ARR

ALISON M. JAGGAR

VULNERABLE WOMEN AND NEO-LIBERAL GLOBALIZATION: DEBT BURDENS UNDERMINE WOMEN’S HEALTH IN THE

GLOBAL SOUTH

ABSTRACT. Contemporary processes of globalization have been accompanied by a serious deterioration in the health of many women across the world. Particularly disturbing is the drastic decline in the health status of many women in the global South, as well as some women in the global North. This paper argues that the health vulnerability of women in the global South is inseparable from their political and economic vulnerability. More specifically, it links the deteriorating health of many Southern women with the neo-liberal economic policies that characterize contemporary economic globalization and argues that this structure is sustained by the heavy burden of debt repayments imposed on many Southern countries. In conclusion, it argues that many Southern debt obligations are not morally binding because they are not democratically legitimate.

KEY WORDS: debt cancellation, gender inequality, neoliberalism, women’s health

WHAT IS NEO-LIBERAL GLOBALIZATION?

Interpreted broadly, the term “globalization” refers to any system of transcontinental travel and trade.1 In this broad sense, globalization has always existed; after all, the fore-parents of every one of us walked origin- ally out of Africa. However, contemporary globalization is distinguished by its integration of many local and national economies into a single global market, regulated by the World Trade Organization. This treaty organi- zation was established in 1995 to determine the rules for global trade. WTO rules supersede the national law of any signatory nation and are rationalized by a distinctive version of liberal political theory, namely, neo-liberalism.

Although its name suggests that it is something novel, “neo-liberalism” in fact marks a retreat from the liberal social democracy of the years following World War II. It moves back toward the non-redistributive laissez faire liberalism of the seventeenth and eighteenth centuries, which held that the main function of government was to make the world safe and predictable for the participants in a market economy. Following are some main tenets of contemporary neo-liberalism.

Theoretical Medicine 23: 425–440, 2002. © 2002 Kluwer Academic Publishers. Printed in the Netherlands.

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“Free” trade

Neo-liberalism promotes the free flow of both traded goods and of capital. However, not only does it not require the free flow of labour, the third crucial factor of production, but it also seeks actively to control that flow.2

Although immigration from poorer to wealthier countries is currently at record levels, much of it is achieved in the teeth of draconian border controls that often cost would-be immigrants their lives.

Opposition to government regulation

Neo-liberalism opposes government regulation of such aspects of produc- tion as wages, working conditions and environmental protections. Indeed, legislation intended to protect workers, consumers or the environment may be challenged as an unfair barrier to trade. In the neo-liberal global market, weak labor, consumer or environmental standards may well become part of a country’s “competitive advantage.”

Refusal of responsibility for social welfare

Neo-liberalism presses governments to abandon the social welfare responsibilities that they have assumed over the twentieth century, such as providing allowances for housing, health care, education, disability and unemployment. Social programs, such as the Canadian health-care system, may even be challenged as de-facto government subsidies to industry.3

Resource privatization

The final feature of contemporary neo-liberalism is its push to bring all economically exploitable resources into private ownership. Public services are turned into profit-making enterprises, sometimes sold to foreign investors, and natural resources such as minerals, forests, water and land are opened up for commercial exploitation in the global market.

Many people have come to equate “globalization” with neo-liberalism and they regard the costs of this system as inevitable consequences of modernization and progress. This equation discourages attempts to ques- tion the justice of neo-liberal globalization or to envision alternatives to it. The present paper sketches some consequences of this system for women’s health and offers some reasons for questioning its democratic legitimacy.

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GLOBAL NEO-LIBERALISM IS BAD FOR (MOST) WOMEN’S HEALTH

The consequences of neo-liberal globalization have been almost entirely good for some people, almost entirely bad for others, and mixed for many more. Those who have reaped most of globalization’s rewards have tended to belong to the more privileged classes in the global North or to elite classes in the global South.4 Those who have been harmed overall by neo-liberal globalization have usually been people who were already poor and marginalized, in both the developing and the developed worlds. Since women are represented disproportionately among the world’s poor and marginalized, neo-liberal globalization has been harmful especially to women – although not to all or only women. This section sketches a few of the ways in which the various features of global neo-liberalism, mentioned above, have tended to worsen the health of many women in the global South relative to more privileged women, to many men of their own social class, and even absolutely.

“Free” trade

The most obvious consequence of trade liberalization is that it has increased enormously the gap between the world’s rich and poor, so that this gap has now reached what the United Nations Human Development Report for 1999 called “grotesque” proportions. In 1960, the countries with the wealthiest fifth of the world’s people had per capita incomes 30 times that of the poorest fifth; by 1990, the ratio had doubled to 60 to one; by 1997, it stood at 74 to one. By 1997, the richest 20 percent had captured 86 percent of the world’s income while the poorest 20 percent captured a mere one percent [1:4].5 For many – perhaps most – poor people in the world, neo-liberal globalization has resulted in their material conditions of life deteriorating not only relative to the more affluent but also absolutely. The 1999 United Nations Human Development Report states that, for more than 80 countries, per capita incomes are lower than they were a decade ago; in sub-Saharan Africa and some other least developed countries, per capita incomes are lower than they were in 1970.

Economic inequality is increasing not only between the global North and South but also within them. In June 2000, for instance, the U.S. Federal Reserve reported that the net worth of the richest 1 percent of US house- holds rose from 30 percent of the nation’s wealth in 1992 to 34 percent in 1998. Meanwhile, the share of the national wealth held by the bottom 90 percent of U.S. households fell from 33 percent in 1992 to 31 percent in 1998 [2]. The Economic Policy Institute asserted that the median inflation-

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adjusted earnings of the average worker were 3.1 percent lower in 1997 than in 1989 and by the end of the nineties the poorest 20 percent of US citizens were making less in real terms than in 1977.6 Homelessness in the United States has reached unprecedented proportions, affecting even people with full time jobs.

In the global North, women, especially women of color, have been disproportionately impoverished by the movement of many hitherto well- paid jobs to low wage areas in the global South. In the North, these jobs have often been replaced by so-called “McJobs,” “casual,” contingency or part-time positions, often in the service sector, which are typically low- paid and lack health or retirement benefits. The reduction in the US real hourly wage since the 1970s affects all US low-paid workers, but it espe- cially affects women and, among women, especially women of colour, because they disproportionately hold those jobs. The US Census Bureau recently reported that the earnings gap between men and women widened for the second consecutive year in 1999.7

The feminization of poverty was a term coined originally to describe the situation of women in the United States but the United Nations reports that the feminization of poverty has now become a global and growing phenomenon, with women comprising 70 percent of the world’s 1.3 billion poor [3]. Even this statistic may understate the extent of women’s poverty, because it is based on the studies of consumption in female-headed compared to male-headed households and so ignores the fact that, within all families, women and girls are less likely to receive available resources such as food and medical care.8

Poverty affects women’s health in a myriad of ways. Poor nutrition associated with poverty directly creates special health problems for preg- nant and lactating women and has contributed to increasing maternal mortality in many poor countries. Because women are poorer, they are more vulnerable to the so-called diseases of poverty, such as TB, diph- theria, yellow fever, malaria, and cholera, all of which have increased in the 1990s [4]. Women’s impoverishment relative to men in their own countries affects their health indirectly as well as directly. For instance, when women are perceived as an economic drain on families, rather than as economic contributors to them, they and their daughters are less likely to receive available resources such as food and medical care. Moreover, impoverishment makes women more vulnerable to domestic violence, sexual harassment and rape.

Economic inequality among countries as well as within them also has negative consequences for women’s health. A steady “brain drain” of doctors, dentists, nurses and other trained medical workers, flows from

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the poor to the rich countries, to the detriment of patients in the poor countries. This phenomenon is quite evident in such first world countries as the United States and Great Britain.9 Sixty percent of Ghanaian doctors are said to practice abroad.

The AIDS epidemic is one of the most dramatic health consequences of global economic inequality. The worst ravages of this epidemic are in the developing countries, where 93 percent of people with HIV/AIDS lived by the end of 1997 and especially in sub-Saharan Africa, where 80 percent of all deaths occur [5]. The higher incidence of HIV among people living in the developing world has special significance for women’s health, because women comprise a higher percentage of adults living with HIV/AIDS in these areas than they do in the global North. 49.75 percent of all people infected with HIV in Sub-Saharan Africa were female, while 27.52 percent of those infected in Asia and the Pacific were female and 24 percent of those infected in Latin America and the Caribbean. The percentage of women to men with HIV/AIDS is lower in the global North, but it is increasing there too, reaching 20.4 percent by 1998. In the United States, Black women are 15 percent more likely to test positive for AIDS than white women, following the global pattern that the most impoverished women are the most vulnerable. Women are now contracting the AIDS virus at a higher rate than any other group, both in the Third World and also in North America [6:26].

In sub-Saharan Africa, women’s increasing rate of AIDS infection is in large part a consequence of poverty, which has forced men to migrate to the cities in search of work and has forced women to sell street sex in order to stay alive and feed their families. Elsewhere in the global South, AIDS among women is linked with the recent enormous growth in sex tourism, itself an outgrowth of global economic inequality.10 Especially in the global South, however, little money is available to cope with this epidemic.11

Anti-regulation

The World Trade Organization pays lip service to the need for protecting consumers, labour and the environment but in practice its rulings have weakened previous standards.12 Women’s health is clearly threatened by WTO stands on a number of regulatory issues including the following:

Abandonment of the Precautionary Principle The World Trade Organization rejects the Precautionary Principle, which puts the burden of proof on the manufacturers to show that food and phar- maceuticals are safe. However the WTO requires that any country wishing

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to ban the import of food or drugs for health reasons should bear the burden of proof for showing that the product in question is unsafe. The full health implications of the WTO’s rejection of the Precautionary Principle are yet to emerge, but any resulting harm is likely to be felt disproportionately by women. In part, this is because women tend to be poorer and so less able to restrict their purchases to foods thought to be safer, such as so-called organic foods. In part it is because children are especially susceptible to health problems resulting from unsafe foods and it is invariably women who are assigned the responsibility of caring for sick and disabled children.

Lack of protection for labor rights The WTO’s disregard for labor rights probably affects women dispropor- tionately; not only because laws banning sex discrimination and sexual harassment are unenforced but also because women are disproportionately represented among the low-paid “sweatshop” workers whose rights to a decent wage and a safe working environment are unprotected.

Failure to protect the environment The WTO’s disregard for environmental protection also has consequences for women’s health. For instance, water pollution increases rural women’s work load by forcing them to travel farther and farther in search of clean water (sometimes as far as 20 kilometers from their homes) and to deal with the health problems that result from families having to drink polluted water.

Cutbacks in social welfare

The worldwide cutbacks in social programmes are the most obviously gendered feature of global neo-liberalism. They have tended to affect women’s economic status even more adversely than men’s because women’s responsibility for caring for children and other family members makes them more reliant on such programmes. In the global South, cuts in public health services have contributed to a rise in maternal mortality; less hospital care is available and patients are discharged earlier – to be cared for at home by female family members. Reductions in social services have forced women to create survival strategies for their families by absorbing these reductions with their own unpaid labour. The effect of these strategies has been felt especially in the global South, where more work for women has resulted in higher school dropout rates for girls. In addition, the intro- duction of school fees in many Southern countries has made education unavailable to poorer children and especially to girls; women currently constitute 64 percent of all illiterate adults.13 Longer hours of domestic

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work and less education obviously contribute to women’s impoverishment by making it harder for them to attain well-paying jobs.

Resource privatization

The increasing privatization of natural resources such as land, forests, minerals and water has led to increasing exploitation, depletion and pollu- tion of the environment and to the further impoverishment of women. Multinational corporations have patented many indigenous seeds and medicines in what Vandana Shiva has aptly called a theft of the commons [7, 8]. The WTO has defended so-called intellectual property rights (IPRs), which guarantee corporations’ global patents on seeds and medicines, including indigenous seeds and medicines.14 These patents are criticized in the United Nations Human Development Report for 1999 because they preclude poor countries’ access to food and medicine, with inevitably adverse health consequences for women, who tend to be even poorer than men.

Neo-liberalism’s assaults on women’s health are overlapping and often mutually reinforcing. Neo-liberalism has had adverse consequences for the health of all poor people but especially for women, whose already unsatisfactory health status has deteriorated even further.

WHY DOES THE GLOBAL SOUTH ACCEPT NEO-LIBERALISM?

When neo-liberal globalization has been so harmful to the health of many people in the global South, it is natural to wonder why they continue to participate in this system. Much of the answer lies in the past.

Neo-liberal policies were introduced in many Southern countries in the 1980s as conditions of borrowing money from international lending institutions or of rescheduling existing debts. Many developing countries engaged in massive borrowing in the 1970s, when interest rates were low but, when interest rates rose sharply at the end of that decade, most debtor countries had difficulty paying the interest on their loans. In the early 1980s a world debt crisis resulted, threatening the failure of major US banks and perhaps a collapse of the world economic system. In order to forestall default by large debtors such as Mexico, international lending institutions such as the International Monetary Fund and the World Bank resched- uled many debts. At the same time, they imposed new loan conditions mandating so-called policies of structural adjustment or SAPs. These neo- liberal economic policies “adjust” the “structures” of local economies so

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that they can be integrated into the global economic system, thus enabling them to gain the foreign currency necessary for servicing external debts. SAPS thus are designed to orient local economies away from production intended to satisfy the needs of local people and towards producing goods for export.15

Any local economy that is integrated into the global economy becomes vulnerable to the vicissitudes of world trade. For example, SAPs encour- agement of cash crop agriculture, has forced many countries in the global South to become permanently dependent on Northern machines and fertil- izers, as well as on world prices for their crops. Thus, SAPs have created guaranteed markets for Northern manufactured products, technologies and consumer goods and simultaneously have ensured a “captive” supply of cheap exploitable labor, cheap raw materials and agricultural products. In a world where the terms of trade for raw materials and agricultural products have historically tended to worsen (with a few conspicuous exceptions, such as oil), such interdependence has inevitably made the North richer and the South poorer.

Although SAPs were promoted as necessary to economic development in the global South, they have harmed rather than helped development in many debtor nations. The growth rates of most debtor countries have been significantly reduced, living standards in many have deteriorated, and some have become trapped in a vicious cycle of stagnation and decline. Some of the countries that are worst off are the most integrated into the global economy; for instance, exports account for close to 30 percent of the GDP of impoverished sub-Saharan Africa, compared to less than 20 percent for industrialized nations. Many Southern countries are now in a state of economic collapse and their debt burden has multiplied many times over. By 1997, the total debt stock owed by the developing world to the developed world was $217 TRILLION, up from $1.4 trillion in 1990.

Although SAPs have been counterproductive from the point of the view of the global South, they have been highly successful from the point of the view of the global North. This is because they have ensured that an increasing proportion of the debtor countries’ resources have gone to paying off foreign debts. Even by the mid-1980s, the Third World was paying out annually about three times as much in debt repayments as it received in aid from all developed-country governments and international aid agencies combined. Ten years later, the developing countries are paying the rich nations $717 million per day in debt service; $12 billion annually flows north out of Africa.

The need to service their debts provides much of the explanation why many countries in the global South have joined the WTO, despite

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the fact that the neo-liberal rules of this organization tend to favor the interests of Northern countries and corporations over those of poor people and countries. Deeply indebted nations, which need foreign exchange to service their debt, cannot afford to be left out of the global trading system. Thus, the existence of longstanding debt is one of the chief mech- anisms maintaining global neo-liberalism. It binds Southern debtors and Northern creditors together in a system advantageous primarily to the priv- ileged classes of the global North. Because this system is harmful to most women’s health, Southern debt should be an important concern for both medical ethics and feminist ethics. I wish to conclude by suggesting that many supposed Southern debt obligations are not morally binding because they were not legitimately undertaken.

NEO-LIBERAL GLOBALIZATION AND DEMOCRATIC CONSENT

Liberal democratic theory holds that all citizens are collectively respon- sible for decisions made by their democratically elected governments. Even citizens who disagree with particular government policies are said to have consented to them indirectly if not directly because they agreed to the rules of the electoral game.16 Like most bio-ethicists, most liberal political philosophers hold that such consent is binding only if it is informed, rational and uncoerced. In practice, however, people’s ration- ality is always imperfect, their information incomplete and their available options restricted; hence the validity of consent is always a matter of judgement. I shall argue that, when many Southern countries undertook their supposed debts, their citizenry was largely uninformed and/or their options were virtually nonexistent.

Consent to the debt as coerced: many Southern countries were forced to borrow because their wealth was stolen

One reason why citizens in the global South cannot be said to have undertaken their supposed debts voluntarily is that neo-liberalism was not introduced into a global state of nature, comprised of nation states that were politically sovereign and economically independent. Instead, it was introduced into a world previously made unequal by colonialism – which also often exacerbated inequalities among and between men and women. Despite the lip service paid by the European Enlightenment to such ideals as universal freedom and equality, European expansion was characterized by violence, slavery and genocide. These destroyed many

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non-European societies and drastically weakened many others, forcibly converting them into sources of cheap raw materials, food and labour, as well as markets for the manufactured goods of the colonizing countries. The import of manufactured goods from Europe and the US undermined production by local artisans and suppressed the manufacturing potential of the colonies. Thus, it made formerly self-sufficient communities econom- ically dependent. Patterns of colonization varied but typically they created powerful local elites whose interests were linked to maintaining an open economy. At the same time, much of the population was severely impov- erished and the seeds were planted of land misuse and environmental degradation.17 In short, colonialism drained massive resources and wealth away from the colonies and destroyed their economic self-sufficiency.

After political independence, the erstwhile colonies were left dependent on the metropolis for manufactured goods and also for training indigenous professional and skilled people. Seeking to end their economically disad- vantageous position as suppliers of raw materials, many Southern countries sought to develop their own industries. However, so much wealth had been siphoned off from their nations during the colonial period that they lacked sufficient capital to invest in new plant or infrastructure and were forced to borrow. It was because they had been impoverished by previous centuries of Northern colonialism that these countries cannot be said to have under- taken their debts voluntarily – even if they consented formally to accept the loans. Basically, they are forced to borrow back wealth that was stolen from them – and to borrow it from (the descendants of) the robbers.

Consent to Southern debt as uninformed or non-existent

The people who bear the overwhelming burden of paying Southern debt are the poorest citizens of the poorest countries in the world. This is especially Southern women. These citizens are held economically respon- sible for debts undertaken by their governments, often before they were born. Every baby born in the developing world today owes about $500 at birth.

In most heavily indebted countries, however, electorates were unin- formed about the meaning or even existence of foreign loans. Debts were often assumed by local elites, who spent them on unproductive prestige projects or siphoned them into personal foreign bank accounts. Many debtor countries were run by autocratic rulers, who were supported by wealthy First World countries as a bulwark against popular insurgencies regarded as “communist,” and they often used borrowed funds on the military repression of their own populations. Thus, much of the money lent to Third World rulers in the 1970s and 1980s by wealthy First World states

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not only did not support economic development but in fact undermined it by subverting democracy.

Given this history, it is plausible to argue that poor people in the global South have no responsibility to pay back money that they did not ask to borrow, from which they enjoyed no benefits, and through which they were even repressed. It is especially unreasonable to expect Southern women to be responsible for the debts because, even if they had the formal equality of the vote, they had even less input than men into taking on the loans and benefited even less from them. We have seen that women in the global South, as a group, receive less food, health care and education than men, and they benefit even less from military expenditures.

Absence of democracy in global economic institutions

So far I have contended that the entry of many Southern countries into the neo-liberal global economic system occurred under considerable duress and was therefore less than fully voluntary. I now wish to argue that a situ- ation of duress continues, since these countries have little or no influence over the conduct of the global economic system, despite being bound by its rules.

The political weakness of what was then called the Third World was already evident in the 1980s, when SAPs were imposed on many debtor nations. At that time, the International Monetary Fund and the World Bank were the main institutions governing the global economy and their policies were heavily influenced by a small group of wealthy countries. At both the World Bank and IMF, the number of votes a country receives is based on how much capital it gives the institution, so rich countries have dispropor- tionate voting power.18 Although it is intuitively reasonable that lenders should be able to determine the conditions under which they lend their money, we have seen that much of the wealth of world’s rich countries was derived, directly or indirectly, from a long history of conquest and colonial exploitation. Since this wealth was acquired illegitimately, I suggest that those who currently claim ownership of it lack the moral right to control its disposal, much less to use it in ways that worsen the lives of those from whom it was taken.

The birth of the WTO created a supranational organization whose rules, as we have seen, supersede the national laws of its members on issues of trade. Joining the WTO limits the sovereignty of member nations over an enormous range of issues, since the WTO construes trade so broadly as to include many matters of ethics and public policy. The WTO is formally democratic in that each of its 142 member countries has one represen- tative or delegate, who participates in negotiations over trade rules, but

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democracy within the WTO is limited in practice in many ways. Wealthy countries have far more influence than poor ones, and numerous meet- ings are restricted to the G-7 group, the most powerful member countries, excluding the less powerful even when decisions directly affect them. Moreover, even though sovereign states are the only official members of the WTO, this organization’s dispute resolution system allows powerful multinational corporations to challenge trade barriers or domestic regula- tions, sometimes seeking to reverse decisions lost in the political arena at home. The dispute resolution system of the WTO violates most demo- cratic notions of due process and openness. Cases are heard before a tribunal of “trade experts,” generally lawyers, who are required to make their ruling with a presumption in favor of free trade, and the burden is on governments to justify any restrictions on this. The WTO dispute resolute system permits no amicus briefs, no observers, no public record of the deliberations, and no appeals.

The present organization of the global economy undermines democracy by increasing the political exclusion of the poorest and most marginalized people across the world. It especially excludes women, who are among the poorest and most marginalized of all. Even though the proportion of women representatives recently has increased in most national legislatures, except those of Eastern Europe, the significance of this gain is diminished when the authority of national legislatures is reduced. The virtual absence of women from the decision-making processes of such bodies as the World Bank, the International Monetary Fund, and the World Trade Organization reflects the very limited influence exercised by women at all levels of global politics.

CONCLUSION

Despite its rhetoric of freedom and prosperity – freedom of enter- prise, freedom from the red tape of government regulation, freedom from onerous taxation and, above all, freedom of trade – the present system of neo-liberal globalization has brought little freedom, democracy or prosperity to most women in the global South. Instead, the current neo-liberal framework traps billions of people in situations of polit- ical and economic deprivation, increasing their health vulnerability and condemning them (and their families) to lives of illness and premature death. Despite the fact that present global economic arrangements are rationalized in liberal terms, the broader liberal tradition has the conceptual resources for challenging their democratic legitimacy through its basic idea that legitimate obligations must be grounded in consent that is informed and uncoerced.

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NOTES

1 This paper was written at the suggestion of Annette Dula and conceptualized in the course of discussions with her. I am extremely grateful for Annette’s suggestions, as well as for the comments of my colleague, Michiko Hase. I am also indebted to Stephen Biggs, who undertook much of the empirical research on which the paper is based. I develop these ideas further in Jaggar 2002. 2 This lop-sided interpretation of “free trade” obviously enables business owners to move production to areas of the world where costs are lowest, perhaps due to lower wages, fewer occupational safety and health requirements or fewer environmental restrictions, while simultaneously controlling the movement of workers who may wish to pursue higher wages. 3 “Defence and security” are among the very few government expenditures excluded from being judged “subsidies,” an exclusion that has permitted the development of a lucrative arms industry. Since the Persian Gulf War, the United States has become the world’s top arms exporter, well exceeding “the total arms exports of all 52 other arms exporting coun- tries combined” [9:120]. 4 The collapse of the Soviet bloc has made the older terminology of First, Second and Third Worlds inapplicable and it is now often replaced by talk about the global North and the global South. Roughly, the “global North” refers to highly industrialized and wealthy states, most of which are located in the northern hemisphere – though Australia and New Zealand are possible exceptions. The “global South” refers to poorer states that depend mostly on agriculture and extractive industries and whose manufacturing industry, if it exists, is likely to be foreign owned. Many (though far from all) of these states are located in the southern hemisphere and their populations tend to be dark-skinned, whereas the indigenous populations of Northern states are mostly (though not exclusively) light- skinned. Northern states often have a history as colonizing nations and Southern states often have been colonized. The binary opposition between global North and South is a useful shorthand but, like all binaries (and like the older terminology of numbered Worlds) it is problematic if taken too seriously. Many states, (e.g., Japan and Russia) do not fit neatly into it. 5 Meanwhile, drawing on a 1998 (Oct 12) report in Forbes magazine, the United Nations Human Development Report declared that that the assets of the world’s three richest people (Bill Gates, Warren Buffett and Paul Allen, whose combined assets totaled $110 billion) exceeded the combined GNP of all the least developed countries on the planet. Within a year, this information was out of date; in 1999, the New York Times reported that the assets of the first two of these were worth more than $140 billion [1:4]. 6 A report from the Center on Budget and Policy Priorities (cited in the New York Times, 5 Sept, 1999) found that the richest 1 percent of US citizens earned as much after taxes as the poorest 100 million – as contrasted with 1977, when the top one percent earned “only” as much as the bottom 49 million. 7 Median income for women who work full-time, year-round fell from $26,433 to $26,324 while median income for full-time employed men rose from $36,126 to $36,376 [10: A12]. 8 Ten years ago, Amartya Sen used demographic data to estimate that between sixty and one hundred million women were “missing” in the world, partly as a result of direct violence but often as a result of systematic neglect [11]. The figure of 60 million is larger than the combined combat death tolls from the First and Second World Wars. 9 Filipino nurses are a familiar feature of hospital life in the United States. As for Great Britain, John Carvel reported in The Guardian Weekly of May 23–29, 2002, that “the total

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number of overseas nurses going on to the UK register increased by 63% to 13,721 nearly as many as the expected total for ‘home grown’ nurses, which was probably about 15,000. The influx left developing countries with gaps in hospital wards.” 10 The countries in Latin America and the Caribbean that are most renowned for sex tourism, the Bahamas, Jamaica, Barbados and the Dominican Republic, have not only the highest percentages of infected people in Latin America and the Caribbean but also the highest percentage of females infected. In Jamaica, girls aged 15 to 19 are three times as likely to contract HIV/Aids as boys in the same age group [12:5]. 11 African countries reacted very coolly to a recent United States offer of a $1 billion annually in loans to buy AIDS drugs, claiming that it would only increase their indebted- ness [13]. Of course, such a loan would also bring huge profits to the United States pharmaceutical companies that manufacture the drugs and which appeal to Intellectual Property Rights in order to block the production of cheaper versions for the developing world. 12 For instance, the WTO ruled against Europe for banning hormone-treated beef and against Japan for prohibiting pesticide-laden apples. “In every case brought to the (WTO) that challenged environmental or public safety legislation, the challengers won . . . When it was Venezuelan oil interests versus the US Environmental Protection Agency’s air quality standards for imported gasoline, the oil interests won. When it was US cattle producers against the European Union’s ban on hormone treated beef, European consumers lost” [14]. 13 UNICEF reports that in Malawi the elimination of modest school fees and uniform requirements in 1994 caused primary enrollment to increase rapidly by about 50 percent: from 1.9 million to 2.9 million. The main beneficiaries were girls. 14 The WTO’s insistence on protecting IPRs shows that neo-liberalism’s hostility to regu- lation and protectionism is really hostility only to certain sorts of regulation and protection. 15 SAPs typically require debtor countries do most of the following:

• To reduce government expenditures, especially spending on social welfare programs (people pay for services or go without).

• To eliminate food subsidies. • To cut jobs or/and wages for workers in government industries and services. • To privatize state enterprises and deregulate other industries, possibly selling them

to foreign investors. • To make their resources, such as minerals, forests and land, available for commercial

exploitation. In the South, they have often encouraged shifting from small subsist- ence farms to large-scale cash crop agriculture, using “modernized” technology.

• To reduce protection for domestic markets, opening them up to foreign investors and stimulating local demand for western goods.

• To devalue local currencies so that they are worth less relative to the dollar. This lowers export earnings and raises import costs by making exports from the local economy cheaper relative to other nations and imports to it more relatively expensive. When the currency of debtor nations is devalued, they are able to buy fewer imported goods with their local currencies while those who have stronger currencies, such as dollars, are able to afford larger quantities of their local goods. When nations in the global South devalue their currency, the typical result is a scarcity of Northern manufactured products, including medicines, educational materials, spare parts and agricultural machinery, because debtor nations can buy less with their devalued currencies.

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• To create “Free Trade” or “Production” or “Export Zones,” in which protective labour and environmental legislation are unenforced. Labour-intensive production processes are withdrawn from the North and exported to these zones. E.g., garments go for finishing to Central American “free trade zones.”

16 This argument is not unproblematic, especially when democracy is less than perfect – as it always is; for this reason, liberal democratic theory also holds out the possibility of civil disobedience for citizens who have strong conscientious objections to particular policies. 17 For instance, European colonization of Africa disrupted farming and herding systems that for centuries Africans had adapted to changing environmental conditions. Europeans seized the best agricultural land for growing coffee, sugar cane, cocoa, and other export crops and colonial cash cropping ravaged the soil, reducing large areas to desert and semi- desert. Meanwhile, small farmers were pushed onto marginal land that previously had been inhabited only by small groups of nomadic pastoralists. Similarly, Spanish colonizers seized much of the best land in Mexico, pushing indigenous people on to the poor soil of, for instance, the Chiapas Highlands. 18 Each has about 150 members with a 24 member Board of Executive Directors. Five of these directors are appointed by five powerful countries: US, UK, France, Germany and Japan. The President of the World Bank is elected by Board and traditionally nominated by the United States representative, while the managing director of the IMF is traditionally European.

REFERENCES

1. Wallach L, Sforza M. Whose trade organization: corporate globalization and the erosion of democracy. Washington, D.C.: Public Citizen, 1999.

2. Denver Rocky Mountain News, 11 June, 2000. 3. UNIFEM. Eradicating women’s poverty. http://www.unifem.undp.org/ec_pov.htm.

March 30, 2001. 4. Harvard Working Group on New and Resurgent Diseases. Globalization, develop-

ment, and the spread of disease. In: Jerry M, Edward G, eds. The Case Against the Global Economy and For a Turn toward the Local. San Francisco: Sierra Club Books, 1996.

5. UNIFEM. Biennial Report: Progress of the World’s Women. http://www.unifem. undp.org. 2000.

6. Sivard RL. Women . . . A World Survey. Washington, D.C.: World Priorities, Inc., 1995.

7. Shiva V, Jafri A, Gitanjali HB, Holla-Bar R. The Enclosure and Recovery of the Commons: Biodiversity, Indigeno U.S. Knowledge and Intellectual Property Rights. New Delhi: Research Foundation for Science, Technology and Ecology, 1997.

8. Shiva V. Protecting Our Biological and Intellectual Heritage in the Age of Biopiracy. New Delhi: Research Foundation for Science, Technology and Natural Resource Policy, 1996.

9. Peterson VS, Runyan AS. Global Gender Issues. Boulder, CO: Westview Press, 1999.

10. New York Times, 27 Sept., 2000: A12. 11. Sen A. Millions of women are missing. New York Review of Books 1990; 20 (Dec.).

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12. Brittain V. AIDS turns back the clock for world’s children. Guardian Weekly, 9–15 May, 2002.

13. Lacey M. President urges Nigeria to fight tyranny of AIDS.New York Times, 28 August, 2000.

14. Weisbrot M. http://www.zmag.org/CrisesCurEvts/Globalism/wtoweis.htm. March 30, 2001.

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