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The wider health context | D2 in 2001 (Table D2.1). The profitability of the control and supply of water is evident not just in the revenue, but also in the vast sums spent on promoting privatization. The European Commission, and in particular the UK and French governments, have also supported the global liberalization of the water sector in support of the big corporations. Meanwhile for much of the past decade French magistrates have been investigating allegations of corruption against Suez and Vivendi, and convicted senior executives of paying bribes to obtain water contracts (Friends of the Earth 2003). Most of the commodification and privatization of the water sector in developing countries has been undertaken at the bidding of the World Bank and IMF (McDonald and Ruiters 2005). Twelve of the 40 Fund loans to different countries in 2000 included conditions on water sector policy reforms that included increased cost recovery and privatization. Nearly 90% of Bank water and sanitation sector loans approved in 2001 contained cost recovery conditions and 86% contained privatization conditions. In 2002 and 2003 all loans promoted privatization. Cost recovery was promoted with 91% of funds in 2002 and 99% in 2003 (Grusky and Fiil-Flynn 2004). Some of the poorest countries, including Mozambique, Benin, Niger, Rwanda, Tanzania, Cameroon and Kenya, have privatized their water supply under pressure from the Fund and the Bank. Various global forums foster the commodification of water. The Global Water Partnership is funded by several government aid agencies, the World Bank, UNDP and other organizations like the Ford Foundation. The World Water Council (WWC) was established to provide decision-makers with advice and assistance. Both institutions portray themselves as committed to human development, but are heavily influenced by the for-profit sector. Because the concept of water as a commodity is still unpopular and politically unacceptable, they provide a vehicle for the major water companies and multilateral banks to influence UN agencies and NGOs, and to disguise their commercial motives as public interest (Friends of the Earth 2003). This is especially apparent at the triennial World Water Forum, which resembles a UN global convention with thousands of participants and a concurrent meeting of senior politicians and bureaucrats who produce a ministerial statement. The second forum in 2000 endorsed a large role for the for-profit sector while rejecting the principle that water be considered a fundamental human right. There was little reference to debt relief, overconsumption, community empowerment, land reform or corporate regulation, despite their importance in resolving water crises worldwide. The views of civil society organizations could only be presented from the floor or in their own press conferences. There was a much bigger media and civil society presence at the third forum 210
table d2.1 Top corporate players in the world water industry Corporation Water subsidiary Country base Total revenue Total profits Water revenue 2001 ($bn) 2001 ($bn) 2001 ($bn) Vivendi Universal Vivendi Water France 51.7 -1.02 11.90 Suez ONDEO France 37.2 1.8 8.84 RWE Thames Germany 55.5 1.11 2.8 (1 yr projected) Bouygues SAUR France 17.9 o.301 2.18 United Utilities United Utilities Water UK 2.7 0.467 1.35 Severn Trent UK 2.6 0.307 1.28 AWG plc Anglian Water UK 2.6 0.195 1.03 Kelda Yorkshire Water UK 1.1 0.231 0.8 Bechtel International Water US/UK 15.1 (2000 figures) n/a n/a Source: Polaris Institute 2003
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About this book Today’s global he
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Global Health Watch 2005-2006 An al
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Contents Boxes, figures and tables
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C2.1 The facts about disability 180
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Illustrations 1 Medicine cannot dea
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Acknowledgements The following indi
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London School of Hygiene and Tropic
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Victoria, Canada; Centre for Health
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Foreword New reports on different a
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Introduction Origins The Global Hea
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Child malnutrition, death and disab
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Human rights and responsibilities A
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impacting on health. The Watch hope
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part a | Health and globalization T
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Health and globalization | A1 and h
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Health and globalization | A1 in 20
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Health and globalization | A1 is gl
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Health and globalization | A1 peopl
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Health and globalization | A1 numbe
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Health and globalization | A1 and p
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Health and globalization | A1 econo
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Health and globalization | A1 Box A
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Health and globalization | A1 half
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Health and globalization | A1 appro
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table a1 Key health concerns with W
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Health and globalization | A1 Healt
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Health and globalization | A1 merci
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Health and globalization | A1 thems
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Health and globalization | A1 Even
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Health and globalization | A1 • A
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Health and globalization | A1 non-v
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Health and globalization | A1 27-28
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Health and globalization | A1 Jenki
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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
Page 179: part c | Health of vulnerable group
Page 182 and 183: Health of vulnerable groups | C1 me
Page 184 and 185: Health of vulnerable groups | C1 pr
Page 186 and 187: Health of vulnerable groups | C1 Th
Page 188 and 189: Health of vulnerable groups | C1 Ca
Page 190 and 191: Health of vulnerable groups | C1 Bo
Page 196 and 197: Health of vulnerable groups | C1 Pa
Page 200 and 201: Health of vulnerable groups | C2 DP
Page 206 and 207: Health of vulnerable groups | C2 di
Page 209 and 210: part d | The wider health context T
Page 211 and 212: D1 | Climate change Introduction En
Page 213 and 214: increasing quantities are now causi
Page 215 and 216: development, local availability foo
Page 217 and 218: 14 Droughts threaten the food secur
Page 219 and 220: Protocol can meet their targets by
Page 221 and 222: 15 Transport and travel are major d
Page 223 and 224: • Redesign trade rules. Governmen
Page 225 and 226: D2 | Water Access to enough clean w
Page 227: water consumption worldwide. Each p
Page 231 and 232: 16 Protesting against the privatiza
Page 233 and 234: Box D2.3 Regulating private water c
Page 235 and 236: The private sector overestimates th
Page 237 and 238: Box D2.7 US citizens told to boil t
Page 239 and 240: to water. Worse still, it does this
Page 241 and 242: References Barlow M, Clarke T (2002
Page 243 and 244: D3 | Food Undernutrition is by far
Page 245 and 246: Functional and Productive Capacity
Page 247 and 248: table d3.1 Corporate control of US
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Page 251 and 252: average Indian family of four reduc
Page 253 and 254: Bank’s US$ 93.5 million loan to C
Page 255 and 256: Avery N, Drake M, Lang T (1993). Cr
Page 257 and 258: D4 | Education Some 135 million chi
Page 259 and 260: ledge about health-care practices a
Page 261 and 262: 2005, and on present trends about 4
Page 263 and 264: Box D4.3 Programmes that aim to emp
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Page 267 and 268: unable to recruit 9000 badly needed
Page 269 and 270: Gordon D et al. (2003). The distrib
Page 271 and 272: D5 | War War has an enormous and tr
Page 273 and 274: 19 Chechnya destroyed. War has wide
Page 275 and 276: initiated a ‘war on terrorism’.
Page 277 and 278: 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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