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The wider health context | D3 McMichael P (2001). The impact of globalisation, free trade and technology on food and nutrition in the new millennium. The Proceedings of the Nutrition Society, 60:215–20. — (2004). Development and social change: A global perspective, 3rd ed. London, Sage Press. Micronutrient Initiative (1998). Fighting the hidden hunger. Ottawa, MI Publications. Nestle M, Jacobsen MF (2001). Halting the obesity epidemic: A public health approach. Public Health Reports, 115:12–21. Patnaik U (2004). External trade, domestic employment and food security: Recent outcomes of trade liberalisation and neo-liberal economic reforms in Inda. at: International Workshop on Policies against Hunger III. Berlin, German Federal Ministry of Consumer Protection, Food and Agriculture, 20–22 October. Pelletier D, et al. (1995). The effects of malnutrition on child mortality in developing countries. Bulletin of the World Health Organization, 73:443–8. Pinstrup-Andersen P, Babinard J (2001). Globalisation and human nutrition: Opportunities and risks for the poor in developing countries. African Journal of Food and Nutritional Sciences, 1:9–18. Pistorius R, van Wijk J (1999). The exploitation of plant genetic information. Political strategies in crop development. Oxon, CABI Publishing. Popkin BM (2001). Nutrition in transition: the changing global nutrition challenge. Asia Pacific Journal of Clinical Nutrition, 10(Suppl):S13–8. Sanderson S (1986). Emergence of the ‘World Steer’: Internationalisation and foreign domination in Latin American cattle production. In: Tullis FH, Hollist WL, eds. Food, the State and international political economy. Lincoln, University of Nebraska Press. Standing Committee on Nutrition (SCN) (2004). Fifth report on the world nutrition situation: Nutrition for improved development outcomes. Geneva, UN Standing Committee on Nutrition. Shiva V (2004) (personal communication). Stevens C, Kennan J (2001). Food aid and trade. In: Devereux S, Maxwell S, eds. Food security in Sub-Saharan Africa. Pietermaritzburg, University of Natal Press. UNICEF (1994). State of the World’s Children. New York, NY, UNICEF. UNICEF (1998). State of the World’s Children. New York, NY, UNICEF. WHO (2002). Diet, nutrition and the prevention of chronic diseases. Report of the joint WHO/FAO expert consultation. Geneva, World Health Organization (WHO Technical Report Series, No. 916). World Bank (2002). From Action to Impact: the Africa Region’s Rural Strategy. Washington, DC, World Bank, Rural Development Operations, the Africa Region. 238
D4 | Education Some 135 million children between the ages of 7 and 18 in the developing world have never been to school (Gordon 2003). Globally, over 100 million children aged 6–12 are not enrolled in primary school, while 137 million young people will begin their adult lives lacking the basic tools of literacy and numeracy (UNESCO 2004). The burden of illiteracy, like the burden of disease, falls overwhelmingly on those who are female, poor and rural. This chapter discusses why all this should concern health sector policy-makers and activists, and suggests how education and health activists could together address the common causes of inequality in health and education. Education as a determinant of health outcomes Education – particularly for girls and women – improves health outcomes. Even a few years of basic education is correlated with greater use of health services, increased social status and decision-making power for women, and better health outcomes. For example, education levels are strongly predictive of better knowledge, safer behaviour and reduced HIV infection rates – so much so that education has been described as ‘the single most effective preventive weapon against HIV/AIDS’ (UNAIDS 2002, World Bank 2002) (see Box D4.1). Education improves health outcomes for two main reasons. It provides some protection from such shocks as ill health and disability, price and credit swings, and natural and environmental disasters by enabling more secure employment, higher incomes, and better access to economic assets and credit. Even among those with similar incomes, the educated are generally healthier than the uneducated (Pritchett and Summers 1996), because: • education equips them to understand, evaluate and apply facts; • it increases the ability to acquire and use health-related information and services (World Bank 1993, WHO 2003); • it gives greater bargaining power in household decisions and personal relationships – particularly important for women, as it often translates into increased allocation of household resources to child health, schooling and nutrition (Thomas 1990, Herz and Sperling 2004); and • it increases social status. Child and maternal mortality Each extra year of maternal education in the 239
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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
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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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Health of vulnerable groups | C1 Pa
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Health of vulnerable groups | C2 DP
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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 and 228: water consumption worldwide. Each p
Page 229 and 230: table d2.1 Top corporate players in
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: Avery N, Drake M, Lang T (1993). Cr
Page 259 and 260: ledge about health-care practices a
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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
Page 279 and 280: the risk of their misuse and divers
Page 281 and 282: Box D5.3 An agenda for peace The Ha
Page 283 and 284: Machel G (1996). Impact of Armed Co
Page 285 and 286: part e | Holding to account: global
Page 287 and 288: E1 | World Health Organization The
Page 289 and 290: The sources consulted worldwide in
Page 291 and 292: Box E1.1 Milestones in WHO history
Page 293 and 294: aised by his attempts to revitalize
Page 295 and 296: • stronger internal focus on perf
Page 297 and 298: 21 WHO - up in the clouds? Reaction
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Page 303 and 304: velop a unified, purposeful health
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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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