Before focusing hopeful eyes on the future, you must be grounded in reality. And the reality of international cooperation is fundamentally perverse, and that’s why it must be changed.”

Ximena de la Barra.International Consultant, United Nations

“This is the battle of solidarity against

egotism” Fidel

INTERNATIONAL COOPERATION

GROWTH of GDP (%)

2005

2004

2003

2002

2001

2000

5,9

6,6

6,1

4,8

4,0

5,9

FOREIGN DEBT (trillions USD)

In 1980, the foreigndebt was 600 billion

dollars

Third World Countries:Economic Situation

The developed world spends USD $ 68 billion annually in development; developing countries spend 378 billion servicing their debt. (5.4 times what they receive).

In 2004, Latin America received 6.843 billion in official development assistance and had net transfer of resources abroad of 77.826 billion (10 times the aid received).

Latin America alone owes 780 billion in foreign debt, and the more it pays, the more it owes. In 2005, negative resource transfers from Latin America and the Caribbean were – 67. 494 billion.(Source: ECLA)

2,8

2,7

2,7

2,5

2,4

Official Development Assistance

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

Cooperation and Development Aid vs. Military Aid

68 billion for development aid One trillion for military aid

Latin America

Worldwide

Receives proportionately less than any other region in development aid

1993 2003

Develop ment Aid

13.6%

11.6%

U.S Milita

ry Aid

3.4 million

115 millon (+340%)

47% of this from the USA

In 2005,

122 million

A more unjust and unequal world.

Of the 6 billion people in the world:

815 million are hungry (13.5 %) (300 million of them children).

Every 3.6 seconds a person starves to death, the great majority children under 5.

2.4 billion people have no basic sanitation (40%).

Over 1 billion lack clean drinking water. 5 million people, mainly children, die every year from waterborne diseases.

854 million are illiterate (14.2%).

4.8 billion are poor people (80%).

In 1992, the income difference between rich and poor countries was 60-fold. Today, it is 74-fold.

Consequences for the World’s Population

40 million with HIV-AIDS (0.6%). Of those, 63% in Africa.

AIDS has left 13.2 million orphans in the world – 12.1 million of them living in Sub-Saharan Africa (Tanzania alone has 500,000 orphans).

16,000 persons are infected daily with HIV-AIDS.

11 million children under 5 die every year from preventable diseases (0.1%).

Every 30 seconds, a girl or boy somewhere in the world dies from malaria- 90% of them in Africa.

Africa has 11% of the world’s population, 25% of the disease burden and only 3% of he world’s health workforce.

In 2005, life expectancy in Europe was 68 for men and 77 for women; but in Africa it only reached 46 for men and 48 for women. In the next ten years, in Botswana it will reach 29; in Swaziland, 30; and in Namibia and Zimbabwe, 33.

Consequences for the World’s Health

The WHO estimates a world shortfall of 4.3 million doctors, midwives, nurses and other health workers.

The Americas has over 35% of the world’s health workforce, and spends over of 50% of the world’s funds dedicated to health. 57 African countries have only 3% of the world’s health workforce, and make only 1% of the world’s health expenditures.

There are 50,000 doctors for Sub-Saharan Africa’s 700 million people. (1 x 14,000 inh).

Medicine sales are concentrated in the industrialized countries. In 2005, only 13.1% were made to developing countries; of these, 4.4% to Latin America and 1.1% to Africa.

The WHO budget for medicines is US $ 51.5 million annually. Reports from WHO indicate 58% (29 million) were spent in normative regulations, global policy and headquarters expenses.

Global Crisis in Human Resources and Medicines

Tendencies in Global Health Cooperation

Industrialized Countries and Most NGO’s Cuba

1. Minimize their historical responsibility for deteriorated development of our countries, condition aid to “good government”, “respect for human rights and the law”. Aid tied to structural adjustment and economic interests of donors.

4. Developed as the sum of potential contributions from the countries involved, on a not-for-profit basis.

3. Main contribution is financial, technological (often outdated), and smaller human resource development programs.

2. Channeled thru private sector and NGO’s, often ignoring the role of government and thus the use of its infrastructure (lack of replicability and sustainability)

4. 80% of financial resources contributed actually return to industrialized countries.

1. Based on national consensus and political will; cooperation as key element in foreign policy as a means to real integration.

2. Mainly channeled thru central and local governments; aims to strengthen or create sustainable infrastructure.

3. 80% of cooperation devoted to providing highly qualified human resources, dedicated to service and humanistic values; to training of human resources and transfer of modern technology.

Tendencies in Global Health Cooperation

Industrialized Countries and Most NGO’s

Cuba

6. For implementation, requires lengthy process, project proposals, exchange of experts, and finally signing of complex agreements.

6. Tends to develop quickly, without complicated formulations. Cooperation agreements signed in which local experts provide assistance.

7. Generally develop pilot or small programs, benefitting limited populations, and usually in the cities.

7. Because of its institutional nature, attempts to benefit largest possible population, and is developed in poorest, most remote regions.

5. Aid does not always meet needs of receiving countries; frequently masks political and economic objectives.

5. Guided by the principle of responding to needs stated by authorities of the receiving countries.

Cuban Global Cooperation: Current Situation (2006)

1. Cooperation with 155 countries; 1846 organizations of solidarity; and 228 political parties.

2. Over 800 projects in implementation.

3. 38,524 Cubans serve in 111 countries; of those 29,594 (76.8%) do so in the health sector in 68 countries.

4. Literacy program in 20 countries.

5. 27,235 young people from 120 countries study in Cuba.• 21,964 (80.6%) study medicine; 10,585 from 10 countries enrolled in

the new community medicine program.• In Venezuela, the same program enrolls 14,185 students.

6. 536 students enrolled in schools founded with Cuban assistance in Gambia, Equatorial Guinea, Eritrea, Guinea Bissau and East Timor.

7. Vision restoration (Operación Milagro) developed in 29 countries in Latin America and the Caribbean, including Cuba.

Agency

ÁREAS GEOGRÁFICASTotal

(111 coun-tries)

%N.

America(2 coun-

tries)

LatinAmerica(17 coun-

tries)

Caribbean (23

coun-tries)

Africa (40

coun-tries)

Europe

(15 coun-tries)

Asia (14 coun-tries)

Sports Institute 0 6380 70 36 63 17 6566 17.04

Armed ForcesMinistry 0 0 0 301 0 0 301 0.78

Higher Ed. Ministry 0 146 3 17 6 0 182 0.47

Education Ministry 0 368 68 15 0 17 468 1.21

Cooperation Ministry 24 184 98 144 59 9 518 1.34

Culture Ministry 3 120 16 0 39 1 179 0.46

Sugar Ministry 0 148 5 14 0 0 167 0.43

AgricultureMinistry 0 285 1 9 0 1 296 0.77

Construction Ministry 0 37 31 75 0 54 197 1.51

Steel Ministry 0 36 18 0 2 0 56 0.15

Total 27 7714 310 611 169 99 8,930 100.0

Public Health Ministry* 2 26228 10018 1925 5 416 29594 76.8

Total 29 33942 1328 2536 174 515 38524 100.0

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

Cuba’s Health Programs: Summary

* Total is 68, since some countries have more than one modality.

MODALITY COUNTRIES IN-COUNTRYPERSONNEL PHYSICIANS %

TECHNICALPERSONNE

L

COMPENSATED COOPERATION 37 1,065 699 65.6 366

COMPREHENSIVE HEALTH PROGRAM 28 3126 2206 70.6 920

SUBTOTAL 65 4191 2905 66.5 1286

SPECIAL PROGRAM: VENEZUELA 1 23803 15485 65.1 8318

SPECIAL PROGRAM: BOLIVIA 1 1276 1020 79.9 256

HENRY REEVE CONTINGENT INDONESIA

1 135 78 57.8 57

VISION RESTORATION(OPERACIÓN MILAGRO) 18 189 110 58.2 79

TOTAL * 68 29594 19598 66.2 9661

GLOBAL HEALTH PROGRAMS: SOCIAL IMPACT

Medical Attention

1. Office visits: 259,594,529 (in 7 years).

2. Home visits: 89,857,702.

3. Lives saved: 1,433,649 (five times the 285,700 lives lost in recent disasters in Central America, Indonesia, Sri Lanka, Pakistan and Indonesia).

4. Surgeries: 1,983,429.

5. Medical and paramedical equipment repaired: 59,568 (for a saving of USD $ 35,500,800 to the receiving countries)

6. 600 comprehensive diagnostic centers (CDC) and rehabilitation centers (CRC); and 35 high-technology centers (HTC).• CDC – 125 completed. CRC – 145 completed, of these 133

operating; 12 in startup. HTC – 4 operating, 4 in startup, 11 in construction, 16 in project phase.

7. Community optical services in Venezuela: 4,785,525 cases seen, resolving health problems of 3,602,504 (75.3%). One of every 8 inhabitants has received this service.

8. Vision restoration: benefitted 327,586 patients, of whom 36,703 from Latin America, 18,843 Caribbean, 71 816 Cuba, and 200,224 Venezuelan (one of 1393 inh. of these countries).

9. Henry Reeve Disaster Contingent: 3,989 sent to Guatemala, Pakistan and Bolivia.

10. In Pakistan: 32 mobile hospitals donated by Cuba.

Human Resource Training

11. Since 1961: 45,352 graduates from 129 countries.• 30,109 (66,4%) from 41 Sub-Saharan countries.• 8,718 (19,2%) from 18 Latin American countries.

12. Cuban medical teams abroad have graduated 3,392 paramedical and technical health workers.

GLOBAL HEALTH PROGRAMS: SOCIAL IMPACT

11. Opening of the Caribbean Nursing School in Dominica with 150 students; preparations for second school in Belize.

12. Literacy: 2,451,509 persons learned to read and write in 13 countries. Declared illiteracy-free: Venezuela and Canton Cotacachihi.

GLOBAL HEALTH PROGRAMS: SOCIAL IMPACT