Health and Poverty as Challenges for Human Security: Two Case Studies on Northern Vietnam and Bangladesh

Abstract

About one fifth of the world population, that is 1.2 billion people, live in extreme income poverty with less than one US $ a day. Another 1.6 billion have less than two US $ a day (CHS 2003: 73). Most of the poor live in severe livelihood uncertainty and lack access to basic education and health services. The United Nations’ Millennium Development Goals (MDGs) aim at cutting poverty in half by the year 2015. As health1 is considered crucial for poverty reduction, three MDGs focus directly on health, covering maternal mortality, infant mortality, HIV/AIDS, malaria and tuberculosis. The MDGs 4 – 6 directly concern health issues, while other MDGs such as goal three (“Promote gender equality and empower women”) and seven (“Ensure environmental sustainability”) deal with nutrition, water and sanitation and thus impact on health2 (see box 40.1). The concept of ‘human security’ has emerged slowly but steadily over the 1990’s –influenced by the end of the Cold War, the awareness of previously neglected insecurities and globalization– and the question was raised about the expected implications of this concept for health and human development (Chen/Narasimhan 2003a). There are various definitions3 of ‘human security’, which obviously “means different things to different people”4. This chapter applies the definition of the Commission on Human Security (CHS), that stated as the objective of human security “to protect the vital core of all human lives in ways that enhance human freedoms and human fulfilment” (CHS 2003: 4). The emergence of the concept of ‘human security’ will be briefly reviewed (40.2), before focusing on human, livelihood and health security (40.2.1) including current debates of human and health security in South and Southeast Asia (40.2.2) as well as the linkages of poverty, health and human security (40.2.3). Empirical evidence will be presented based on two case studies (40.3) on Vietnam (40.3.1) and Bangladesh (40.3.2). Lessons learned (40.3.3) will be summarized, before turning to the conclusions (40.4).