BMJ 2000;321:835 ( 30 September ) 2000

Letters

Accurate figures would help to assess countries' needs better

EDITOR - In his news item Lamar reports Médecins Sans Frontières as saying that developing countries spend twice as much a year on debt repayments as on health and education combined. Over the past decade I have read similar comparisons for many countries and regions of the developing world. Occasionally the comparison is combined with the figure - sometimes grossly inaccurate - for debt servicing. Not once have I seen the figures for education or health expenditure, nor the figure for aid.

My own interest is in Zambia. From various sources I have learnt that in the mid- 1990s Zambia's debt servicing was about US$350m (interest US$200m, repayments US$150m). Annual aid in these years was about US$500m. It may be true to say that debt service payments made by Zambia in the mid-1990s came to more than the country spent on education and health combined, but, if it is true, then it is also true to say that aid pays for all Zambia's education and health care. I have never seen this last truth mentioned.

Zambia, and much of southern Africa, is going through one of the great tragedies of history. The causes are many and include rapid population growth, AIDS, and incompetent government. This tragedy is not a result of rich countries taking cash out of Zambia. On the contrary, rich donors and creditors (the United Kingdom, the United States, Germany, France, Italy, Japan, the European Union, the International Monetary Fund, the World Bank, etc) are putting money into Zambia and most other sub-Saharan African countries as well.

Zambia and much of sub-Saharan Africa needs ten times as much aid as it is getting. If organisations that previously have given us incomplete and misleading figures could give us accurate and agreed figures on debt servicing, aid, and health and education expenditure country by country, we would be better able to assess each country's needs and help more effectively and generously.

Gerald Danaher, retired general practitioner.