PaanLuel Wël Media Ltd – South Sudan

"We the willing, led by the unknowing, are doing the impossible for the ungrateful. We have done so much, with so little, for so long, we are now qualified to do anything, with nothing" By Konstantin Josef Jireček, a Czech historian, diplomat and slavist.

United Nations Millennium Development Goals: Eradicate Extreme Poverty and Hunger in Africa

By Ayuen Garang Ajok, Washington, DC

I) Introduction

            Achieving the Millennium Development goals (MDGs) has become a global challenge, especially in the global south. Based on the statistical data as of 2008, the world’s population count was 6.7 billion people. Out of 6.7 billion people, about 1.3 billion lived on less than $1.25 Purchasing Power Parity dollars per person per day. Also, 1.7 billion people lived on between $1.25 and $2.50 PPP dollars (Chen and Ravallion, 2012).[1]

However, the scourge absolute economic depression is one of the most serious problems facing humanity in our global stage today.[2] In the context of countries in sub-Saharan Africa, there have been contemporary challenges in terms of political, economical, and social challenges in attaining these goals. In the year 2000, when the United Nations Millennium Declaration was established, the MDGs goals were aimed to reduce the proportion of people living in extreme poverty by half by 2015. In the implementation of the MDGs, the entire international communities at large were involved in these initiatives.[3] The MDGs goals that were initiated were eight goals that include; eradication of extreme poverty, and hunger; achieving universal primary education, promoting gender equality and empowering women, reducing child mortality, improving maternal health, combating HIV/AIDS, malaria, and other diseases, ensuring environmental sustainability, and developing a global partnership for development.[4]

This research paper will examine the MDGs number 1 eradication of extreme poverty and hunger. I chose to analyze this goal because it is one of the most fundamental goals in the MDGs document. This paper will also scrutinize what are the contemporary problems that make it difficult for countries in sub-Saharan Africa to eradicate poverty and achieve goal number one of the MDGs. Also, this paper will address a question under what policy framework would countries in the global South attain the MDGs goal number one, which focus on eradication of poverty and hunger?

                                                                   II). Theories

            In this section of the paper, my research will investigate the competing theories from Gans, Herbert J (1995), Bailey, Martha and Sheldon Danziger (2013), Suzanne Mettler and Joe Soss (2004, John Rawls (1999), Martha C. Nussbaum (2006), and Thomas Pogge(1998) in order to help us understand the implication policy that hindered MDGs goals.  Gans (1995) argued that the antipoverty policy should be exploited as window of opportunity for community development. Gans (1995) also argued that the community development policies bring jobs and money into poor neighborhoods. On the other hand, the author articulated that when these policies are implemented properly, they would supply on-the-job training to local residents that some other residents can apply framework outside their neighborhoods.[5] Bailey, Martha and Sheldon Danziger (2013), stated that when poor seek to deserve their economic status, so do the affluent. The authors discussed that the flaws that caused poverty are laziness, substance abuse, discrimination, inferior schools, low wages, and political influence.[6]

                        Suzanne Mettler and Joe Soss (2004) explained that mass political behavior sometimes could be problematic to understand. Mass political behavior sometimes could be influenced by public policy.[7] Significantly, it is stated “public policies define the boundaries of political community, establishing who is included in membership, the degree of inclusion of various members, and the content and meaning of citizenship.[8] According to Nussbaum in her book entitled Frontiers of Justice, she argues that institutions are significant when it comes to promoting human capabilities.  The author believes that institutions help in providing capabilities to less affluent citizens, especially the poor.  She also states that states should promote capacity building and promote the welfare of society. Institutions provides public orders in order to protect less affluent and minorities from issues such as discrimination, equal access of power, providing basic human capabilities. [9]

John Rawls (1999) stated that it is important for the society to move toward development if the affluent societies honor the law of people, and stood for the right of the poor or less affluent in our society. He emphasized that the system of human rights should be well protected and the duties and obligations should also be protected for all persons in any given territory.[10] Hill, Peter S., Glulam Farooq Mansour, and Fernanda Claudio (2010) stated that unequal distribution of income and workforce is a challenging problem to public policy. The authors pose that these problems are confronting international agencies, the national government, to maintain their intentions to coordinate interventions in order to fight the problems of inequality across the globe.[11]

In Thomas Pogge’s theoretical framework, he established that well-off countries such as the United States and the European Union collectively have responsibilities to help less affluent societies in other corners of the world.  Pogge argued that the rich nations should help less developed countries with institutions reforms so those challenges poor faces are resolved.  The author states that it is developed countries responsibility to involve in the fate of the poor through exclusive policies and help them. We imposed burden on them economically, exclude them from the benefits of natural resources, and discriminate against them. It is our moral responsibility to help them through institutional reform that will provide them with good transparency.[12]

III). Analysis

            In this analysis section, the reasons why the MDGs goals are not achievable are investigated with the help of existing literature.  In Hill Peter’s article entitled Conflict in Least-developed Countries: Challenging the Millennium Development Goals, the author argued that in order to achieve the MDGs there must be securing peace, and build local ownership in terms of leadership, and implementation of effective programs.  The problems with unequal distribution of resources sometimes make it hard for the MDGs goals to be achieved. For instance, because of complex social, geographical, and political reasons, maternal mortality remains a challenge. When looking at the mortality issue, the skilled birth attendance has risen from 14% in 2003 to 19% in 2007, and the massive increase in access to health services from virtually no coverage to 82% in 2006 provides a base from which to build further positive progress. [13]Hill’s argument is well supported by Nussbaum theory of human capabilities. Nussbaum argues in her book that institutions and individuals should have responsibilities in supporting educations and should empower the disadvantage people in order to promote their capabilities.[14] In the year 2000, about 191 countries set a summit and agreed on the eight MDGs on how they should be achieve in order to increase human development in many developing nations in our globe in order to eradicate the problems of the World’s poorest (Samir, 2002).[15] Samir (2002) in the literature, argued that the implementations of the MDGs goals were not developed for the initiatives of south development itself, but they were developed primarily by the triad (the United States, Europe, and Japan), and were co-sponsored by the World Bank, the International Monetary Fund, and the Organization for Economic Cooperation and Development to work collectively to fight against world hunger and many other contributing factors in developing countries (Samir 2002).[16]

            According to the Millennium Development Goal report, about 600 million people worldwide face a great deal of challenges regarding unimproved water sources. It is also noted that almost one billion people survive on an income of less than $1.25 per day, and also mothers continue to die needlessly in childbirth and that children suffers and die from preventable diseases.  Also according to the literature, hunger remains a global challenge, and ensuring that all children are able to complete primary education remains a fundamental, but unfulfilled, target that has an impact on all the other Goals.  The enrollment rates of children of primary school age increased markedly in sub-Saharan Africa, from 58 to 76 per cent between 1999 and 2010. In Africa, many countries in that region succeeded in reducing their relatively high dropout rates even as their primary school age populations were growing.[17]

Lawrence M. Mead (1992) argued that there four explanations that explain nonwork. One the four explanation that affect number of people that work in the labor market in the United States is the issue of low wages, lack of jobs, jobs exist but there are other “barriers” to employment such as racial bias or a lack of child care. [18]However, the author stated, “ Economic change produced a less secure America”. [19] He argued the rise of inequality is viewed as a reason why many don’t find jobs. [20]

The politics of global governance and lack of development approach are stated to be reasons contributing to factors why the MDGs goals are not easily achieved. According to United Nations Educational, Scientific and Cultural Organization (UNESCO), it is stated that 57 million children remain out of school, and also about 250 million children are illiterate due to the poor quality of education. In this case, many developing countries, there are high numbers of children who are enrolled in school, but there are still high numbers of dropout rates.[21]

The issue of poverty in sub-Saharan Africa and in Southern Asia is rampant and it remains widespread. In sub-Saharan Africa, poverty fell by 5 percent to less than 48 per cent between 2005 and 2008. The high rate of children dropping out of school in sub-Saharan Africa is increasingly high because of the issue of poverty and many other contributing factors. In the literature, it was found that absolute number of people living in the extreme poverty have decreased from 395 million in 2005 to 386 million in 2008. This drop reversed the long-term trend of increase since 1981.[22]

In terms of development challenges, billions of people in developing nations are subjected to life- long severe poverty and this drive people to live low life expectancy with the issues of social exclusion, ill health, illiteracy, and dependency. The annual death toll from poverty-related causes is stated to be around 18 million, or one-third of all human deaths, which adds up to approximately 270 million deaths since the end of the Cold War. In the estimate of the World Bank, it is stated that 44 percent of the world’s population, the 2,735 million people are living under $2 per day.[23]

             Africa is confronting a lot of challenges around the discourses of education. Education is important to development, and achieving a universal primary education is a challenge to MDGs. For example in Africa, excluding North Africa, the enrollment rates in sub-Saharan Africa rose from more than two- thirds, in which 43 million more African children were enrolled in primary school in 2010 than in 1999 (UN, 2012). Authors agree that poverty, poor educational quality, and late entry into schools affects education achievement in sub-Saharan Africa. It is particularized that poor health, nutritional status and lack of infrastructure are some of the key elements that are affecting the MDGs number two. The author gave an alternative solution and stated that Africa needs pragmatic and proactive policies and programs that address infrastructure issues.[24]In this, Thomas Pogge’s theoretical framework is well supported that institutional reforms with good policies will help poor nations to strengthen their institutions policies.[25]

In the article entitled Economic Growth and Human Development with Capabilities Expansion, Amin Ajab stated that the roles of institutions are the key to development. The author was able to provide constructive inputs in explaining why institutions are engines to development. He began by arguing that great institutions introduced toward economic development should always have some rules and regulations for economic performance of different activities and provide the necessary incentives for socio-politico-economic activities in the society or economy. He argued that for economic performances to take place, there should be economic rules and regulations implemented. The author argues that the key to economic growth comes from institutions. Institutions create the environment for the efficient functioning of economic markets accordingly by increasing output growth, socio-political freedoms of people and equitable and fair society with well-established democratic governance.[26]

            According to Addison Tony in the article entitled Aid Debt Relief and New Sources of Finance for Meeting the Millennium Development Goals, she stated that aids contribution could only be achieved as millennium development goals by providing aid in order to help economic growth (thereby reducing poverty aid relaxes the budgetary constraints impeding development spending (including pro-poor services and infrastructure).  In her arguments she identified that by providing aid, we could promote human security; growth, and foster peaceful livelihoods, and increased development spending might redress grievances, reducing the need to resort to violence as a livelihood or to express frustration with the status quo.[27]  Based on O’Neill theory of institutions, Tony’s (2005) arguments are well supported in O’Neill’s article.  O’Neill discussed that if government take responsibility as an institution and institutionalized rights of people universally; the well-being of society will be met. O’Neill argued that in order to achieve some of the rights; government should have implications of guiding actions through institutions mechanisms.[28]

            In the literature presented by Amir Attaran in the article entitled, An Immeasurable Crisis? A Criticism of the Millennium Development Goals and Why They Cannot Be Measured, the author stated that it is harder to get sufficient and reliable data for the health MDGs in order to provide sufficient information for helping developing nations.  For this reason, even the most basic life indicators, such as births, and deaths are not directly registered in the poorest countries due to the lack of obtaining health sufficient information.[29]  In the explanations of Attraan, he stated that without reliable vital registration systems to track even the existence of births or deaths, naturally the data for the medical circumstances of those births or death or the lives in between then this information is unreliable.[30]

             Through Tony Addison’s arguments in the article entitled, Aid, Debt relief and New Sources of Finance for Meeting the Millennium Development Goals, the author expressed explicitly that in the countries in which 46 are fragile states and in which 30 are low -income countries according to the World Bank and the UK Department for International Development (DFID), she agreed that for Africa to be on development track, donors will need to invest heavily in building up central and local state institutions in order to make aid effective in those countries.  She argued that donors therefore needs to be conscious of absorptive capacities and work with recipient countries to remove bottlenecks that impede aid effectiveness in those countries that are marked by violent conflict, including those who are in post conflict recovery. She also added that it is an important matter that needs to be addressed if aid flows are increased substantially in order to achieve the MDGs.[31]

 Klooper Hester (2007) in the article entitled Poverty and development: Pulling forces and the challenges for nursing in Africa, he stated that developing countries in Sub-Saharan Africa are facing many challenges because of lack of structured leadership establishment, and failure of empowering nurses’ leader with tactical capacity.[32] Liberals view the lack of strong institutions in those fragile states, and lack of severe economic mismanagement to be a major problem that is affecting or challenging most of the fragile states[33] in Africa in order to attain MDGs.[34]

            According to the liberals, institutions play a large role in the structure of the state or government (Donald 1998).[35]  Liberals believe that although policies, and polities may not seem beneficial in the short term, the shift toward more political, and economic openness can contributed to intrastate stabilities. Without them, conflict can arise (Michael 2006).  It has also been recognized by the author in the literature that creating infrastructures, international organizations will assume more liberal values, and policies, not only in economic development, but also in trying to create sustainable peace, and work towards preventing of conflict (Michael 2006).[36]  Author Klooper stated that capacity building implies that nurse leaders focus on health and health systems and not on nurses and nursing. “Nurses should leave behind the old boxes of nursing research, nursing administration and nursing care in favor of broader, patient- and system-focused approaches” (Villeneuve & MacDonald, 2006: 84).[37] According Muula Adamson‘s article entitled Will Africa Achieve the Millennium Development Goals?, The author stated that lack of safe water, and poor sanitation is the reasons why Africans experiences such high levels of morbidity, and mortality. Water can be contaminated with diarrhea-causing organisms at the source, during transportation from the source to home, during storage, and through cups and dippers.  He also stated that many people in Africa do not have piped water in their homes but rather get water from rivers, and streams, wells, boreholes, and open lakes. He also stated that many Africans constantly live in an overcrowded environment, without safe sewerage system, and available drinking water, so it is with no surprise that diarrheal diseases are common, and persistent. [38]

In the empirical studies that was conducted by Andy (2004) on 16 countries and in which 14 were countries in Africa, the author found that in Africa the mortality rate is still higher in children under age of 5 than for those in 1990s. Also, the author found that poverty level in Africa was rampant. He stated that poverty is a major problem that is facing people in developing countries. The author found out that in Africa about one third of population in children in Africa were under-nourished.[39] The problem with mortality rate was noted to be another problem that is challenging in Sub-Saharan Africa. When it comes to mortality rate,  more than 500,000 women a year died during pregnancy and  in childbirth, and it is stated by the author that faster progress on reducing maternal mortality also remains a key challenge. Because of this problem of the mortality death rate, it is noted that attaining the millennium development goals will be hard to achieve, and will remain a challenge.[40]

According to McClellan Charles in the article entitled Policy Point – Counterpoint: The UN Millennium Development Goals and U.S. Aid to Africa, the author stated that United States gives twenty percent of the national budget from the United States goes yearly to foreign aid for reinforcing America’s sense of generosity to developing nations.  He also stated that about less than one percent of the current U.S budget goes to aid. The author McClellan in the literature stated, “For the American public in general and its political leaders, Africa barely appears on the radar screen.” Because of lack of foreign interest from America, and Europe when American only sees Africa as a European influence, there is little interest in providing aid in Sub-Saharan Africa. Americans are only interested in Africa when it comes to global health and environmental concerns; these issues allow Americans to their African interests as a new light.[41]

Although the problem of attaining the MDGs was posed as an issue, Andy 2004 said that some positive progress has been made in trying to increase the rate of deliveries in Sub-Saharan Africa, for example, the percentage of deliveries with a skilled attendant rose by two thirds in southeast Asia and north Africa between 1990, and 2000 (Andy Haines, 2004).[42]  Resources are important. Current health spending in most low income countries is insufficient for achieving the health goals.  In many countries, particularly in Southern Africa, the shortage of health services and other public sector staff has now become one of the most serious rate limiting factors in scaling up the response to HIV/AIDS, and other public health problems.[43]

            The author McClellan stated that in the 1980s many of the African Nations were threatened by diseases, their economic gain was deteriorating due to the fact that aids was largely ignored, and later many challenges arrived in the continent. The cases of HIV/AIDS were determined to be a major problem in Sub-Saharan Africa, especially in southern Africa in the country of Botswana, and Lesotho. The disease nearly affected forty percent of the adult population in those countries. The HIV/AIDS rate in Sub-Saharan Africa was estimated to be seven percent, which is ten times then the rest of the world.      [44]Another key element that the McClellan (2007) tended to discuss was the problem of poverty in Sub-Saharan Africa.  The author in the literature stated that poverty seems to be the key to every other issue: poor people are malnourished, and more prone to disease; they tend to have more children which leads to greater environmental degradation. Such conditions lead to absent husbands, prostitution, illiteracy, and emigration.  Low tax bases create fewer jobs, diminish social services, and cause resentment, which helps to fuel terrorism, and political instability. Extreme poverty is defined as living on less than one dollar per day, and Africa has more such people than any other part of the world.[45]

In the article by Lopper Hester the author stated, “a member of society is considered poor if his or her living standard falls below an acceptable norm according to the prevailing socio-cultural values in that society” (World Bank, 2007). In the literature, the author explains that poverty trends are shown as a percentage of people living on less than one US Dollar per day. The reason why many of the African states were not able to attain some of the millennium development goals were that they have lost the capacity to lead, initiate, and coordinate economic policies, except for facilitating globalization: the practice, and ideology of deepening global connectedness to global governance, to global capital flows, to global trade, to global civil society, to global migration, and to the new cultural imperatives of global modernity. The focus on development demands a continued increase in enrollments primary, secondary and tertiary educational facilities (World Bank, 2006). [46]

Achieving the millennium development goals through universal education was one of the key elements that were pointed out in the millennium development goals. In the literature, Klooper 2007 stated that in many African countries in Sub-Saharan Africa, enrollments in primary education are not mirrored in secondary, and tertiary education enrollment. In achieving the goal of universal education, significant progress towards primary education has been met, with enrollment increasing from 57% in 1999 to 70% in 2005. Klooper as an author also in the literature stated that although the educational goals are met in some cases, there is still a gap of 30 % that remain and the number of school age children is increasing daily.  Klooper mentioned that in 1990 there were 237 million children under the age of 14 in Sub-Saharan Africa (SSA), this number has increased to 348 million in 2007 and is expected to reach 403 million in 2015 (UN, 2007).  This goal is well under way but has a lot of work to do before accomplishing universal education for everyone in the SSA.[47]

The 2007 United Nations Report shows that in terms of meeting the MDG of environmental sustainability, SSA has not been doing well.[48]  The issue of access to clean drinking water was viewed as another factor that is challenging in attaining the millennium development goals.  It is stated that 42% of people in rural areas had access to clean water in 2004 in SSA, and 63% of the total population lacked access to basic sanitation facilities – barely increasing from the 68% in 1990, and far from the target of cutting this proportion in half by 2015. The insufficient of human resources was seen to be another factor why it is hard for many countries in Sub-Saharan Africa to meet some of the millennium development goals and health need for the people in all Africa.[49]

            According to J.D. Sachs, and J.W. McArthur (2005) in the article entitled The Millennium Project: a plan for meeting the Millennium Development Goals, the author stated scarcity of financial resources to be a major reasons why it is hard to scale up some of proven interventions in the poorest countries. The authors stated that if there is an increase in financing, linked to effective governance structures in low-income countries, and then dramatic results will be produced. The core challenge of the MDGs is in the financing, and implementation of the interventions at scale—for two reasons; one is the sheer range of interventions that should be sequenced, and integrated to reach the goals and second is the need for national scaling-up to bring essential MDG-based investments to most of the population by 2015.[50] According to Emily Panetta in the article entitled Progress being made on Millennium Development Goals, she said that the World Health Organization (WHO) stated that there are challenges that are affecting many African countries and some of progress is being made, but WHO added that, “progress has been limited because of conflict, poor governance, economic or humanitarian crises, and lack of resources. The effects of the global food, energy, financial, and economic crises on health are still unfolding, and action is needed to protect the health spending of governments and donors alike”.[51]

            Some of the challenges that are contributing to the MDGs being unattainable are identified in the literature. The first challenge of the MDGs is the strengthening of health systems. The author Dodd in the literature stated that if the health systems are not efficient, and equitable to people, then countries will not be able to scale up some of the programs for diseases prevention, and control that are required to meet the specific health goals — of reducing child, and maternal mortality and rolling back HIV/AIDS, tuberculosis and malaria. The second challenge is to ensure that health is prioritized within overall development, and economic policies. This means looking beyond the health systems, and addressing the broad determinants of ill health. Addressing issues of low levels of education, poverty, unequal gender relations, high-risk behaviors, and an unhealthy environment, as well as raising the profile of health within national processes for poverty reduction and government reform will help developing countries to reach this goal. The third challenge is to develop health strategies that respond to the diverse, and evolving needs of countries. The author argues that MDGs indicate desirable outcomes in terms of overall improvements in human wellbeing. The fourth challenge is to mobilize more resources for health in poor countries. Currently, low-income countries cannot afford the MDG, and aid is not filling the gap. The fifth challenge is to improve the quality of health data in order to measure each country’s progress towards the MDG. At a global level, the demonstration of progress can help to generate further resources, and sustain political momentum for health-sector investment. At a country level, reliable information can help ensure that polices are correctly orientated, and targeted at those most in need.[52]

According to Thomas Franklin in the article entitled Reaching the Millennium Development Goals: equality and justice as well as results, it is stated that in Sub-Saharan Africa, the depletion of natural resources and degradation of environment are factors that are posing problems in achievement of MDGS in developing nations. Also it is stated that poverty levels in fragile states, where almost one tenth of the developing world’s population live, will probably remain higher than they were in 1990.  Political, social, and economic policies were viewed to be some of the major problems that made it hard for millennium development goals to be achieved. The author stated that people living in extreme poverty are ignored in the society that they live in. The author also stated that these issues could be easily solved through the controlled application of technology, science, and medicine, which would save millions of lives every day.[53]

            For Africa to be better off in terms of development, it would be better for Africa to investment in infrastructure, and the advancement of policies that promote long-term national development so that they would be able to achieve MDGs.  Many of the African governments are seen on a global view as not being serous in achieving the MDGs.  Taylor 2007 stated that  ‘‘the nonhegemonic status of African ruling classes deprives the state of the relative autonomy that makes reforms possible, despotism unnecessary and liberal democracy viable.” The author also added that indeed, ‘‘it is highly unlikely that African ruling classes will choose to adopt the principles of market rationality when they know full well that their power depends on their capacity to use the state as a predatory means to acquire wealth and build political clienteles’’.[54]

IV). Conclusion

            Based on the analysis, many of the authors in the literature concluded that lack of good governance; lack of rule of law, and lack of government capacity to promote MDGs makes it difficult for most of sub-Saharan Africa countries to achieve this goal. The mismanagement of resources by the political institutions was viewed to be the root cause of why MDGS are unattainable. Scholars argued that different levels of intervention by regional powers could be utilized in support of the creation in meeting some of the MDGs with the object of mitigating the level of economic development in the regional areas in Sub-Saharan Africa.  The international community has recognized these standards, however due to the complexity of the water sanitation, health, and civil war problems in the fragile states to be majors that poses challenges to the achievement of the MDGs, and for these MDGs to be attained, there should be some reforms in the political institutions, economies policies must be reform, and development goals need to be implemented by the government whether locally, nationally, and internationally.

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An Immeasurable Crisis? A Criticism of the Millennium Development Goals and Why They Cannot Be Measured

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[5] Gans, Herbert J. 1995. The War Against the Poor: The Under Class and Anti- poverty Policy. New York: Basic Books

[6] Chih, Lin Ann and David R. Harris (eds). 2008. The Colors of Poverty: Why Racial and Ethnic Disparities Persist. New York: Russell Sage Foundation.

[7] Suzanne Mettler and Joe Soss(2004) The Consequences of Public Policy for Democratic Citizenship: Bridging Policy Studies and Mass Politics

[8] Suzanne Mettler and Joe Soss(2004) The Consequences of Public Policy for Democratic Citizenship: Bridging Policy Studies and Mass Politics

[9] Martha C. Nussbaum, Frontiers of Justice: Disability, Nationality, Species Membership, Cambridge: The Belknap Press of Harvard University Press, 2006.

[10] John Rawls, The Law of Peoples, Cambridge: Harvard University Press, 1999.

[11] Hill, Peter S., Glulam Farooq Mansour, and Fernanda Claudio, 2010, Conflict in least-developed countries: challenging the Millennium Development Goals.” Bulletin of the World Health Organization Aug. 2010: 562+. Academic Search Premier. EBSCO. Web. 13 Sept. 2010

[12] Thomas W. Pogge, “A Global Resources Dividend,” in David A. Crocker and Toby Linden (eds.), Ethics of Consumption: The Good Life, Justice, and Global Stewardship, Lanham: Rowman & Littlefield Publishers, Inc., 1998, 501-536.

[13] Hill, Peter S., Glulam Farooq Mansour, and Fernanda Claudio, 2010, Conflict in least-developed countries: challenging the Millennium Development Goals.” Bulletin of the World Health Organization Aug. 2010: 562+. Academic Search Premier. EBSCO. Web. 13 Sept. 2010.

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