The following is abridged from Cuban President FIDEL CASTRO's speech to the World Health Organisation in Geneva on May 14, when he was presented with the WHO's Health for All medal.
The world economy grew six-fold and the production of wealth and services grew from less than US$5 trillion to more than $29 trillion between 1950 and 1997. Why then is it still the case that each year, 12 million children under five die — 33,000 per day — of whom the overwhelming majority could be saved?
In no act of genocide, in no war, are so many people killed per minute, per hour and per day as those who are killed by hunger and poverty on our planet.
The children who die and could be saved are almost 100% poor, and of those who survive, we must ask why 500,000 are left blind every year for lack of a simple vitamin which costs less than a pack of cigarettes.
Why are 200 million children under five undernourished? Why are there 250 million children and adolescents working? Why do 110 million not attend primary school and 275 million fail to attend secondary school? Why do 2 million girls become prostitutes each year?
Why in this world — which already produces almost $30 trillion worth of goods and services per year — do 1 billion 300 million human beings live in absolute poverty, receiving less than a dollar a day — when there are those who receive more than $1 million a day?
Of the 50 million people who die each year in the world, 17 million — approximately 50,000 per day — die of infectious diseases which could almost all be cured, or, even better, prevented, at a cost of sometimes no more than $1 per person.
What is the cost to humanity of the unjust and intolerable order which prevails in the world? In 1996, 585,000 women died during pregnancy or in childbirth, 99% of them in the Third World — 70,000 due to abortions carried out in poor conditions.
Apart from the huge differences in the quality of life between rich and poor countries, people in rich countries live an average of 12 years longer than people in poor countries. Even within some nations, the difference in life expectancy between the richest and poorest is 20-35 years.
Just in the area of maternal and postnatal services, over the last 50 years 600 million children and 25 million mothers have died. They could have survived in a more rational and just world.
According to UN estimates, the cost of providing universal access to basic health-care services would be $25 billion per year — just 3% of the $800 billion currently devoted to military expenditure — and this after the end of the Cold War.
There is no let-up in arms sales, which have the sole purpose of killing, while medicines to save lives become increasingly expensive. The market in medicines in 1995 reached $280 billion. The developed countries, with 14.6% of the world's population, consume 82% of the medicines. The rest of the world consume only 18%.
Prices of medicines are prohibitive for most in the Third World. The control of patents and markets by the large transnational companies enables them to raise those prices as much as 10 times above their production costs. Some of the latest antibiotics are priced at 50 times their production cost.
Old illnesses have returned and new ones are appearing: AIDS, the ebola virus, anthrax — more than 30. Either we defeat AIDS or AIDS will destroy many Third World countries. No poor person can pay the $10,000 each year that current treatments cost — which merely prolong life without actually curing the disease.
The climate is changing. The seas and the atmosphere are heating up. The air and water are becoming contaminated. Soil is eroding, deserts are growing, forests are disappearing, and water is becoming scarce.
Who can save our species? The blind, uncontrollable law of the market? Neo-liberal globalisation, like a cancer which devours human beings and destroys nature? That cannot be the way forward.
As a Cuban and a revolutionary, I am optimistic. With a current infant mortality rate of 7.2 per 1000 live births during the first year; a doctor for every 176 inhabitants — the highest level in the world — and a life expectancy of more than 75 years of age, Cuba has fulfilled the WHO's Health for All program for the year 2000 since 1983 — in spite of the cruel blockade it has suffered for almost 40 years, in spite of being a poor, Third World country.
The attempt to commit genocide against our country has only made us redouble our efforts and increased our will to survive. The world can also fight and win.