Social Justice in an Open World: The Role of the United Nations
lennium Development Goals is to ensure that, through cooperation with the pharmaceutical industry, individuals in developing countries are provided with access to affordable essential medications. Some countries and regions have experienced a regression during the past few decades, even in terms of broad indicators such as life expectancy and infant mortality. This has been especially true in Eurasia. At least until recently-and the evidence of a reversal is far from overwhelming-health conditions were deteriorating dramatically in much of the region, particularly in the Russian Federation in the context of general neglect, the under-financingof public services, and the breakdown of a wide range of social institutions. An actual decline in life expectancy was registered-a rather exceptional development in these modern times. This overall decline in health conditions was accompanied by increased inequalities, as the affluent minority had access to higher-quality private health care and facilities at home or abroad. The health sector, perhaps to an even greater degree than the education sector, is becoming highly commercialized in many parts of the world. It is fast becoming an industry driven by supply and demand, with producers and consumers, and those with means have a distinct advantage over the poor in terms of their ability to secure a wide array of quality services. Social security systems are under severe stress, as the demand for services far exceeds available resources in many settings, and private insurance is increasingly seen as an alternative to publicly financed systems of protection. Those living in more affluent countries typically have greater access to health information and are theoretically in a better position to understand their health and nutritional needs and the workings of the healthcare system. Nonetheless, the residents of richer countries tend to be prone to obesity, while poor people in developing countries are undernourished, and many are starving. Those higher on the social ladder, particularly in developed countries, are also more aware of environmental challenges and are better able to protect themselves from pollution and other hazards. Affluent countries and social groups consume more energy and are therefore the biggest polluters, but they are also the ones with the greatest capacity to mobilize resources to ensure a clean environment.
3.2.6 Ambiguous trends in the distribution of opportunities for participation in civic and political M e The Forum was not in a position to address this vast and complex subject beyond offering a few general observations. Judgments on progress or regression in the realm of political participation are heavily dependent on the perspective and criteria adopted by the observer; this is true with regard to all the aspects of inequality examined thus far but is particularly the case here. Apart from the