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Universal access to education is vital to the future health and well-being of our global society.

Date Posted on Global Envision: September 18, 2007

One of the silent killers attacking the developing world is the lack of quality basic education for large numbers of the poorest children in the world’s poorest countries—particularly girls. Yet unlike many of the world’s most grievous ailments, this is a disease with a known cure. We know what tools are needed and what models are proven to work. We also know that the cost of that cure—perhaps $7.5 billion to $10 billion per year—is minuscule compared with the enormous benefits such education would bring for health, economics, women’s empowerment, and basic human dignity.An estimated 110 million children—60 percent of them girls—between the ages of 6 and 11 will not see the inside of a classroom this year. Another 150 million are likely to drop out before completing primary school.

More than half of all girls in sub-Saharan Africa do not complete primary school, and only 17 percent are enrolled in secondary school. Rates in rural areas are even worse. For instance, a 1996 study in Niger found that only 12 percent of girls in rural areas were enrolled in primary school, compared with 83 percent of girls in the capital.

The situation can be even worse for vulnerable children. In developing nations, those with disabilities and those affected by AIDS face even greater obstacles to education, while orphaned children are less likely to be enrolled in school than their peers who live with at least one parent. Only 6 percent of children in refugee camps are enrolled in secondary education, and opportunities for internally displaced children are even more limited.Access is only part of the story. The other crucial factor is quality. As highlighted by Education for All: The Quality Imperative, the 2005 Global Monitoring Report by UNESCO, too many children leave school without mastering a basic set of skills. “Ensuring a decent quality of education is an essential component of reform.”

Strong Evidence

The good news is documented in What Works in GnU Education, a 2004 Council on Foreign Relations report that I co-authored with Barbara Herz, and is reinforced in a Mother’s Day 2005 report by Save the Children: we have extremely strong evidence both on the high returns on girls’ education and on what works to get girls in school. What is striking is the breadth of benefits derived from educating girls—not only economic benefits in terms of higher wages, greater agricultural productivity, and faster economic growth, but also health benefits, HIV prevention, and women’s empowerment.

Two 1999 World Bank studies found that dosing the education gender gap in South Asia and sub-Saharan Africa would have led to faster economic growth between 1960 and 1992, while increasing the share of women with a secondary education can yield growth in per-capita income. Another 63-country study attributed 43 percent of the decline in malnutrition achieved between 1970 and 1995 to more productive farming as a result of increased female education.

Even more impressive are the gains to health that come from educating girls. An extra year of female education can reduce infant mortality by 5 percent to 10 percent. In Africa, children of mothers who receive five years of primary education are 40 percent less likely to die before age 5 than are children of uneducated mothers. Across both Africa and Southeast Asia, mothers who have a basic education are 50 percent more likely than uneducated mothers to immunize their children.

Education has also proven to be one of the most powerful tools to prevent the spread of HIV/AIDS. A recent study in rural Uganda found that, in comparison with young people with no education, those with some secondary education were three times less likely to be HIV-positive, and those with some primary schooling were about half as likely to be HIV-positive. In Kenya, a study of 17-year-old girls found that those in secondary school were almost four times as likely to be sexually inactive as those who had dropped out after primary school. In Swaziland, a 2003 study found that more than 70 percent of in-school youths were not sexually active, while nearly 70 percent of out-of-school youths were sexually active. And school-based AIDS education programs have been shown to reduce early sexual activity and high-risk behavior. According to the Global Campaign for Education, seven million cases of AIDS might be prevented over the next 10 years if all children completed basic education.

What Works

In making progress on girls’ education, there are three things to keep in mind.

First, while sending girls to school may be clearly beneficial both for the girls themselves and for their countries, in most poor nations it is the parents who make the ultimate choice on schooling, and for them this calculation may not seem so clear. Rightly or wrongly, such extremely impoverished parents often feel they need their girls’ labor for extra income or, more frequently, just to help with the grueling requirements of life, such as the long hours spent collecting water or firewood or caring for the younger children in the family.

The good news is, when you reduce the cost and increase the benefits of sending girls to school, most parents will choose a better future for their children. It is critical to develop and widely implement policies that work to align the temporary interests of parents with the long-term well-being of their girls and their societies.

The simplest and most basic strategy to reduce costs for parents is to eliminate the per-child school fees that are still charged in many developing countries. We know this strategy works because countries that have reduced or eliminated school fees have seen enrollment skyrocket overnight. In Uganda, Kenya, and Tanzania, enrollment increased dramatically in the very first year after fees were abolished: from 3.4 million to 5.7 million students in Uganda in 1996; from 5.9 million to 7.2 million in Kenya in 2003; and from 1.5 million to 3 million in Tanzania in 2002.

Beyond eliminating fees, even modest additional incentives to parents have made a huge difference. Scholarships and conditional cash transfers have been shown to lift attendance of both girls and boys in countries such as Bangladesh, Mexico, and Brazil. School-based health and nutrition programs have also proven successful. In Kenya, for instance, school meals were found to raise attendance by 30 percent and to boost test scores.Reducing the distance children must travel to school is also critical because it both cuts down on the time children must spend away from home and alleviates parental concerns for the safety of their children, especially their girls, as they walk to and from school. Policies that both build parental trust and make schools more girl-friendly—such as hiring more female teachers, forming parental committees, and providing latrine facilities for girls—have all been shown to increase girls’ enrollment.

Second, while it is crucial that countries make an extra effort and institute special initiatives to target girls’ education, these endeavors will work only in the context of a broader focus on universal basic education for all children. Though the educational gaps for girls are especially large, the problems for boys—particularly poor, rural boys—are also dramatic. Furthermore, efforts to get girls into schools will never be successful unless there is a decent quality of education—respectable class sizes, trained teachers, quality instructional materials—for both girls and boys.

Third, while the impetus for all major education reforms must come from the local and national levels of countries themselves, it is critical that there be a global compact that pairs a commitment from developing countries to institute necessary reforms with a clear contingent commitment from donors to provide resources to countries that fulfill their part of the compact. This is especially critical because the major cost for poor countries seeking universal basic education is the recurring cost of teachers’ salaries.

The key to such a compact is certainty. Donors must feel certain that there is a commitment to good governance, careful monitoring, and national ownership of any plan to expand basic education. Leaders of developing countries, on the other hand, must have the certainty that, if they are willing to take on the enormous task of mobilizing political will and resources to seek universal basic education, then donors will live up to their part of the compact by providing the substantial funds needed to fill their financing gap.

This was the promise of the Dakar meeting hosted by UNESCO in 2000, where more than 180 nations—including the United States—committed to the simple yet profound goal (which later became a Millennium Development Goal) of achieving universal basic education by 2015. The global compact on education that emerged from Dakar required developing countries to demonstrate a real commitment to the goal of universal basic education by developing their own national education plans—based on political will, domestic resource mobilization, and accountability—while rich countries pledged that “no country seriously committed to Education for All will be thwarted in its achievement of universal primary school completion by 2015 due to lack of resources.”Instilling confidence that donors will live up to their pledge is particularly important in light of the multiple crises facing most poor countries and the reality that many of the economic benefits of achieving universal basic education will not be realized until after current leaders have left office. When the leaders of a poor nation consider taking on such a challenge even though the political payoff may flow to their successors, it is essential that the global community at least make it dear that those leaders will not be left without the resources to succeed.

In the five years since Dakar, there has been some progress on these promises. The world established the Fast Track Initiative (FTI), a new global financing mechanism designed to direct coordinated funding to low-income countries that have developed quality national education plans. As of July 2005, 16 countries had been endorsed by FTI, and an estimated 44 others could be ready over the next two years.

FTI represents an important step toward a certain and viable global compact on education. Unfortunately, donors’ contributions have to date been far short of what is required. As the World Economic Forum’s Global Governance Initiative reported, donors in 2004 delivered less than 10 percent of what is needed annually to achieve universal primary education. The global community will ultimately need to provide another $7.5 billion to $10 billion annually, above the pathetic $2 billion that is now provided in external assistance for basic education.

While reform must always emanate from the local communities and national governments of poor nations, it would be inexcusable if educational and political leaders in developing nations were discouraged from taking bold steps to provide all of their children a free and quality basic education simply because they lacked confidence that donor nations would hold up their end of the global bargain.

Contributed by Gene B. Sperling, Senior Fellow for Economic Policy and Director of the Center for Universal Education.

To read another Global Envision article about the benefits of access to education, see Private Education in India can Benefit Poor People.

Art: Edward Hopper

Whether oil scarcity is a result of peaking or plateauing, one affected sector not on many people’s minds is health care. Orion magazine published an article on the issue in its July/August edition under the title “Medicine After Oil” in which Daniel Bednarz not only highlights the important role oil plays in our Western health care system but also proposes a new system for a world after oil dependence.

“Petrochemicals are used to manufacture analgesics, antihistamines, antibiotics, antibacterials, rectal suppositories, cough syrups, lubricants, creams, ointments, salves, and many gels. Processed plastics made with oil are used in heart valves and other esoteric medical equipment. Petrochemicals are used in radiological dyes and films, intravenous tubing, syringes, and oxygen masks. In all but rare instances, fossil fuels heat and cool buildings and supply electricity. Ambulances and helicopter “life flights” depend on petroleum, as do personnel who travel to and from medical workplaces in motor vehicles. Supplies and equipment are shipped—often from overseas—in petroleum-powered carriers. In addition there are the subtle consequences of fossil fuel reliance. A recently retired doctor [informed Bednarz], “In orthopedics we used to set fractures mostly by feel and knowing the mechanics of how the fractures were created. I doubt that many of the present orthopedists could do a good job if you took away their [energy-powered] fluoroscope or X-ray.”

America has a shocking health system, with premium (”Ferrari”) care provided to those who can afford it, and a “jalopy model” serving the over 50 million un- and underinsured who very often receive no treatment, defer treatment until their condition cannot be ignored, or face economic ruin when they seek adequate care. With rising prices for oil, this number will swell, moving health care more and more out of reach for ordinary citizens - and not just in the US. Worldwide people in the so-called developed world could join ranks with those in the majority world and experience ill health in epidemic proportions.

The solution Bednarz promotes is an obvious one: moving away from treatment medicine to giving priority to public health strategies, in particular prevention of disease and promotion of health within the population as a whole. “Typically accomplished through the diffusion of information, low-cost therapies, and the promotion of healthful nutrition and lifestyle, preventive medicine allows people to avoid or postpone disease, and to stay clear of the costliest and most energy-intensive sectors of the medical system—doctors’ offices, pharmacies, and the hospital.”

Unlike the much more elitist treatment based model, public health care is “inherently egalitarian - if the entire community is not protected, then no one’s health is assured”. In addition: even though public health is overburdened and underfunded (receiving in the US about 5 percent of health-care dollars, with the balance going to treatment medicine and to biomedical research), it nevertheless exists and does not have to be reinvented. “Public health workers, for example, educate about and test for HIV/AIDS and other sexually transmitted diseases; they interdict infectious diseases like avian flu; they create emergency plans to deal with a variety of disaster scenarios; they monitor waste management and air and water quality”. All that is needed to meet the health-care challenges of the coming energy transition, or, for that matter, those of climate change, is to re-prioritise health policy strategies.

The question that Bednarz doesn’t address though in this context is how the medical establishment will react to such transformation. He mentions some ‘public health’ officials are beginning to address possible oil scarcity’s effect on health care, but there is no hint on how such changes would be greeted by the traditional medical establishment that monopolises the health system, with a lot of its privileges, status and defensive ideologies at stake. Such concerns though are based on our current environment; the ‘after-oil world’ will be a totally new one, with very different dynamics, worldviews and also chaos that could lead to all kinds right now unpredictable outcomes. One of those could indeed be a more just and democratic society, one which, amongst other things, successfully promotes health and wellbeing for all people. The latter certainly is Bednarz’s hope - and mine.

Every day, more and more people are shopping smarter, eating healthier, and enjoying an abundance of fresh, locally-grown products. The website Sustainable Table was created to celebrate this fast-growing, dynamic movement, to educate consumers on food-related issues, and to help build community through food.

Today’s dominant form of agriculture relies on synthetic fertilisers and chemical pesticides, large amounts of water, major transportation systems and factory-style practices for raising livestock and crops.  Artificial hormones in milk, antibiotic-resistant bacteria, mad cow disease, and large-scale outbreaks of potentially deadly e.coli are all associated with this industrial form of food production.

Sustainable agriculture on the other hand involves food production methods that are healthy, do not harm the environment, respect workers, are humane to animals, provide fair wages to farmers, and support farming communities.  Sustainable Table promotes the positive shift toward local, small-scale sustainable farming by providing lots of interesting information ranging from why it is important to eat well to taking 3 steps to eat sustainably to shopping smarter. The site also looks closer at what sustainable agriculture means, includes a sustainability directory, covering a long list of terms  from agribusiness, GMO, pesticides and vegetarian diet to defining ‘watershed’, offers educational resources and much more.

Despite being US centred, Sustainable Table gives lots of inspiration to discover new ways to eating healthy, shopping smart, and enjoying sustainably-raised food!

The (main) clip below is remarkable in many ways (apart from being long). It shows a person who is facing death in probably a few months time, giving his last university lecture in a in a lively, upbeat, humourous and wise-cracking, while exemplifying a deep sense of humanity, a passion for learning and helping others to learn and looking back at a visionary life whose contributions to entertainment technology will live on as a foundational legacy. This video is a moving and at times very emotional contribution to life - as a fountain of opportunities and a providore for brick walls that often need to and at the same time can be overcome, on the roads to making dreams a reality. Despite the length of the clip and some of the references to American culture, it is more than worth watching it for its passion, wisdom and touching portrayal of a remarkable human being. (The first clip is an appetiser, a brief Wall Street Journal summary of the lecture).

Pausch received his bachelor’s degree in Computer Science from Brown University and his Ph.D. in Computer Science from Carnegie Mellon University. He has been a co-founder of CMU’s Entertainment Technology Center (ETC), a National Science Foundation Presidential Young Investigator, and a Lilly Foundation Teaching Fellow. He has done sabbaticals at Walt Disney Imagineering and Electronic Arts (EA), and consulted with Google on user interface design. Pausch is the author or co-author of five books and over 70 articles, and the founder of the Alice software project.

German magazine Der Spiegel reports on an interesting European initiative: to rid cities of traffic signs. While some anally fixated law abiders might cry out in horror in the face of envisioned anarchy, traffic psychologists have proposed for years now that traffic regulations are counter-intuitive to expressing a natural instinct to care for others. The arguments goes that rules strip us of responsibility and the ability to be considerate; we have lost our sense of social responsibility.

Germany has 648 valid traffic symbols. Like here in Australia, cities have become a jungle of coloured metal; apparently some 20 million traffic signs have already been set up all over the country. And, of course, the forest of signs is growing more dense. Such exaggerated regulation seems senseless. It is not surprising that 70 percent of traffic signs are ignored by drivers. What’s more, the glut of prohibitions is tantamount to treating the driver like a child, which foments resentment. He or she may stop in front of the crosswalk, but that only makes him/her feel justified in preventing pedestrians from crossing the street on every other occasion. Every traffic light baits them with the promise of making it over the crossing while the light is still yellow. People develop a kind of tunnel vision: they’re constantly in search of their own advantage, and their good manners go out the window.

The alternative is a world in which drivers are trusted to be responsible. And in such a world, where situations are unclear, they will feel forced to drive more carefully and cautiously. “Unsafe is safe” is the motto of a new breed of traffic planners. Materially, all of this translates into a world of cobble stone paved roads, like in medieval times - with no stop or directive signs, no parking meters (those municipalities must have found other revenue raising strategies!) and not even lines painted onto streets. Makkinga, in the Dutch province of Western Frisia has only one sign -at the entrance to the small town (population 1,000) - it reads “Verkeersbordvrij” - “free of traffic signs. In terms of traffic, drivers and pedestrians blend into a colorful and peaceful traffic stream.

Makkinga is not the only town attempting to try something new. The dream of streets free of rules and directives is currently trialled by seven cities and regions, in a project implemented by the European Union. The aim is to encourage drivers and pedestrians to interact in a free and humane way - by means of friendly gestures, nods of the head and eye contact, without the harassment of prohibitions, restrictions and warning signs. Ejby, in Denmark, is participating in the experiment, as are Ipswich in England and the Belgian town of Ostende. In the German town of Bohmte in Lower Saxony ( population 13,500), the main road will be re-furbished in early 2007, using EU funds. “The sidewalks are going to go, and the asphalt too. Everything will be covered in cobblestones,” Klaus Goedejohann, the mayor, explains. “We’re getting rid of the division between cars and pedestrians.”

The plans derive inspiration and motivation from a large-scale experiment in the town of Drachten in the Netherlands, which has 45,000 inhabitants. There, cars have already been driving over red natural stone for years. Cyclists dutifully raise their arm when they want to make a turn, and drivers communicate by hand signs, nods and waving. “More than half of our signs have already been scrapped,” says traffic planner Koop Kerkstra. “Only two out of our original 18 traffic light crossings are left, and we’ve converted them to roundabouts.” Now traffic is regulated by only two rules in Drachten: “Yield to the right” and “Get in someone’s way and you’ll be towed.”

Strange as it may seem, the number of accidents has declined dramatically. Experts from Argentina and the United States have visited Drachten. Even London has expressed an interest in this new example of automobile anarchy. And the model is being tested in the British capital’s Kensington neighborhood. I wish Australia’s traffic planners would show interest too.

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