ON THE SITUATION OF
1995, funding for the health sector has increased, although as a proportion of
GDP it is still one of the lowest in Latin America, second only to Haiti.
Overall funding for the health sector between 1994 and 1998 was as follows:
32. It has
recently been said that health and disease “are processes that are determined
intersectorially, wherein the leading causes are social, economic,
environmental, and lifestyle-dependent, as well as biological.”
Hence, drinking water, drainage, garbage collection, and access to electricity
are essential in preventing disease and improving public health. Until 1994
around 32 percent of Guatemala’s population had no access to water, 68 percent
of homes had no drainage, 25 percent had no sewer connection, and 44 percent had
These figures vary considerably depending on the proportion of inhabitants of
indigenous origin, as can be seen from the following table.
Haiti, Guatemala has the lowest life expectancy at birth in Latin America.
Average life expectancy at birth in Guatemala is 64.2 years for men and 67.2
years for women. The following chart displays the corresponding figures for
Central America as a whole.
also has a general mortality rate of 7.4 (for the 1995-2000 period), which is
the highest in Central America.
Its infant mortality rate is 46.0 (per 1000 live births), which is also the
highest in Central America.
The following two tables display infant mortality rates, one in comparison with
the other nations of Central America and the other broken down by sex,
rural/urban areas, ethnic groups, and regions; figures for child mortality have
also been added to this second table.
35. The main
causes of death in Guatemala vary in accordance with socioeconomic status,
gender, and ethnic origin. Respiratory ailments and diarrhea are the leading
causes among both sexes; the cause of death that ranks third among men is
homicide and, among women, malnutrition. Guatemala’s two leading causes of
death (respiratory ailments and diarrhea) would be highly preventable with
improvements in hygiene levels, nutritional standards, and environmental
conditions. The following table shows the ten leading causes of death for both
figures show that malnutrition is still a serious problem and a cause for
concern in Guatemala, even though incidence rates have fallen in recent years.
According to the data obtained, almost 45 percent of the population suffers from
chronic malnutrition (too small for their age), 2.5 percent have acute
malnutrition (low weight for their size), and 24 percent have global
malnutrition (low weight for their age). The next table shows the malnutrition
figures broken down by region, sex, area, and ethnic origin.
Persons with Disabilities
with disabilities face additional obstacles in exercising the full range of
economic, social, and cultural rights due to them, including access to health
care, education, and employment opportunities under fair and equitable
conditions. Pursuant to Article 53 of the Constitution, which provides
protection for individuals with physical, mental, and sensorial limitations, and
the provisions of the peace accords, which assign top priority to the needs of
people who suffered as a result of the conflict and of veterans of either the
army or of the URNG with disabilities, in 1996 Congress enacted Decree 135-96,
the Law on Attention for People with Disabilities. This law establishes general
obligations for the State and civil society that are intended, inter
alia, to ensure that persons with disabilities enjoy equal access to
opportunities and services, to abolish the different forms of discrimination
that keep persons with disabilities from exercising their rights, and to support
their comprehensive rehabilitation.
38. One of
the most valuable measures demanded by this law was the creation of the National
Council for Persons with Disabilities (CONADI), which is made up of
representatives of state agencies responsible for establishing policy in the
relevant areas, including the ombudsman and delegates from civil society. Its
composition reflects one of the law’s objectives: guaranteeing that people
with disabilities can participate in designing the programs and policies that
affect them. Nevertheless, nongovernmental organizations working in this area
have told the Commission that since the CONADI’s creation several years ago,
it has not been receiving the funding needed for it to make real progress toward
achieving its goals.
Commission continues to receive information about the hurdles faced by people
with disabilities, particularly in the areas of education, health care, and
employment. In the area of education, for example, information from
nongovernmental sources indicates that in certain cases, children with special
needs who could nonetheless flourish in the public school system are pressured
into special education programs or into remaining at home; at the same time, the
special education services available for those children who really need them are
few and far between, particularly in rural areas where access to education is
already severely restricted. The Commission has received information about a
pilot program to provide integrated education in ten public schools that was
launched in the metropolitan region some years ago, and looks forward to
receiving further information about this initiative and other similar positive
efforts. Access to education is absolutely critical for all children, and it
plays a key role in guaranteeing that people with disabilities develop their
potential, find useful employment in the future, and participate fully within
Access to technical and professional training is equally important for
adults with disabilities. In this regard, in its comments on the draft report,
the State noted that the Technical Training and Productivity Institute (INTECAP),
“albeit with limitations, is working to train such people in skills or trades
that will enable them to do jobs that, in addition to earning them incomes, can
allow them to work on their own behalf and not necessarily in a dependent
capacity.” The State also
reported that this program is operating in the main regions of the country.
Access to health care is also essential, both to prevent all preventable
forms of disability and to ensure early detection, intervention, and
rehabilitation in other cases. In addition, although some first steps have been
taken to improve access to buildings and mobility—for example, special
platforms for wheelchairs have been installed on some buses in the
capital—major challenges still remain unresolved.
Inter-American Convention on the Elimination of All Forms of Discrimination
Against Persons with Disabilities, which was opened for signature in Guatemala
City in June 1999, contains additional provisions that are consistent with the
general goals of the Law on Attention for People with Disabilities and that are
intended to guarantee the right of disabled people to exercise their basic
rights and freedoms free of discrimination. The Commission urges the State to
give close consideration to the ratification of this instrument of protection.
Guatemalan State urgently needs to resolve the serious economic and social
problems it faces. Resolving those problems largely depends on due compliance
with the fiscal income and expenditure commitments set forth in the peace
accords. In this context, fiscal policy is of particular importance, in that it
is one of the main tools for ensuring a more equitable distribution of the
fruits of economic development and for supporting Guatemala’s sustainable
development in the medium and long term.
Agreement on Social and Economic Aspects stipulates that tax policy “should be
designed to enable the collection of the resources needed for the performance of
the State's functions,” and that it should be based on a system that is fair,
equitable, obligatory, and globally progressive.
Thus, in order to increase the State’s income for tackling society’s
different needs and for promoting social development, in the peace accords the
Government agreed to ensure that “by the year 2000, the tax burden, measured
as a ratio of gross domestic product, increases by at least 50 percent as
compared with the 1995 tax burden.”
This target (year 2000) was rescheduled, and it was decided that by the year
2002 the tax burden would be equal to 12 percent of GDP.
The agreement also addressed the need for developing a national consensus
regarding fiscal policy, a process requiring the participation of different
social actors. Thus, a Fiscal Pact Preparatory Commission was set up, which
produced the document Toward a Fiscal Pact
in Guatemala, which served as the basis for reaching agreement.
On May 25, 1999, after a lengthy period of dialogue and negotiation, more
than 130 social organizations and representatives of the three branches of
Government signed the document entitled Fiscal Pact for a Future with Peace and
Development. Subsequently, representatives of civil society and of the business
community signed the Political Agreement for Financing Peace, Development, and
Democracy in Guatemala, which contains concrete measures marking the start of
changes in tax and administrative structures for building Guatemala’s new
46. The Commission values the signing, with broad social participation, of the Political Agreement for Financing Peace, Development, and Democracy in Guatemala. The Fiscal Pact itself and the increased tax burden are not goals in and of themselves; instead, they are mechanisms for bringing about greater social justice and sustainable development.
Conclusions and Recommendations
The peace accords have served as a basic framework of reference for
socioeconomic policy in Guatemala. In recent years there has been some progress
in the protection of social and economic rights in Guatemala but, at the same
time, the Guatemalan people are still entrenched in poverty, without access to
basic services, lacking opportunities, and living in a society of great social
and economic inequalities.
Lack of access to education and continuing high illiteracy rates —
together with shortcomings in health services, high levels of infant and
maternal mortality, malnutrition, the absence of basic hygiene services in
households, among other deficiencies — prevent true human development and,
consequently, the sustainable development of Guatemala. Moreover, in Guatemala
people with disabilities encounter additional hurdles in exercising their
economic, social, and cultural rights.
Although the Guatemalan State has made a great effort to reach agreement
on the Fiscal Pact, there is still much to be done in order that it may
effectively satisfy social demands.
consideration of the above analysis and conclusions, the Commission recommends
that the State:
Continue to make every effort to reach the goals set in the peace
accords, to ensure an equitable distribution of wealth and to provide the State
with additional resources for financing public investment and social spending.
Duly comply with the Fiscal Pact and implement proper mechanisms to
prevent tax evasion.
Continue to work in conjunction and constructively with the
representatives of civil society, in pursuit of social justice and sustainable
development for the present and future generations in facing the different
problems and challenges that lie ahead.
Expand the efforts underway for supporting and funding the implementation
of the recommendations of the Commission for Historical Clarification intended
to repair the damage caused by the human rights violations that occurred during
the armed conflict.
Ratify the Inter-American Convention on the Elimination of All Forms of
Discrimination Against Persons with Disabilities.
UNDP Report on Guatemala, 1999.
 Between 1995 and 2000, the general mortality rates in the other Central American nations were as follows: Costa Rica, 3.9; El Salvador, 6.1; Honduras, 5.4; Nicaragua, 5.8; Panama, 5.1. See: ECLAC, Indicadores Sociales Básicos de la Subregión Norte de América Latina y El Caribe; LC/MEX/L.387, August 10, 1999.
The Guatemalan State noted in its
response to the draft report that, thanks to the efforts it made between 1980
and 2000, infant mortality fell from 91 deaths per thousand live births to
See UNDP 1999
Report on Guatemala.
The Guatemalan State has noted that to comply with the goals contained in its
annual operating plans, Congress approved the amount of Q5,585,738.00 for
financial year 2001, which represents a 74 percent increase over the year 2000
Traditionally, Guatemala has had extremely light fiscal burdens, averaging out
at 7.8 percent of GDP. In contrast, the average for Latin America as a whole
is 13.5 percent.
In Guatemala, revenues from indirect taxes account for between 75 and 80
percent of the total. Not only does this mean that the Guatemalan tax system
is highly regressive, it also has the effect of strengthening social
inequalities in income distribution.
In its comments to the draft report the Guatemalan State noted that it was
unable to meet that target because of private sector resistance to a tax
reform that would ultimately lead to a greater burden of direct taxation. The
State also explained that “the productive sector does not strictly speaking
oppose the tax reform process; however, it will support it only if it chiefly
relies on indirect taxes, essentially VAT, believing that direct taxation
punishes entrepreneurial initiative and effort and tends to dissuade private
In its comments on the draft report the State reported that “tax evasion in
Guatemala is alarming. Although no exact figures are available, a simple
calculation shows its importance and its detrimental impact on efforts to
improve tax revenues. In 1998, for example, VAT revenue totaled Q5,299.1
million; however, according to that same year’s private spending figure
(Q105,428.5), that total conceals an evasion rate of almost 50 percent.