stresses a common and comprehensive security. The concept of global security moves us beyond the narrow traditional view of national security with its emphasis on military force and war to emphasize the global dimensions of emerging threats and problems and the need to achieve security with others. Within the broader context of global security is the concept of  human security , derived from the globalist school of thought. Human security focuses on the individual as the primary object of security. It embraces a people-centered approach of anticipating and coping with the multiple threats ordinary individuals face in an increasingly globalized society. The emergence of the concept of human security during the 1990s is attributed to three developments: (1) the end of the Cold War, which radically altered the global political and security environment; (2) a better understanding of the everyday insecurities experienced by the world’s poor, who comprise the vast majority of the world’s population; and (3) the process of globalization, which ushered in unprecedented changes and uncertainty, thereby influencing a reevaluation of traditional views of security.

13.4: Infectious Diseases

1. 13.4 Describe the three epidemiologic transitions to better understand contemporary concerns about infectious diseases

The microbes (such as bacteria), viruses, parasites, and fungi that are the agents of infectious diseases are integral components of the natural and human environments. Throughout recorded history, our ancestors have been extremely vulnerable to, and mostly defenseless against, infectious diseases.  Pathogens  (i.e., organisms capable of causing disease) have routinely demolished societies. In many cases, there are outbreaks of diseases; that is, essentially localized, endemic occurrences. When infectious diseases spread to a relatively large number of people, they are classified as  epidemics . Although epidemics generally impact populations worldwide,  pandemics  are long-lasting, catastrophic, and truly global in their consequences. Two factors that have always been at the root of infectious disease threats to human populations are (1) social, economic, and environmental conditions that enable infectious diseases to exist among human hosts and (2) various means of transmission to new populations. As our ancestors developed agriculture and moved from isolated villages to more densely populated areas, they were exposed to more diseases. 8  Altering the natural environment enables microbes to infect humans. Humans are infected when they come into contact with natural  hosts  (i.e., organisms that carry diseases). The hosts are not negatively affected by the disease. Transmission of infectious diseases can occur within a single species or from one species to another. Humans often infect other humans. But host animals also infect humans, a transmission known as  zoonosis . Infectious diseases are transmitted through air, water, direct contact with the host’s bodily fluids, and sexual activity, as well as through vectors such as mosquitoes and other insects.

To better understand contemporary concerns about infectious diseases, we will discuss the problem within the framework of epidemiologic transition theory. Each transition is characterized by “a unique pattern of diseases that is ultimately related to modes of subsistence and social structure.” 9  There are basically three distinct epidemiologic transitions. The  first epidemiologic transition , as we mentioned earlier, occurred when our ancestors established agricultural communities. Think about sanitation problems in permanently settled areas and the close interaction of humans and their domesticated animals. Both of these situations provided favorable environments for the dispersal of infectious diseases. Cattle, goats, sheep, pigs, and fowl transmitted tuberculosis, anthrax, and other diseases. Large proportions of populations were routinely killed by plagues, especially as trade among communities increased and people traveled to distant places. An example of an early pandemic is the  Plague of Justinian , named after the Roman emperor, which devastated Europe around 541 CE. Increased trade and migration between Asia and Europe and the Medieval Warm Period of the twelfth and thirteenth centuries contributed to the proliferation of rats and fleas that transmitted bubonic plague. Believing that cats were witches, Europeans inadvertently helped spread the plague by killing cats. Known as the  Black Death , the bubonic plague killed roughly twenty-five million people, or one of every three Europeans. Individuals who manage to survive infectious diseases acquire immunity to them but can still transmit them to others. For example, most Europeans survived diseases such as tuberculosis and smallpox. West Africans lived with malaria and yellow fever. However, groups that lived in isolation from Europeans or Africans became quickly infected with their diseases when they came into contact with them. Millions of Native Americans were killed by diseases brought to the Americas by Europeans. 10  Many Europeans died of malaria and yellow fever in Africa, Asia, and the Americas.

Poverty and Migration help Spread Diseases Globally. A woman searches through trash in Mumbai, India.

The  second epidemiologic transition  coincided with the Industrial Revolution in Europe. Various inventions that accompanied the Industrial Revolution contributed to declining rates of infectious diseases. But overcrowding, environmental degradation, and unsanitary conditions led to the rebounding of cholera, smallpox, and tuberculosis. Developments in medical science and technology diminished epidemics not only in Europe but also in places affected by European migration, colonization, and commercial relations. We are now experiencing the  third epidemiologic transition . Just in the past three decades, we have seen an unprecedented emergence of new diseases and a re-emergence of infectious diseases that were thought to have been eliminated.

3.5: Influenza and Avian Flu

1. 13.5 Report the cause, spread, effects, and control measures of influenza and avian flu

Of all the major infectious diseases, influenza demands the unique and urgent attention of the global community because of its lethality and the speed with which it is transmitted. Of the more than fifteen hundred microbes known to cause disease in humans, influenza continues to dominate in terms of overall mortality. Every year, 5 to 10 percent of the American population gets the flu, and about 36,000 of them die. Even in normal times, an estimated 1.5 million people worldwide die from influenza infections or related complications each year.  Influenza , which is a viral infection of the respiratory tract, is very contagious and poses serious threats to children, the elderly, and individuals with compromised immune systems. It is estimated that three influenza pandemics in the twentieth century killed more than 50 million people. The  Spanish flu  pandemic of 1918–1920 is generally regarded as the most lethal plague in history, causing roughly 50 million deaths worldwide. Pandemics in 1957 and 1968, which originated in China and Hong Kong, together killed more than 2.5 million people. Given the efficiency with which flu is transmitted through air, close contact is not required for people to become infected. Furthermore, it is very difficult to identify and quarantine infected people who are spreading the disease.

Throughout the world, large commercial poultry farms, as well as the proliferation of chickens kept by families, have provided ideal conditions for the avian flu to spread. Furthermore, rapid population growth, especially in Asia, has given rise to densely populated urban areas. For example, during the 1968–1969 influenza pandemic, China had 790 million people and 12.3 million chickens and other poultry. China now has 1.3 billion people and more than 13 billion chickens. Poultry, pigs, and people living together or in close proximity enhance the transmission of avian flu from animals to humans. Although the avian flu (HSN1) caused 88 deaths out of a total of 165 cases globally, transmission from human to human had not occurred. The global community feared that the virus would undergo changes enabling it to  reassort  (i.e., mix genes with other human influenza viruses that are also present). This process can produce an entirely new viral strain, one that is capable of sustained human-to-human transmission.

Responding to the threat of a pandemic, governments, international organizations, and nongovernmental organizations (NGOs) concentrated on quarantine and the extensive culling of birds in affected areas. European countries were advised by the Animal Production and Health Division of the UN Food and Agriculture Organization to require travelers to fill out forms detailing their travel history and the agricultural products in their possession, which is the practice in the United States. Increased checks of airline passengers and their belongings were also regarded as effective countermeasures. Within rich countries, governments allocated resources to develop vaccines, primarily  Tamiflu , to deal with a pandemic.

13.6: Malaria

1. 13.6 Report the cause, spread, effects, and control measures of malaria

Malaria is found primarily in the tropics and is transmitted by mosquitoes. It is the most common vector-borne disease. The spread of human settlements and various activities in forested areas have led to increased contact with mosquitoes that carry the viruses that cause this disease. Global transportation and global warming have enabled malaria to spread and grow outside tropical areas. Discarded tires, bottles, cans, and other containers that collect water become fertile breeding grounds for mosquitoes. Humans contract malaria when bitten by female mosquitoes. Malarial parasites infect red blood cells, causing chills, fever, and often death. Of the estimated 300 million to 500 million people infected with malaria each year, roughly 1.5 million die from the disease.

Globally, Africa suffers the most from malaria. More than 90 percent of malaria deaths occur there, despite the relative ease with which the disease can be prevented and cured. In many ways, the prevalence of malaria in Africa is a manifestation of that continent’s endemic poverty. Malaria was once believed to be caused by swamp air. The role that mosquitoes play in transmitting the disease was not discovered until 1898. Several factors have contributed to the increase of malaria in different parts of the world. As population pressures have influenced farmers to cultivate areas bordering on swamps and as agroforestry has grown, mosquitoes have multiplied and have more opportunities to infect humans. The construction of dams and irrigation systems for agriculture has radically altered the natural environment and provided breeding places for mosquitoes. Natural disasters such as earthquakes often destroy sanitation facilities, cause severe flooding, and allow standing water to accumulate in which mosquitoes breed. Finally, global warming is widely believed to be responsible for increased rainfall and higher temperatures, which can result in flooding. These environmental conditions facilitate the spread of malaria.

Efforts to eradicate malaria began in 1898. In addition to draining swamps and removing standing water from around homes, insecticides and larvicides were used. Quinine was also used to treat infections. A major breakthrough in fighting malaria came after World War II when DDT was applied. DDT was first used in 1939 as an agricultural insecticide in Switzerland. However, it was during the war that its public health applications were discovered. The Allies used DDT to control typhus epidemics. Complete eradication of malaria was achieved in places such as the United States, southern Europe, Sri Lanka, and much of Brazil by massive DDT spraying. Success in reducing malaria problems influenced the World Health Organization (WHO) to initiate its  Global Malaria Campaign  in 1955 to intensify the use of DDT to control malaria. However, by the 1960s, malaria began to re-emerge in countries that had made significant progress in eliminating it because many countries were unable to continue the highly organized and costly spray program essential for success. Furthermore, widespread use of DDT engendered resistance to it at a time when more people were becoming aware of its danger to human health and the environment. As we discussed in  Chapter 10 , the toxicity of pesticides was stressed by Rachel Carson in her influential book Silent Spring. The WHO adopted a more comprehensive approach that included strengthening basic health services, focusing on the unique social and economic conditions in each region, and concentrating on treating patients with malaria. Known as the  horizontal approach , this new strategy emphasized control and containment, as opposed to complete eradication.

Rotarians worldwide have made eradicating malaria a major goal. The emphasis on bed nets was influenced by the growing ineffectiveness and health hazards of other approaches, such as indoor spraying and the use of chloroquine. Other organizations, such as the UN Children’s Fund (UNICEF), play a leading role in providing bed nets. An insecticide-treated bed net costs around $3. These bed nets are heavily subsidized or given away. A special initiative to eradicate malaria was launched in Zambia. Using $35 million donated by the  Bill and Melinda Gates Foundation , Zambia’s objective is to provide bed nets to 80 percent of its population. An additional $82 million was donated by international organizations and governments to supply the most effective malaria drugs to every public clinic and to pay for coordinated spraying programs across Zambia. Death rates from malaria have declined by around 60 percent in Zambia. In 2015, there was a significant breakthrough in efforts to control malaria. Clinical trials on the vaccine RTS,S prevented malaria in roughly one-third of the children receiving it. The vaccine’s efficacy would be increased when it is used along with other interventions such as bed nets. RTS,S was developed over two decades through a unique cooperative endeavor of organizations, including the Bill and Melinda Gates Foundation and the pharmaceutical company GlaxoSmithKline. 11

13.7: HIV/AIDS

1. 13.7 Recognize the causes and preventive measures of HIV

When AIDS was first recognized in 1981, the general assumption was that this deadly disease was essentially limited to homosexuals and West Africans. Today, however,  HIV/AIDS  has become a pandemic. More than thirty-three million people worldwide, 60 percent of them women, are infected. Roughly two million people die every year from AIDS. Although Africa remains the epicenter of the AIDS pandemic, home to roughly 70 percent of the people in the world who are living with HIV and experiencing 72 percent of the world’s AIDS-related deaths, the disease is rapidly growing in China, India, Russia, Latin America and the Caribbean, Eastern and Central Europe, and elsewhere. It is generally accepted that HIV evolved from the  simian immunodeficiency virus  (SIV) found in chimpanzees in southwestern Africa. It is believed that individuals acquired the disease from exposure to blood in the process of handling the meat of a chimpanzee that carried the virus. Compared with other infectious diseases, HIV/AIDS—while devastating—is transmitted in very specific ways and is thus more controllable. The virus is passed from one individual to another through the exchange of bodily fluids during sexual intercourse, through blood transfusions, from mother to fetus, through intravenous drug use, and through other activities in which infected blood is transmitted from one person to another. Early symptoms of HIV infection include chronic fatigue or weakness, noticeable and sustained weight loss, extensive and persistent swelling of the lymph glands, routine diarrhea, and sustained deterioration of the central nervous system.

Globalization is a major factor contributing to the spread of HIV/AIDS. As global tourism continues to grow and people venture to all corners of the world, they increase their risk of contracting infectious diseases.  Sex tourism , which involves traveling to specific countries to participate in the local sex industry, is a potent source of infectious diseases, especially HIV/AIDS. Furthermore,

Africa is at the Epicenter of the Aids Pandemic, but the Disease is Growing Around the Globe. Nurses distribute free condoms during an AIDS awareness event on a street in China.

as we discussed in  Chapter12 , the growth in human trafficking and the sex trade in many parts of the world helps spread HIV/AIDS. Poverty, ethnic conflicts, and wars facilitate the transmission of HIV/AIDS.

13.7.1: Global Responses to AIDS

Condom usage is a relatively inexpensive and effective approach to reducing the risk of infection and transmission of HIV. Governments, NGOs, and international organizations support condom distribution programs, although this practice remains controversial for some groups that stress abstinence. Given the reality of increased human sexuality, using condoms will undoubtedly be the dominant and practical approach to fighting HIV/AIDS. Thailand provides an example of how governments have integrated condom usage into an overall strategy to impede the spread of the disease. Thailand began mandatory HIV testing of high-risk individuals, such as homosexuals, commercial sex workers, and intravenous drug users. It also implemented the  100 Percent Condom Program . The principal objectives of the program are to protect 100 percent of commercial sex acts through mandatory condom usage in brothels and to diminish the commercial sex trade through sustained educational efforts. Free condoms are distributed to sex workers, who are instructed to use them or face several penalties. The commercial sex business is closely monitored by the government to ensure compliance.

Medical advances and a deeper understanding of HIV/AIDS—in addition to the fact that the disease was concentrated among high-risk groups—enabled rich countries to make significant progress in decreasing the transmission of the virus. Antiretroviral drug therapies, though expensive, allowed many patients with HIV/AIDS to continue living relatively normal lives. Deaths from the disease have declined in most developed countries, although both HIV/AIDS and mortality rates have increased among the poor in these societies, especially among African Americans. Despite opposition by pharmaceutical companies concerned about intellectual property rights, Brazil, Argentina, Costa Rica, Cuba, and Uruguay took the unprecedented approach of providing government-subsidized antiretroviral medications to patients with HIV/AIDS, thereby setting global precedents for widespread access to AIDS medications. Brazil, in particular, has made it legal for government laboratories to ignore drug patents in order to produce low-cost generic drugs to stop the spread of the disease. As we discussed in  Chapter 12 , Holland and Australia have implemented policies to reduce the spread of HIV/AIDS by providing supplies of clean needles and treatment for drug addicts.

Although the United States has been involved in the global efforts to reduce HIV infections, a significant change in U.S. policy was initiated by Franklin Graham, founder of  Samaritan’s Purse , an evangelical charity based in South Carolina. Bringing together evangelical Protestants and Catholic leaders, as well as overseas missionaries who worked in countries devastated by HIV/AIDS, Graham focused national attention on the problem. Perceptions of the disease as affecting primarily heterosexuals, as opposed to only homosexuals, enabled many conservatives to take action instead of disregarding the pandemic because they believed it was God’s punishment of homosexuals. President George W. Bush, influenced by Graham and the evangelicals, announced the Emergency Plan for AIDS Relief and committed $25 billion over five years to preventing HIV infections and treating patients. 12  However, political pressure from conservatives influenced the U.S. government to allocate a third of the money to abstinence-promoting programs and to avoid spending money on sterile syringes and needles for intravenous drug users. Essentially, the U.S. government adopted Uganda’s  ABC (Abstinence, Be Faithful, and Use Condoms) program , which helped significantly reduce the prevalence of HIV/AIDS in that country. The William J. Clinton Presidential Foundation HIV/AIDS Initiative concluded an agreement with generic drug manufacturers to lower the price of triple combination antiretroviral drug regimens to less than $140 per patient per year. The Clinton Foundation has concentrated its efforts against HIV/AIDS in Mozambique, Rwanda, Tanzania, South Africa, and several Caribbean states.

The WHO and U.S. government agencies—including the Food and Drug Administration (FDA) and the Alcohol, Drug Abuse, and Mental Health Administration—convened the First International AIDS Conference in Atlanta, Georgia, in 1984. This was followed by the initiation of the WHO’s Special Program on HIV/AIDS in 1985, which set the objective of reducing the growth of HIV/AIDS globally and to lessen the disease’s impact on the countries most seriously affected. Concerned about HIV/AIDS patients’ inability to afford drugs to treat the disease, members of the World Trade Organization (WTO) ratified the  Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS)  in 1994. TRIPS included a provision to allow states to waive patent protections without authorization from the patent holder in national emergencies for noncommercial use. A major breakthrough in the fight against the pandemic came in 1996 when the  Joint United Nations Program on AIDS (UNAIDS)  was founded. UNAIDS’s main objective is to be the leading advocate for global action against HIV/AIDS. Several organizations, reflecting UNAIDS’s comprehensive approach to the problem, participate in the program. These include UNICEF; the UN Development Program; the UN Population Fund; the UN Educational, Scientific, and Cultural Organization (UNESCO); the World Bank; the UN Office on Drugs and Crime; and the International Labor Organization. These organizations have been joined by the eight leading industrial countries (known as the G-8), various NGOs, and pharmaceutical companies (such as Boehringer Ingelheim, Bristol-Myers Squibb, GlaxoSmithKline, Merck, and F. Hoffmann-LaRoche). Pharmaceutical companies discounted their antiretroviral medications and allowed countries to manufacture drugs inexpensively for patients in poor countries. In 2014, the twentieth International AIDS Conference was held in Melbourne, Australia. AIDS experts noted that HIV rates were at a twenty-year high, with most cases in Africa. However, the experts were optimistic that with adequate funding from the global community for further research, an AIDS-free world is within reach.

13.8: SARS

1. 13.8 Report the origin, spread, effects, and control measures of SARS

SARS emerged in China’s Guangdong Province in late 2002. The virus that caused SARS was transmitted from the civet cat to individuals handling and consuming the animal’s meat. This highly contagious disease is spread when individuals come into contact with droplets from an infected person’s coughing or sneezing. The symptoms of SARS are high fever, chills, muscle aches, and a dry cough. The vast majority of individuals infected with SARS improve without having to undergo extensive medical treatment. However, between 10 and 20 percent of those who contract the disease require breathing assistance from a mechanical ventilator for an extended period of time. Many of them eventually die.

The transmission of the disease globally began when twelve guests in the Metropole Hotel in Hong Kong contracted it from an infected physician from Zhongshan University. Unaware that they were infected, these guests carried the disease to Singapore, Vietnam, Canada, Ireland, and the United States. More than eight hundred cases of SARS worldwide are believed to have originated with this one  superspreader . Global communications helped spread the most recent information about SARS, thereby heightening global awareness of the deadly virus and generating pressure on governments, especially that of China, to take action to prevent its spread globally. Global communications also enabled the scientific community to engage in unprecedented cooperation to control the virus.

Governments responded quickly. Vietnam—which had the first documented case of SARS, even though SARS originated in southern China—implemented detection and prevention measures immediately. These included (1) prompt identification of people with SARS, their movements, and their contacts; (2) appropriate protection of medical personnel treating these patients; (3) isolation of suspected SARS cases; (4) exit screening of international travelers; and (5) timely and accurate reporting and sharing information with others. 13  Canada, the United States, and other countries took similar actions. The WHO also responded promptly by sending investigative teams to Guangdong, the first Chinese city to experience SARS. Also, WHO personnel visited Beijing and pressured government officials to give an accurate assessment of the SARS problem and to improve its reporting system. Roughly sixty teams of public health officials and experts were recruited from the United States, Britain, Germany, France, and other countries to assist with efforts to control the spread of infections in areas affected by SARS. Several factors contributed to this rapid global response. First, the disease was greatly feared, partly in light of the threat of biological weapons. Public health officials did not want to repeat the slow global response that had allowed HIV/AIDS to grow. WHO leadership plus the success of medical researchers resulted in solutions to the disease.The global response to SARS marks a radical departure from earlier responses to infectious diseases and has become a model for dealing with potential pandemics.

13.9: EBOLA

1. 13.9 Report the origin, spread, effects, and control measures of Ebola

The outbreak of Ebola in Guinea and its spread to the neighboring countries of Liberia and Sierra Leone was declared a global emergency by the WHO in 2014. Ebola has killed more than eleven thousand known victims. Although these three countries became the epicenter of the Ebola epidemic, the disease also spread to Nigeria. Discovered in 1976 in the Democratic Republic of Congo, near the Ebola River, Ebola is one of the world’s deadliest viruses, with fatality rates as high as 90 percent in some communities. Ebola comes into the human community via fruit bats, a delicacy in Central and West Africa, and by people consuming the meat of wild animals infected by these bats. Ebola causes vomiting, diarrhea, and hemorrhagic fever that induces bleeding. It is highly contagious among humans and is transmitted by exposure to bodily fluids of those infected, including corpses that are being buried. Although experimental drugs have been given to some patients with Ebola, there is no cure for Ebola. It is contained by quarantining infected individuals and monitoring those who have been in close contact with them, particularly family members and caregivers.

Sierra Leone, Liberia, and Nigeria declared national emergencies to limit the spread of Ebola. These West African countries implemented prevention measures that included restricting travel and quarantining some communities. Several airlines terminated flights to the affected countries, the United States withdrew Peace Corps volunteers from West Africa, and several companies and organizations reduced operations and allowed employees to leave. The WHO responded by allocating $100 million to stop transmission of Ebola by improving surveillance of the virus, protecting health care workers, and helping individuals understand how to avoid being infected. The World Bank and the African Development Bank disbursed $260 million to Guinea, Liberia, and Sierra Leone to strengthen their very weak health care systems. Johnson & Johnson and GlaxoSmithKline agreed to cooperate to develop an Ebola vaccine and to produce millions of doses quickly. The European Union contributed $250 million to develop new Ebola vaccines, drugs, and diagnostic tests.

13.10: Global Responses to Infectious Diseases

1. 13.10 Outline role of the WHO in preventing the spread of infectious diseases

As early as 1851, European countries convened the  International Sanitation Conference  in an effort to prevent the spread of infectious diseases from developing countries to Europe, primarily through travel and trade. Significant improvements in sanitation, nutrition, and medical technology in Europe have reduced outbreaks of infectious diseases. But Europe remained vulnerable to the importation of diseases. Shortly after the United Nations was founded, the WHO was created as a specialized agency to develop international rules concerning infectious disease control. Under the International Health Regulations developed by WHO, countries are required to report outbreaks of yellow fever, cholera, plague, and other diseases. This information is disseminated to other countries, and surveillance strategies are implemented to help prevent transmission. Countries are also required to provide safe drinking water, food, and disposal of refuse, wastewater, and other things dangerous to health at their airports and ports. The International Health Regulations also require countries to provide health services, equipment, and services for isolating infected persons and for disinfecting, disinsecting, and deratting ships and aircraft. The U.S.  Centers for Disease Control and Prevention (CDC) , based in Atlanta, Georgia, also plays a leading role in preventing and controlling the transmission of infectious diseases into the United States. Both the CDC and WHO emphasize the importance of research and the development of medicines to prevent the emergence and spread of infectious diseases.

As we have seen, an important component of the global response to the emergence and re-emergence of infectious diseases is stressing preventive measures. These include protecting and chlorinating water supplies, disposing of human feces in a sanitary manner and maintaining fly-proof latrines, paying special attention to cleanliness in food preparation and food handling, stressing the importance of frequent hand washing, and eliminating potential mosquito breeding sites. Routine preventive immunization programs have effectively reduced outbreaks of many infectious diseases.

Case Study Obesity: A Global Epidemic

Obesity is now a global epidemic. Obesity and overweight are generally defined as excessive fat accumulation that has serious health consequences. Obesity and overweight are the fifth leading cause of death globally. The World Health Organization (WHO) has warned that obesity puts populations at risk for developing noncommunicable diseases (NCDs), which have been declared a global epidemic. Obesity is an underlying cause of infertility in women and impotence in men. Globally, obesity rates have doubled since 1980. More than 1.5 billion adults and 43 million children, mostly in the developing world, are obese or overweight. More women are obese or overweight than men worldwide. With the exception of Mexico, rich countries have the highest percentage of obese and overweight persons. Mexico leads the overall list, with almost one-third of its population obese or overweight. America is a close second, with 24 percent, followed by Britain with 23 percent, Slovakia with 22.4 percent, Greece with 22 percent, and Australia with 21.7 percent.

There are many causes of obesity and overweight. As part of our ancestors’ evolutionary adaptation to food scarcity, human beings store calories when food is available. A gestating mother’s environment directly influences her children’s weight in later life. Children born to parents who did not have adequate diets during pregnancy tend to have higher rates of obesity. The children of starving mothers, anticipating starvation during their own lives, tend to hoard calories. As food remains abundant, they tend to overeat and gain weight. Brighter lights contribute to obesity by confusing the body’s biological clock, which signals when we should eat and sleep. Contemporary lifestyles deprive many individuals of adequate sleep, and an increasing amount of time is spent watching television and on the computer.

Cultural globalization, increased food supplies, declining population growth rates, and urbanization are major causes of obesity. Cultural globalization has led to the homogenization of lifestyles, diets, and an automobile culture globally. The hectic pace of life influences people to eat fast foods that have lots of sugar, fat, and salt. Overcrowding and crime in urban areas contribute to a decline in exercise. The availability of high-calorie snacks and soft drinks guarantee the growth of the obesity epidemic.

Solutions to obesity and overweight are well known, though difficult to achieve in a world with constant advertising and global competition among food companies for market share. While individuals are ultimately responsible for their behavior, losing weight requires support from families and communities. Food consumption is an essential component of culture. Consequently, greater efforts must be made at a societal level to promote proper nutrition and smaller food portions. Global and local food companies could help by reducing the fat and sugar content of food and be more responsible in marketing products to children. By decreasing sedentary activities and increasing exercise as part of a daily routine, individuals can gradually help reduce obesity and overweight. Wellness programs in workplaces, hiking and walking trails, and communities designed to encourage walking and biking instead of driving could make a difference. Finally, working with children to make them aware of the benefits of proper nutrition and physical activity will slow the growth of the obesity and overweight epidemic.

Summary

This chapter focuses on the impact of NCDs: the causes of NCDs, major NCDs (such as cancer, heart disease, diabetes, and Alzheimer’s disease), and global responses to NCDs. It also examines the globalization of infectious diseases; rapid increases in global travel, trade, and migration; growing use of illegal drugs; human trafficking for sexual purposes; rapid population growth; environmental changes; widespread poverty; and inadequate medical resources—all factors that have facilitated the global spread of infectious diseases. These diseases pose significant threats to humans as well as to global security. By discussing infectious diseases—such as influenza, avian flu, malaria, HIV/AIDS, and SARS—we were able to see the social, economic, and political challenges these diseases pose and the ease with which they are spread globally. We discussed various responses to the globalization of infectious diseases. The case of SARS demonstrates that rapid transportation and instantaneous communications have raised global awareness of how quickly infectious diseases are transmitted worldwide. The global response to SARS is widely regarded as a model for how to deal with emerging as well as current infectious diseases. Some organizations, such as the WHO, play a pivotal role in reducing the expansion of infectious diseases. NGOs as well as individuals are also actively involved in fighting pandemics. However, many governments have inadequate resources to deal with NCDs and infectious diseases. Furthermore, countries have different priorities. Cultural values and practices also complicate global efforts to prevent the emergence and spread of diseases. This chapter discusses the newly identified epidemics of obesity and noncommunicable diseases (NCDs), which are related to each other. Global organizations are targeting these preventable diseases that cause 63 percent of all deaths and increase poverty worldwide.

Discussion Questions

1. Discuss the causes and effects of the global obesity epidemic. How does obesity relate to the global epidemic of noncommunicable diseases (NCDs)?

2. Discuss the role of the WHO in preventing the spread of infectious diseases.

3. Discuss the factors that facilitate the spread of HIV/AIDS and various efforts to deal with this pandemic.

4. Discuss the leading causes of noncommunicable diseases.

5. Discuss how conflicts, global warming, and poverty contribute to the emergence and spread of infectious diseases.