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Acknowledgements Research Support Centre, Zimbabwe; University of the West Indies, Trinidad; War on Want, UK; Water for All Campaign, Public Citizen, US; WaterAid, UK; Wemos, Netherlands; Women’s Global Network for Reproductive Rights, Netherlands; World Alliance for Breastfeeding Action (WABA), Malaysia. The secretariat would like to express their deep gratitude to Robert Molteno and Anne Rodford at Zed Books and to typesetter Ewan Smith and cover designer Andrew Corbett for their speedy and efficient facilitation of this edition of the Watch. Thanks also to Moyra Rushby and Gill Reeve and the rest of the staff and board of Medact as well as Antoinette Ntuli, Farana Khan and Halima Hoosen-Preston at GEGA and Ravi Narayan, Nisha Susan and Abraham Thomas at the PHM Global Secretariat for supporting us so well. Global Health Watch secretariat and editorial team: Claudia Lema; David McCoy; Patricia Morton; Michael Rowson; Jane Salvage; Sarah Sexton. xvi
Foreword New reports on different aspects of the state of the world’s health appear daily. International and national organizations of all kinds produce vast amounts of data, statistics and analysis. But what is lacking in this flood of information is honest and transparent assessment of the actions and policies that affect health and health inequalities, for good or ill, presented in a format that is accessible and understandable by health workers and civil society groups. How far do all the health projects, programmes, technical cooperation, aid and loans actually improve the health of poor people round the world? And how far do the actions of transnational corporations, global financial institutions and international trade rules undermine it? Recognizing this, the People’s Health Movement, the Global Equity Gauge Alliance and Medact came together in 2003 to plan a review of the performance of the very institutions that normally write global reports. It was time to turn the tables by reporting and assessing the actions of international health agencies such as the World Health Organization and UNICEF, donor agencies, rich country governments, the World Bank, the International Monetary Fund and the World Trade Organization. It was time to produce an alternative world health report that would highlight the root causes of poor health and reveal the gap between humanitarian rhetoric and reality. This first edition of the Global Health Watch is the result, designed to create a joint platform for civil society organizations and individuals working in health and health-related sectors, including gender discrimination, global trade environmental protection, access to water and food, the arms trade, the peace movement and disaster relief. Global Health Watch 2005–2006 has achieved this, and we hope to continue and improve the collaboration between these actors. The report has limitations. We tried to involve people from as many countries as possible, but lacked adequate input from many regions, including the Middle East and China. Many key issues relevant to health are covered, but not everything of importance. With a limited budget and a tiny secretariat, we were simply unable to cover everything. What we have created, however, is the prototype of an instrument to ‘watch’ how international and national governments, agencies, banks, corporations, rules and structures act and perform in improving or worsening health and health inequities. This edition does not xvii
Page 1 and 2: About this book Today’s global he
Page 3 and 4: Global Health Watch 2005-2006 An al
Page 5 and 6: Contents Boxes, figures and tables
Page 7 and 8: C2.1 The facts about disability 180
Page 9 and 10: Illustrations 1 Medicine cannot dea
Page 11 and 12: Acknowledgements The following indi
Page 13 and 14: London School of Hygiene and Tropic
Page 15: Victoria, Canada; Centre for Health
Page 19 and 20: Introduction Origins The Global Hea
Page 21 and 22: Child malnutrition, death and disab
Page 23 and 24: Human rights and responsibilities A
Page 25 and 26: impacting on health. The Watch hope
Page 27: part a | Health and globalization T
Page 30 and 31: Health and globalization | A1 and h
Page 32 and 33: Health and globalization | A1 in 20
Page 34 and 35: Health and globalization | A1 is gl
Page 36 and 37: Health and globalization | A1 peopl
Page 38 and 39: Health and globalization | A1 numbe
Page 40 and 41: Health and globalization | A1 and p
Page 42 and 43: Health and globalization | A1 econo
Page 44 and 45: Health and globalization | A1 Box A
Page 46 and 47: Health and globalization | A1 half
Page 48 and 49: Health and globalization | A1 appro
Page 50 and 51: table a1 Key health concerns with W
Page 52 and 53: Health and globalization | A1 Healt
Page 54 and 55: Health and globalization | A1 merci
Page 56 and 57: Health and globalization | A1 thems
Page 58 and 59: Health and globalization | A1 Even
Page 60 and 61: Health and globalization | A1 • A
Page 62 and 63: Health and globalization | A1 non-v
Page 64 and 65: Health and globalization | A1 27-28
Page 66 and 67:
Health and globalization | A1 Jenki
Page 68 and 69:
Health and globalization | A1 Satte
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Health and globalization | A1 WHO (
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and regulatory authorities mandated
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Health care systems | B1 4) selecti
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Health care systems | B1 • And si
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Health care systems | B1 • declin
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Health care systems | B1 user charg
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Health care systems | B1 focus on t
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Health care systems | B1 for health
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Health care systems | B1 their cont
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Health care systems | B1 health car
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Health care systems | B1 ing servic
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Health care systems | B1 Box B1.7 G
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Health care systems | B1 many of th
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Health care systems | B1 the lack o
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Macro-economic factors Impoverished
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Health care systems | B1 HALE 2000
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Health care systems | B1 But improv
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Health care systems | B1 high-incom
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Health care systems | B1 Structural
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Health care systems | B1 the high t
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Health care systems | B1 and histor
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Health care systems | B1 norms (Loe
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Health care systems | B1 Foster M,
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Health care systems | B1 Toole M et
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B2 | Medicines Introduction Essenti
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Health care systems | B2 of new med
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Health care systems | B2 chapter re
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Health care systems | B2 the fourth
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Health care systems | B2 agenda thr
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Health care systems | B2 nonetheles
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Health care systems | B2 decision o
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Health care systems | B2 for the an
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Health care systems | B2 expenditur
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Health care systems | B2 Medawar C
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Health care systems | B3 between he
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Severe shortage Low density Moderat
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Health care systems | B3 sector and
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Health care systems | B3 to the US,
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Health care systems | B3 500 400 30
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Health care systems | B3 have been
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Health care systems | B3 to underta
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B4 | Sexual and reproductive health
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Health care systems | B4 10 Policy-
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Health care systems | B4 women and
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Health care systems | B4 of funding
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Health care systems | B4 debate on
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Health care systems | B4 the sexual
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Health care systems | B4 perspectiv
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Health care systems | B5 genome res
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Health care systems | B5 drugs base
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Health care systems | B5 Complete f
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Health care systems | B5 when a tes
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Health care systems | B5 are allowi
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Health care systems | B5 of life sc
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part c | Health of vulnerable group
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Health of vulnerable groups | C1 me
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Health of vulnerable groups | C1 pr
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Health of vulnerable groups | C1 Th
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Health of vulnerable groups | C1 Ca
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Health of vulnerable groups | C1 Bo
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Page 194 and 195:
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Health of vulnerable groups | C1 Pa
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Health of vulnerable groups | C2 DP
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Page 204 and 205:
Page 206 and 207:
Health of vulnerable groups | C2 di
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part d | The wider health context T
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D1 | Climate change Introduction En
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increasing quantities are now causi
Page 215 and 216:
development, local availability foo
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14 Droughts threaten the food secur
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Protocol can meet their targets by
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15 Transport and travel are major d
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• Redesign trade rules. Governmen
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D2 | Water Access to enough clean w
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water consumption worldwide. Each p
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table d2.1 Top corporate players in
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16 Protesting against the privatiza
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Box D2.3 Regulating private water c
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The private sector overestimates th
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Box D2.7 US citizens told to boil t
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to water. Worse still, it does this
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References Barlow M, Clarke T (2002
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D3 | Food Undernutrition is by far
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Functional and Productive Capacity
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table d3.1 Corporate control of US
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keting and processing means that sm
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average Indian family of four reduc
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Bank’s US$ 93.5 million loan to C
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Avery N, Drake M, Lang T (1993). Cr
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D4 | Education Some 135 million chi
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ledge about health-care practices a
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2005, and on present trends about 4
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Box D4.3 Programmes that aim to emp
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• per capita public spending fall
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unable to recruit 9000 badly needed
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Gordon D et al. (2003). The distrib
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D5 | War War has an enormous and tr
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19 Chechnya destroyed. War has wide
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initiated a ‘war on terrorism’.
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an explosive force equivalent to ab
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the risk of their misuse and divers
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Box D5.3 An agenda for peace The Ha
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Machel G (1996). Impact of Armed Co
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part e | Holding to account: global
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E1 | World Health Organization The
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The sources consulted worldwide in
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Box E1.1 Milestones in WHO history
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aised by his attempts to revitalize
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• stronger internal focus on perf
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21 WHO - up in the clouds? Reaction
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in favour of so-called ‘vertical
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to speak openly, while bullying and
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velop a unified, purposeful health
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to medicines, and the mobilizing ro
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Recommendations WHO’s core purpos
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doctors, and more people with exper
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E2 | UNICEF In 2005, Carol Bellamy,
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In sum, for almost a decade, childr
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prompted a global debate on how to
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E3 | The World Bank and the Interna
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22 World Bank: the centre of world
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approach to conditionality is being
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tal policies should explicitly refe
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E4 | Big business This chapter deal
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23 The Marlboro Man was described b
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dedicated funding [Articles 5.6 and
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grass roots in building government
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24 A pack of Cerelac cereal food pu
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USAID has also funded work on breas
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(from whatever its source, and howe
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These trends in taxation are underp
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Norway Denmark Netherlands Luxembou
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Global aid trends - allocation Wher
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weapons, vehicles and military trai
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table e5.1 Value (in £) of new DFI
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OECD (2005). Development Co-operati
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25 Breaking the chains of debt: pro
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Box E6.1 Zambia: inflation or death
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have met the Fund’s conditions, a
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E7 | Essential health research Rese
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Developing national health research
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for African Medical Editors (Certai
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Neither the consultations leading u
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Box E7.4 Asking the social-politica
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• global architecture for health
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part f | Conclusions Global Health
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current debt relief mechanism - the
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agreement, and taking health and he
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ity of the now-developed countries
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tion and water are experiencing sim
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