The truth about global health

Now the World Health Assembly has drawn to a close – and as the G8 approaches, with its talk about a dangerous and corporate-led ‘New Alliance for Food Security and Nutrition’ – it’s time to focus on some truths about health.

1. Technology is not the (only) answer

The World Health Organization tends to focus on scientific and technical matters, but is that enough?

Human beings are amazing, they really are. We have created antiretroviral drugs, we have devised methods to prevent malaria and we have invented a treatment for tuberculosis. The technology we have created is incredible, and for all the media attention given to technology as a means to solve all global ills, you would be forgiven for thinking it is a panacea as far as health is concerned.

But it’s not. Of the 39million people living with HIV only eight million have access to antiretroviral drugs, 660,000 people died from malaria in 2010, and in 2011 8.7million people fell ill with tuberculosis. All of this despite comparatively easy technological fixes being available. So technology, it seems, is only one part of the puzzle.

2. We will not improve health if we do not tackle poverty

In my role as the director of an NGO that works to strengthen marginalised communities in their struggle for health, I am constantly reminded of the root causes of ill health; the social and economic reasons that people live unhealthy lives.

I have seen people benefit from technology by having one illness treated, only to die shortly afterwards from something else. If you’re so poor you face a myriad of threats to your health, a technological fix for one will often do little more than change the cause of death. The average life expectancy for people living in a low income country is 60 years, and in the poorest areas it’s very much lower that this, whereas those in high income countries can expect 80 years of life. Across the whole of Africa life expectancy has increased by only six years in the last 20. An extra six years is not to be sniffed at of course, but it hardly reflects the scale of technological gains that some of humanity’s brilliant scientific minds have achieved.

Around the world, for millions of people, the cause of their illness is poverty; lack of nutritious food and clean water, poor sanitary conditions in which to live, and lack of education and employment. Poverty is the cause, and sickness is the result.

But of course we already knew that. Everyone knows that poverty and poor health are closely connected. Perhaps what we don’t always remember quite so well is that it doesn’t need to be this way.

3. Poverty is not inevitable

It’s estimated that the wealthiest 0.1% of people in the world own 81% of the financial wealth in the world. In fact, the richest 300 individuals in the world have the same amount of wealth as the poorest 3billion.

It’s so easy to be lulled into a belief that this appalling level of inequality is inevitable. But it simply isn’t! This global imbalance in resources is an avoidable phenomenon. It has come about as a result of specific policies and decisions made by those who seek to extract wealth from others, those who are part of a poverty creation industry.

This industry, just like the global health sector, has developed its own ‘technology’ – technical tools to preserve inequality, and redistribute wealth from the poor to the rich. These tools include ingenius and highly technical practices related to tax havens, trade agreements, patent rules and other legal frameworks. It’s a well-funded technology, supported by elite lobbyists, policymakers, lawyers, and resources to co-opt (or buy-off) elected officials.

And it’s extremely efficient, so much so that the gap is widening even further and inequality is on the rise.

4. This is good news!

It may not seem like it, but yes, this is in fact good news. The fact that poverty is created by human tools and systems means humans have the ability to change it. We can create new tax laws that stop tax evasion so that the world’s poorest countries can fund their health systems. We can redraft trade agreements so that they strengthen the most vulnerable traders rather than the most powerful ones. We can change patent rules and other agreements so that public health is placed above corporate profits.

The World Health Organization’s scientific and technical work matters, but if the organisation is to fill its mandate it needs to focus much more on tackling the social and economic causes of poor health. We all do. We have the technical ability to do all these things. All we need to do is mobilise together to generate the political will.

And let’s never, not for a single moment, believe that it’s impossible. It isn’t.


About Martin Drewry

Director of Health Poverty Action
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5 Responses to The truth about global health

  1. Tadesse says:

    Thanks Martin!
    A substantive argument based on stratling facts.

  2. Simon Wright says:

    Interesting discussion. Undoubtedly WHO has a bias towards health servcies (which ought to include public health and prevention of diseases) but is not UNDP looking at many of the factors that drive poor health. WHO did convene the Commisison on Social Determinants of Health led by Michael Marmot which had a strong emphasis on the social factors. And for the post2015 debate, we have hit this conundrum many times – that all of development is necessary for good health, that the health sector needs to contribute both through services and influencing the parts of national and global governance which affect health.

  3. massimo serventi says:

    Short, clear, rigth to the point-s. Thanks.
    I would add a determinant in health achievement in poor countries : the lack of honest,sincere,passionate commitment of local leaders. Those who have spent years in Africa (like me) understand what I mean. In my work I have an example : African doctors do exceed in prescribing drugs to patients, especially children (literature says so, not only I). They do for a reason: money,profit,professional gain. Clients ‘want’ drugs, doctors ‘satisfy’ their will. However poor people are furthermore impoverished when they have to buy unnecessary drugs. Resistance to antibiotics is another by-result of this trend. All contribute to present and future poverty.
    Massimo Serventi

  4. Nick says:

    It’s going to be ending of mine day, but before end I am reading this enormous piece of writing to improve my knowledge.

  5. Massimo Serventi says:

    interesting and inspiring reflections.thanks. I add one.rural populations are less served than urban care and education are less.
    Massimo Serventi(65)

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