EPIBuilding a Sustainable Future
Lester R. Brown

Chapter 6. Early Signs of Decline: Introduction

In recent years U.N. demographers have stunned the world by announcing that life expectancy among the 750 million people living in sub-Saharan Africa has dropped from 61 to 48 years. This precipitous drop was primarily the result of governments’ failure to check the spread of the HIV virus. While industrial countries held HIV infection rates among adults under 1 percent, in some African countries they climbed above 30 percent. 1

For the first time in the modern era, life expectancy, a seminal indicator of development, has dropped for a large segment of humanity. For the people of sub-Saharan Africa, a failure of leadership is quite literally reversing the march of progress. Is this failure of the political system an anomaly? Or is it an early sign that the scale of emerging problems can overwhelm our political institutions?

During the decades following World War II, life expectancy climbed throughout the world with advances in public health, vaccines, antibiotics, and food production. But as the twentieth century drew to a close, the HIV epidemic brought this trend to an end in many countries. 2

Today the variation in life expectancy among countries is wider than at any time in history, ranging from a low of 33 in Swaziland and 37 in Botswana to a high of 82 in Japan and 81 in Iceland. Not surprisingly, life expectancy usually correlates with income levels except where the distribution of income is heavily skewed. In the United States, where income is concentrated among the wealthy and where some 24 million Americans are without health insurance, life expectancy is shorter than in countries like Sweden, Germany, or Japan. Indeed, U.S. life expectancy of 77 years now lags behind the 78 years of Costa Rica, a developing country. 3

The stresses in our early twenty-first century civilization take many forms. Economically we see them in the widening income gap between the world’s rich and poor. Socially they take the form of the widening gap in education and health care and a swelling flow of environmental refugees as productive land turns to desert and as wells go dry. Politically we see them manifest in conflict over basic resources such as cropland, grazing land, and water. And perhaps most fundamentally, we see the stresses the world is facing in the growing number of failed and failing states.

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1. United Nations, World Population Prospects: The 2004 Revision (New York: 2005); Joint United Nations Programme on HIV/AIDS (UNAIDS), 2004 Report on the Global AIDS Epidemic (Geneva: 2004), p. 191.

2. United Nations, op. cit. note 1; UNAIDS, op. cit. note 1.

3. United Nations, op. cit. note 1; health insurance from U.S. Census Bureau News, “Income Stable, Poverty Up, Numbers of Americans With and Without Health Insurance Rise, Census Bureau Reports,” press release (Washington, DC: 26 August 2004).

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